Mentalization-Based Therapy for Adolescents Delivered Online
ISBN: 978-1-4338-3883-5Available formats
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Working with adolescent clients, many of whom often do not wish to engage in therapy can be challenging, whether in person or in teletherapy. It is not uncommon for teenage clients who present with risks such as self-harm to also present with characteristics of borderline personality disorder, including anxiety, depression, and self-hatred.
Mentalization is the ability to accept that actions derive from inner states and intentions and the ability to imagine what those inner thoughts and desires might be. Mentalization-based treatment for adolescents, or MBT-A, is a psychodynamic-based therapy that helps adolescent clients identify internal thoughts that determine outward behaviors. This therapeutic approach, developed by Dr. Peter Fonagy and other clinical researchers, is designed to help practitioners and clinicians to guide adolescent clients towards improved emotional regulation and interpersonal relationships.
In this video program, Dr. Carla Sharp analyses and discusses the administration of MBT-A with Dr. Trudie Rossouw, who demonstrates this approach with an adolescent female client who is experiencing trouble with school and at home with her family.
This video features an adolescent actor portraying a client on the basis of a composite of case material.
Mentalization-based treatment (MBT) promotes a child's ability to make sense of their own mind, and the minds of others around them. The approach draws on traditional psychodynamic principles but integrates them with findings from attachment theory, the empirical study of mentalization, and features of other evidence-based approaches.
Mentalizing involves understanding the mental states (e.g. thoughts, feelings, intentions) of oneself and others, and the operation of this capacity is referred to as reflective functioning (RF). The ability for RF can mediate affect regulation and positive interpersonal relations, while deficits in RF can drive misperceptions of others’ mood and behavior.
When a child fails to develop a sufficient capacity to mentalize, they are deprived of one of the most valuable tools to maneuver relationships, a skill that is at the heart of both the capacity to self-regulate and to manage an increasingly complex interpersonal world. The capacity to mentalize creates resilience and internal resources in the face of a demanding external world.
Trudie Rossouw, MBChB, FFPsych, MRCPsych, MD (Res), currently works within her own private practice as a consultant child and adolescent psychiatrist in North London. She possesses more than 20 years of experience in the UK National Health Services, where she worked in outpatient clinics as well as an inpatient unit for adolescents.
Carla Sharp, PhD, is professor in the clinical psychology doctoral program at the University of Houston. She is also the director of the Adolescent Diagnosis Assessment Prevention and Treatment Center and the developmental psychopathology lab at the University of Houston.
Her work has significantly advanced the scientific understanding of the phenomenology, causes, correlates, and treatment of personality pathology in youth. She is the recipient of the 2016 Mid-Career Award, North American Society for the Study of Personality Disorders, and the 2018 Award for Achievement in the Field of Severe Personality Disorders from the Personality Disorders Institute and Borderline Personality Disorder Resource Center, New York. She is the current president of the International Society for the Study of Personality Disorders, incoming associate editor for APA journal Personality Disorders: Theory, Research and Treatment, and a workgroup member for updating the American Psychiatric Association practice guidelines for borderline personality disorder.
She has published more than 270 peer-reviewed publications (h-index 59), in addition to numerous chapters and books, including Handbook of Borderline Personality Disorder in Children and Adolescents (Springer, 2013). Her work has been funded by the NICHD, NIAAA, NIMH, the Brain and Behavior Research Foundation, and other foundations.
Sharp, C., Kerr, S., & Chanen, A. (2021). Early identification and prevention of personality pathology: An AMPD informed model of clinical staging. In A. Skodol and J. Oldham (Eds). The American Psychiatric Association Textbook of Personality Disorders (pp. 285-337). Washington, DC: American Psychiatric Association.
Sharp, C., Shohet, C., Givon, D., Penner, F., Marais, L., & Fonagy, P. (2020). Learning to mentalize: A mediational approach for caregivers and therapists. Clinical Psychology: Science and Practice, 27(3), 1-17.
Beck, E., Bo, S., Poulsgaard Jørgensen, M., Gondan, M., Poulsen, S., Storebø , J., Andersen, C.F., Folmo, E., Sharp, C., Pedersen, J., & Simonsen, E. (2020). Mentalization-based Therapy in Groups for Adolescents with Borderline Personality Disorder: A Randomized Controlled Trial. Journal of Child Psychology and Psychiatry, 61(5), 594-604.
Sharp, C., & Rossouw, T. (2019). Working with borderline teens. In A. Bateman and P. Fonagy (Eds). Handbook of mentalizing in mental health practice (3rd edition) (pp. 281-300). New York: Wiley.
Chanen, A., Sharp, C., Hoffman, P., and the Global Alliance for Prevention and Early Intervention for Borderline Personality Disorder (2017). Prevention and early intervention for borderline personality disorder: a public health priority. World Psychiatry, 16(2), 215-216. [IF: 40.595].
Sharp, C., & Tackett, J. (Eds.). (2014). Handbook of Borderline Personality Disorder in Children and Adolescents. New York, NY: Springer.
Fonagy P., Rossouw T., Sharp C., Bateman A., Allison L., & Farrar C. (2014) Mentalization-based treatment for adolescents with borderline traits. In Handbook of borderline personality disorder in children and adolescents, p. 313-792. Springer.
The Use of Mentalization-Based Treatment for Adolescents (MBT-A) With a Young Woman With Mixed Personality Disorder and tendencies to Self-Harm., Journal of clinical psychology: In treatment, Vol. 71(2), 178–187.
Rossouw, T, & Fonagy, P. (2012). Mentalization-Based Treatment for Self-Harm in Adolescents: A Randomized Controlled Trial., Journal of the American Academy of Child & Adolescent Psychiatry, 51(12), 1304–1313.
Rossouw, T. (2013). Mentalization-Based Treatment: Can It Be Translated Into Practice in Clinical Settings and Teams?, Journal of the American Academy of Child & Adolescent Psychiatry, 52(3), 220–222.
Bleiberg, E., Rossouw, T., & Fonagy, P. (2012) Adolescent breakdown and emerging borderline personality disorder, in Eds. Bateman & Fonagy, Handbook of mentalizing in mental health practice, 463 – 510. American Psychiatric Publishing.
Rossouw, T., (2012) Self-harm and young people: Is MBT the answer? In Midgely & Vrouva (Eds.), Minding the child: Mentalization based interventions with children, young people and their families, 131- 144, Routledge.
Vrouva, I., Fonagy, P., Fearon, P., & Rossouw, T. (2010) The risk-taking and self-harm inventory for adolescents: Development and psychometric evaluation. Psychological Assessment, 22(4): 852-865.
Rossouw, T. (201o) Reflections on the ethical complexities of medical life in apartheid South Africa. In A. Bartlett & G. McGauley (Eds.), Forensic mental health: concepts, systems and practice, 381 – 386. Oxford University Press.
Rossouw, T., & Lubbe, T. (1994). Psychotherapy with a young boy with elective mutism. Psychoanalytic Psychotherapy in South Africa, Vol.2, 21-31.
Rossouw, T. (2009). Exploring the inner world in a patient suffering from manic-depression. In R. Doctor & R. Lucas (Eds.), The organic and the inner world. ( Karnac.)
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