Change in reflective functioning during psychotherapy—A single-case study

Abstract

It has been suggested that deficits in mentalization are a core problem of borderline personality disorder and that enhancement of mentalization represents a central mechanism of change in psychotherapy with this group of patients. The present single-case study investigates changes in mentalization measured by the Reflective Functioning Scale on the Adult Attachment Interview and its relationship with clinical measures of psychopathology during a long-term psychotherapy. The usefulness of evaluating RF along three subdimensions, the object, content and process of RF, is underlined. Furthermore, it is argued that there is a complex interaction between RF and symptomatology that becomes evident when evaluating RF along the different subdimensions. Areas for future research clarifying the relationship between mentalization, psychotherapy and psychopathology are suggested.