Mentalizing after mentalization based treatment

The purpose of this paper is to examine a gap in knowledge about the interaction between mentalizing skills and social inclusion activity immediate after completing an intensive mentalization-based treatment (MBT) program.

Lived experience was explored through the use of timelines, repeated cycles of audio-recorded focus groups and inductive thematic analysis.

Destructive cycles between self-hatred and social-exclusion were first disrupted by MBT because people felt understood. Being understood reduced self-hatred which was an essential precursor for attempting new forms of mentalizing in social interactions. This process was challenging but continued as a virtuous cycle after treatment finished.

The sample was limited because at three, it was small. However, the study was co-produced between professional and service users at all stages. Lived experience was carefully explored in depth and triangulated between three people. The authors acknowledge too that they have reflected on experience within only one to three years after MBT finished. Future studies might usefully replicate the methodology to trace experience up to the eight year follow up point undertaken by Bateman and Fonagy (2008).

There is a great sense of loss for service users when therapy ends and that ending needs to be managed on both sides. Service users start to acquire powerful new skills and thought processes at the end of therapy. While this may not be overwhelming, they will not be used to them and so it helps when therapists help service users think about their plans and ideas for things they want to do or changes they might make in their lives.

While supporting quantitative data about the outcome of therapy, this study offers the type of qualitative detail about how the psychological and social interact post-therapy, which can inform the successful management of those processes by those involved.