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Stephen Locasse Group

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Mentalization Based Treatment For Personality D...


Mentalization-based therapy shares common elements and techniques with psychodynamic, cognitive-behavioral, systemic, dialectical behavior, and social-ecological therapies. MBT practitioners work to create a safe environment in which patients can begin a deep exploration of their own feelings and those of others, ultimately developing their capacity for mentalization. The health professional is very much focused on the client's present and not so much on the past

Dialectical behavior therapy (DBT) is based in behaviorism, mindfulness, and the investigation of self, and mentalization-based therapy is based in psychoanalysis, attachment theory, and acceptance, among others. Both can be useful modalities.

There have been studies conducted on mentalization for borderline personality disorder, with participants showing improvement in depressive symptoms, a decrease in suicidality and self-mutilation, and better social and interpersonal functioning, among other outcomes. Session frequency can differ but some therapists recommend two sessions a week both one-on-one with a mental health professional as well as group treatment; these sessions can last for 12 to 18 months or more.

Look for a licensed, experienced mental health professional with an understanding of borderline personality disorder, and some training and experience in mentalization-based interventions. In addition to finding someone with the appropriate educational background and relevant experience, look for a therapist with whom you feel comfortable working on personal, family, and relationship matters.

While MBT and Dialectical Behavior Therapy (DBT) are both effective at treating borderline personality disorder and have similar roots in CBT and goals of emotional regulation, there are some key differences between the two treatments.

Antisocial personality disorder (ASPD) is an under-researched mental disorder. Systematic reviews and policy documents identify ASPD as a priority area for further treatment research because of the scarcity of available evidence to guide clinicians and policymakers; no intervention has been established as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment which specifically targets the ability to recognise and understand the mental states of oneself and others, an ability shown to be compromised in people with ASPD. The aim of the study discussed in this paper is to investigate whether MBT can be an effective treatment for alleviating symptoms of ASPD.

This paper reports on a sub-sample of patients from a randomised controlled trial of individuals recruited for treatment of suicidality, self-harm, and borderline personality disorder. The study investigates whether outpatients with comorbid borderline personality disorder and ASPD receiving MBT were more likely to show improvements in symptoms related to aggression than those offered a structured protocol of similar intensity but excluding MBT components.

This study tests the hypothesis that patients with comorbid BPD and ASPD receiving outpatient MBT would be more likely to show improvements in symptoms related to aggression than those offered an outpatient structured protocol of similar intensity but excluding MBT components. This comorbid population was selected for pragmatic reasons, as a subsample of a trial originally designed to compare MBT to Structured Clinical Management (SCM) in a sample of consecutive referrals to a personality disorder unit that specialises in BPD [49]. At the time of the original trial, MBT had not yet been indicated for ASPD and the trial was not designed with this diagnosis in mind. Nevertheless, our original design allows us to measure change in important psychological features directly related to characteristics of ASPD such as anger, hostility, impulsivity (as reflected in self-harm and suicide) and difficulty in relaxing interpersonal control related to loss of dignity, self-worth and self-


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