Mentalisation Based Therapy is a form of talking therapy that is commonly used in the treatment of some mental health conditions. It is best associated with Borderline Personality Disorder and other personality disorders.

Like all types of talking therapies, there are both advantages and disadvantages to Mentalisation Based Therapy, as we cover in this article.

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Mentalisation based therapy aims to change long-held thought patterns

What is Mentalisation Based Therapy?

Mentalisation-based Therapy (MBT): MBT uses a range of techniques to try and help an individual understand themselves and their thoughts more. Mentalisation itself is the ability for an individual to think about thinking – essentially allowing an individual to examine their own thoughts, and the effect they have. MBT can help an individual understand what goes through the mind of others, as well as making an individual more aware of what happens in their own mind. This form of therapy is useful in various personality disorders.

Advantages of Mentalisation Based Therapy

  • The evidence is great: Not many talking therapies have the level of support that MBT has from research. Research into this form of therapy has consistently shown that MBT is effective for a broad range of conditions [1]. This includes Borderline Personality Disorder – a notoriously difficult condition to treat.
  • Long-term benefits: MBT also has a strong success rate in terms of long-term benefit. One study provided an eight-year follow up to MBT treatment, and the results were highly impressive – with many participants in remission [2]. MBT teaches long-term skills that can help a person navigate their future and prevent relapse.
  • Helps everyone in the patient’s circle: MBT is not only good for the patient, but it is also very useful for those who live and interact with the patient. MBT typically improves relationships and friendships, which can help everyone.
  • Group therapy can help: MBT is often delivered in a group. While this might put some people off, it can be incredibly therapeutic. Working in small groups gives each patient the knowledge that they aren’t alone with their problems, and that others ave similar symptoms. One big problem with personality disorders is that those suffering with them see the world in a very different way, but by coming together, improvements can be made.
  • Multiple conditions can be treated: While personality disorders are primarily targeted with MBT, many other conditions can benefit too. This is particularly useful, as personality disorders usually run comorbid with other conditions like Depression or eating disorders – both of which can benefit from MBT.
  • Takes the past and present into account: One common issue with talking therapies is that few treatments take both the past and present into account. However, MBT goes into detail in both – looking at the potential triggers and past issues that have caused the negative thoughts, and looks at practical ways of helping a person process such thoughts in a more positive way.

Disadvantages of Mentalisation Based Therapy

  • Takes a long time: Without doubt, the biggest vice when it comes to MBT is the sheer length of time that it takes. MBT usually lasts between 1 and 2 years – which is a very long time. Moreover, there is no guarantee that MBT will work.
  • Difficult to make changes: MBT aims to tackle long-term thought processes and patterns – which is not something that is easily achievable. Making these changes will be difficult, and unfortunately, in some cases it will simply be near-impossible.
  • Working as a group isn’t for everyone: As we mentioned earlier, MBT is normally delivered in a group setting. There are advantages, however group work isn’t for everyone. Those with personality disorders often struggle to connect with other humans, which means they may not enjoy working with others, or it may even worsen their symptoms.
  • MBT isn’t too intensive: Due to MBT’s focus on gradual change, it isn’t something that is going to offer a quick solution to problems. While no therapy can provide overnight success, MBT is one of the longest therapies in length. For those wanting something more intensive and not the long-term commitment, MBT probably is one to avoid.
  • Difficult to discuss the past: MBT does place emphasis on looking back at the past and reviewing what events or memories led to thought processes becoming harmful. This will commonly involve past traumas and difficult memories – which can be problematic. On the other hand, it also requires a person to realise that they too have made decisions that have not helped their situation. But not everyone is willing to admit this.
  • Requires commitment: Due to the length of time MBT takes, and the radical change it tries to implement, MBT requires a lot of commitment from the patient. It won’t be enough for them to be a bystander, they must put all of their effort into change. This is without doubt difficult, but it will reap rewards in the long-term if done correctly.

See Also


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[1] Bateman, A. & Fonagy, P. (2009). Randomized Controlled Trial of Outpatient Mentalization-Based Treatment Versus Structured Clinical Management for Borderline Personality Disorder. American Journal of Psychiatry. 166 (12), p1355-1364.

[2] Bateman, A. & Fonagy, P. (2008). 8-Year Follow-Up of Patients Treated for Borderline Personality Disorder: Mentalization-Based Treatment Versus Treatment as Usual. American Journal of Psychiatry. 165 (5), p631-638.