Working With Parents

In Working With Parents, Norka Malberg, PsyD, and Jordan Bate, PhD, use mentalization-based treatment for children (MBT-C) to work with three types of parents with different presenting problems: a married mother with an adopted son who is acting out; a couple whose daughter has been recently diagnosed with autism; and a single mother with a son experiencing depression while in college. This video presents segments from each session and further examines clips from those segments. This video showcases MBT-C and its theory that the child's caregiving network must be included in the therapeutic process, all demonstrated in real time. While all clients are portrayed by actors, these cases are based on actual situations.

Mentalization-based treatment for children (MBT-C) is a time-limited, manualized therapy adapted from the adult MBT model. It is transdiagnostic, supporting children with a wide range of emotional, behavioral, and relational difficulties. Treatment usually involves 9-12 weekly individual sessions, with the option to extend. A core feature is that MBT-C is embedded in the child's caregiving network. Parents' and sometimes schools or other systems—participate in parallel or integrated work aimed at strengthening caregivers' reflective functioning, which is seen as central to change. Therapists use a mentalizing stance (curious, present-focused, affect-attuned) while helping children connect their experiences and behaviors with underlying mental states. Child sessions are typically play-based, targeting attention control, emotion regulation, and explicit mentalizing skills. Parent sessions focus on understanding the child’s inner world, exploring the parent’s own emotional reactions, and working through interactional ruptures and repairs.

Formulation emphasizes mentalizing strengths and vulnerabilities in both child and parent rather than relying solely on diagnostic labels. The model is grounded in mentalization theory and attachment research: children develop mentalizing capacities through caregivers who respond contingently and reflectively. Difficulties often arise when mentalizing collapses under stress, especially in the context of insecure attachment, trauma, or chronic misattunement. Recent developments integrate findings from neuroscience (social cognition and emotion-regulation networks) and developmental psychopathology (early regulation, sensory processing, and social attention). This integrative lens is particularly relevant to autism, emphasizing that atypical sensory, motor, and social processing shape the development of mentalizing rather than reflecting a simple absence of it.

Norka Malberg, PsyD, is in private practice in Barcelona, Spain. She is assistant clinical professor at the Yale Child Study Center, Yale School of Medicine where she conducts the early childhood seminar for child psychiatric residents. She is also in the faculty of the Masters of Contemporary Psychodynamic Psychotherapy at Ramon Llui University in Barcelona, Spain. Dr. Malberg obtained her clinical doctorate from University College London under the supervision of Dr. Peter Fonagy on the development of group interventions applying mentalization-based therapy to working with chronically ill adolescents in hospital settings. Since then, she has become one of the main trainers and supervisors of mentalization-based treatments for children, adolescents and families. In 2017, she became one of the coauthors of the book Mentalization-Based Treatment for Children: A Time-Limited Approach, published by APA Books. In 2023, she coauthor the book: Working With Parents in Therapy: A Mentalization-Based Approach, also published by APA Books. She is coeditor of the child and adolescent sections of the Psychodynamic Diagnostic Manual III, published by Guildford (in press) Dr. Malberg is the author of multiple journal articles and book chapters on the topics of child psychodynamic psychotherapy, trauma, autism, parenting, dimensional diagnosis, and mentalization-based treatments. 

Jordan Bate, PhD, received her PhD in clinical psychology from The New School for Social Research, and a BA in history and political science from Williams College. She completed a postdoctoral fellowship in clinical psychology at Lenox Hill Hospital. Her research is broadly focused on applying attachment theory to child and parent-child psychotherapy. Beyond demonstrating treatment outcomes, she is interested in understanding the process of psychotherapy and exploring questions about what makes psychotherapy interventions effective, and how to effectively train clinicians and disseminate new treatments. She has specific interests in studying how trauma and adverse childhood experiences impact individuals and families, as well as interventions designed for pregnant and postpartum women and new parents. 

APA Videos

Mentalization-Based Treatment With a 10-Year-Old Boy
Norka T. Malberg, PsyD, and Karin Ensink, PhD

Child and Adolescent Therapy Deliberate Practice
Jordan Bate, PhD

Emotion Focused Skills Training
Joanne Dolhanty, PhD, CPsych, and Anne Hilde Vassbø Hagen, Cand.Psychol

Parent-Child Interaction Therapy
Cheryl Bodiford McNeil, PhD

Adoption-Specific Therapy in Practice
Jill Waterman, PhD

Parents of Children With Autism Spectrum Disorder
V. Mark Durand, PhD

APA Books

Working With Parents in Therapy: A Mentalization-Based Approach
Norka Malberg, Elliot Jurist, Jordan Bate, and Mark Dangerfield

Strengthening the Parent-Child Relationship in Therapy: Laying the Foundation for Healthy Development
Larissa N. Niec

Working With Parents of Aggressive Children: A Practitioner's Guide, Second Edition
Timothy A. Cavell and Lauren B. Quetsch

Good Enough Parenting: A Six-Point Plan for a Stronger Relationship With Your Child
Timothy A. Cavell and Lauren B. Quetsch

Nature Meets Nurture: Science-Based Strategies for Raising Resilient Kids
Stacey N. Doan and Jessica L. Borelli

Raising a Resilient Child in a World of Adversity Effective Parenting for Every Family
Amanda Sheffield Morris and Jennifer Hays-Grudo

Other Suggested Resources

Malberg, N. (2021). Working with autistic children and their families from a mentalization-based therapy for children (MBT-C) approach. Psychoanalytic Perspectives, 18.

Malberg, N. T., & Gori, I. (2024). Epistemic justice and neurodiversity: Mentalization–based treatment with children in the autistic spectrum from a dimensional perspective. Journal of Infant, Child, and Adolescent Psychotherapy, 23(1), 56–71. https://doi.org/10.1080/15289168.2024.2306460

Costa-Cordella, S., Soto-Icaza, P., Borgeaud, K. , Grasso-Cladera, A., Malberg, N. T. (2023). Towards a comprehensive approach to mentalization-based treatment for children with autism: Integrating attachment, neurosciences, and mentalizing, Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1259432

Psicoterapia basada en la mentalización con un niño con ASD: resultados preliminares. (2025). Revista INFAD De Psicología. International Journal of Developmental and Educational Psychology, 1(1), 397-406. https://doi.org/10.17060/ijodaep.2025.n1.v1.2838

Halfon, S., Besiroglu, B., Bulut, P., Epözdemir, S., Aydin, G.,  Koç, H., Sözüer, B., Özsoy, Ö., Tulum, O., Tülü, S., & Midgley, N. (2024). The efficacy of mentalization-based treatment (MBT-C) for children with internalizing and externalizing problems: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 64. 10.1016/j.jaac.2024.12.006.