Mentalization-based Treatment

Abstract

This chapter provides a broad introduction to the theory, practice, and evidence base of mentalization-based treatment (MBT). “Mentalization” refers to the fundamental psychological capacity to “read,” access, and reflect on mental states (e.g., thoughts, emotions, desires, beliefs, attitudes) in oneself and other people. The mentalization-based theory of personality disorders is reviewed, with a focus on the relevance of mentalizing to the developmental experiences and functional challenges associated with personality disorders. The authors summarize the clinical indications for MBT, as well as existing research supporting MBT’s utility in addressing symptoms of borderline personality disorder, antisocial personality disorder, and adolescent self-injury. As a treatment, MBT works to strengthen patients’ ability to initiate and maintain mentalizing under circumstances of emotional and interpersonal stress. Key facets of MBT’s therapeutic approach are considered, including the structure and format of treatment, the therapeutic stance, clinical interventions, and working within the therapeutic relationship. A detailed case example is offered to illustrate the practical application of MBT’s therapeutic techniques.