Understanding the mechanisms by which psychotherapy improves outcomes for individuals with mental health conditions is crucial for the continuous advancement of treatments. One proposed mechanism is mentalizing, which refers to the human ability to comprehend intentional mental states, such as goals, desires, feelings, and wishes, of both oneself and others. Mentalizing is multidimensional and fundamental for social relationships and sense of self.
Deficiencies in mentalizing are observed in various psychopathologies, making it a transdiagnostic concept essential for improving outcomes across diagnoses. Luyten et al. conducted a systematic review to explore the role of mentalizing in psychological interventions.
Methods
The review identified studies from electronic databases, focusing on mentalizing and reflective functioning in adult populations. Validated measures were used to assess mentalizing, with quality assessment conducted using the EPHPP tool.
Results
The review included 33 studies with over 3,000 participants. Pre-treatment mentalizing showed mixed outcomes in predicting treatment outcomes. Changes in mentalizing during interventions were associated with improved treatment outcomes. Adherence to the mentalization-based treatment (MBT) model predicted positive outcomes.
Conclusions
The findings suggest that mentalizing may mediate and moderate treatment outcomes in psychotherapy. However, the heterogeneity of studies and limited data availability restricted a formal meta-analysis.
Strengths and Limitations
The review provided valuable insights into the role of mentalizing across psychopathologies and interventions. While the study had strengths in methodology, such as pre-registration, the limitations included heterogeneity of study designs and measures used.
Implications for Practice
Despite limitations, clinicians should consider the role of mentalizing in psychological interventions. Therapies that promote mentalizing can improve therapeutic outcomes. Further research is needed to standardize treatment types and explore the value of mentalizing in different psychopathologies.
Statement of Interests
There are no conflicts of interests to declare.
Relevant Mental Elf Video
For more information on mentalizing and MBT, watch the in-depth discussion with Anthony Bateman recorded as part of the 2024 BIGSPD Podcast.
Links
Primary Paper
Luyten, P., Campbell, C., Moser, M., & Fonagy, P. (2024). The role of mentalizing in psychological interventions in adults: Systematic review and recommendations for future research. Clinical Psychology Review, 102380–102380. https://doi.org/10.1016/j.cpr.2024.102380
Other References
Additional references and resources to explore the concept of mentalizing further.
