Mentalization-Based Treatment (MBT): what is it and who is it for?

Sometimes we react in ways we don't fully understand ourselves. Or we get caught up in misunderstandings with others. Mentalisation-Based Treatment (MBT) helps people understand themselves and others better. It is about the ability to consider what is going on inside yourself; thoughts, feelings, intentions and to do the same with others. We call this skill 'mentalisation'.

We all do it

Mentalising is something we all do, often without thinking about it. But in people with mental health problems, such as a borderline personality disorder (BPS), this ability can become disrupted. This makes relationships unpredictable, communication confusing and emotions difficult to understand. MBT is designed to improve this.

MBT does not solve everything

MBT is a form of therapy in which you learn to better recognise and understand thoughts and feelings of yourself and others. The aim is not to solve everything, but to get a better overview. This makes people react less impulsively and creates space to approach situations differently.

Who is MBT suitable for?

Originally developed for people with borderline disorder, MBT has since been applied to other problems. Think of:

• borderline personality disorder (BPS)

• antisocial personality disorder

• depressive symptoms combined with relationship problems

• young people with behavioural problems
• families with complex dynamics

Therapy can be individual, group or combined. The form depends on the situation and the treatment goal.

How does MBT work in practice?

.MBT helps people look at themselves and others from a place of calmness and interest. This is done in conversations with a therapist who always brings back to the question: What thoughts are you having?

A practical example of MBT

Suppose someone feels that a friend is ignoring her. Without MBT, that person might immediately withdraw or get angry. In therapy, she learns to dwell on the thought: What do I think she is thinking? Maybe that friend just had a busy week. Taking that step creates less conflict and more mutual understanding.

Underpinned and effective

Multiple studies have shown that MBT is effective, especially with borderline. A well-known study published in The American Journal of Psychiatry showed that people who followed MBT had significantly fewer moments of crisis after 18 months than those who received other treatments. Hospital admissions also decreased and quality of relationships improved.

What distinguishes MBT

What sets MBT apart is its focus on improving daily functioning through better understanding of emotions and intentions. It focuses less on 'understanding' the past and more on how you interact with yourself and others now.

Wondering if MBT is for you? Check out our list of therapists offering this therapy.