Mentalization-Based Treatment (MBT)
Learn about Mentalization-Based Treatment (MBT) an internationally recognised and evidence-based treatment for people living with borderline personality disorder.
What is Mentalization?
Mentalization-Based Treatment – or ‘MBT’ – is a well-established, internationally recognised and evidence-based treatment for people living with borderline personality disorder (BPD). MBT is also indicated for people living with a closely related condition: Complex post-traumatic stress disorder (CPTSD). Since mentalizing is something that all people do – sometimes well, and sometimes not so well – MBT can also be helpful for a broad variety of other diagnoses, situations and relationships.
Mentalising is something that we all do all the time, but mostly without realising it. It’s the way in which our minds connect behaviours and actions to mental states such as thoughts, feelings, beliefs, perspectives, needs, desires, and intentions, both within ourselves and in others.
In other words, it’s the way that our minds tell us what we’re thinking and feeling, and why we’re behaving as we are; it’s also the way our minds guess at what others are thinking and feeling, and why they’re behaving/appearing the way they are.
Mentalising is a skill we all need to be able to do flexibly when navigating everyday life. However, we can sometimes use this skill too much or too little. By practising this skill in therapy, it gives us a better chance of being able to use it in our day-to-day life, even in situations where we may face increased stress or overwhelming emotions.
Practising the skill of mentalizing flexibly helps us to:
develop a language for our thoughts and feelings, and to understand why we do what we do
develop a clear sense of self, and work towards our goals and desires
regulate our emotions
problem-solve
reduce misunderstandings in relationships, and
reduce the need for other ways of coping such as self-injury, hospital admissions and substance use
What’s involved in MBT treatment?
MBT Therapy Program
People receiving MBT participate in both weekly individual therapy sessions and weekly group therapy sessions. Treatment duration is usually either 6 or 18 months.
Individual treatment
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Sessions run for 50 minutes.
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The sessions provide an opportunity to discuss challenges the person may be experiencing/have experienced in their life.
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The therapist may provide direct advice at times, however for the most part they try to think and reflect with the person about problems to help the person gradually develop their own solutions. In doing so, the person will be practicing the skill of mentalizing in each session so they can use it more easily and flexibly outside of sessions.
Group Therapy
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Sessions last for 90 minutes.
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The group therapy program typically starts with a 6-week introductory program (MBT-I). In this group, participants learn what they can expect from the MBT treatment program. Participation in this group is considered a necessary pre-treatment phase for entry into the full program.
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Following this, participants commence the ongoing weekly group (MBT-G).
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Groups typically have two facilitators and up to eight group members.
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During MBT sessions, participants reflect on difficulties in their current lives to improve their understanding of themselves and others. Together with co-participants or therapist support, each person explores what was going on in their own mind and what might have been going on in other peoples’ minds, particularly in situations that have caused a strong emotional response or problematic reaction.
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This will require participants to be curious about their own and others’ experiences, asking each other questions, and sharing perspectives. This serves as a live skills practice group where everyone practices the skill of mentalizing.
Effectiveness of MBT
MBT is effective at reducing symptom severity, specifically interpersonal difficulties, self-harming and suicidal behaviours, co-occurring mental health disorders (depression, anxiety), hospitalisations, and increasing quality of life (1, 2). It is encouraging to note that these improvements are maintained at 5 and 8 years following treatment. MBT is also being trialled as a treatment for CPTSD with/without BPD, as well as for other psychologically treatable difficulties e.g., eating disorders, depression, narcissism, psychosis etc.
Malda-Castillo, Browne, Perez-Algorta (2018). Mentalization-based treatment and its evidence-base status: A systematic literature review, Psychology and Psychotherapy: Theory, Research and Practice
Volkert, Hauschild, Taubner (2019). Mentalization-Based Treatment for Personality Disorders: Efficacy, Effectiveness, and New Developments, Current Psychiatry Reports
Risks and side effects of MBT
Engaging in psychotherapy can be challenging at times. For example, it can be difficult to think about our own and others’ minds, and to practise sharing personal experiences in the individual or group therapy setting. For this reason, some people can feel worse before they feel better. We are aware of this and will support the person in this process.
Other treatments at Spectrum
MBT is not the best treatment option for everyone. Spectrum offers a range of similarly effective treatments that your therapist will discuss with you during assessment.
Treatments
Acceptance and Commitment Therapy (ACT)
Learn about Acceptance and Commitment Therapy (ACT) as a treatment option for borderline personality disorder and complex post-traumatic stress disorder.
Treatments
Dialectical Behaviour Therapy (DBT)
Learn about Dialectical Behaviour Therapy which is a well-established psychological treatment for people with borderline personality disorder.
Treatments
Complex Care Service (CCS)
Learn about Complex Care Service (CCS) that provides whole-of-system interventions for people with severe personality disorder.
Contact the Spectrum intake team for more information or referral
Phone: (03) 8413 8750 (ask for the intake team)
Email: [email protected]