Objectives: Over the past decade, mentalization-based treatment (MBT) approaches have been developed specifically for children, adolescents and families. This study provides a systematic review of MBT applicable to both children and families. Method: Five databases were searched to identify reports of MBT studies published up to February 2020. Studies were screened and reported according to PRISMA guidelines. Results: A total of 34 studies were included in this review. Of these, 14 focused on parent–child dyads, two on child therapy, seven applied the approach to parenting, four evaluated the application of MBT to the school environment and seven focused on adolescent populations. Conclusion: Despite methodological shortcomings and heterogeneity in design, the existing literature does provide tentative support for the use of MBT approaches for these populations, specifically in increasing mentalizing/reflective functioning. Further controlled and methodologically rigorous studies are required.
Objective The current qualitative study aimed to investigate psychologists' experiences of teletherapy throughout the COVID‐19 pandemic, with a particular focus on teletherapy's impact on therapeutic relationships. Method Fifteen participants, consisting of clinical and counselling psychologists employed by the Health Service Executive (HSE) in Ireland, participated in semi‐structured interviews conducted via telephone. Results Constructionist thematic analysis yielded three prominent themes: (i) psychologists experienced a lack of control over therapeutic boundaries with their clients, such as the setting and time in which sessions take place. Teletherapy also encroaches on psychologists' personal boundaries from having aspects of their home lives becoming associated with clients' trauma; (ii) psychologists have to work much harder to make the connection with clients due to the substantial loss of information, including non‐verbal cues, transmitted across teletherapeutic platforms; and (iii) psychologists themselves feel uncontained from being insufficiently supported by the HSE, which impacts on their ability to contain high‐risk clients via teletherapy. Conclusions Various aspects of the therapeutic relationship, including therapeutic boundaries between psychologists and their clients, and psychologists' ability to make the connection and foster containment with their clients, were impacted by teletherapy. Psychologists need to feel heard, supported and appreciated to ensure optimal delivery of teletherapy in future.
Objective The present study explored the experiences of service users of Adult Mental Health and Primary Care services in Ireland in receiving teletherapy during the COVID‐19 pandemic to provide an illustration of these experiences which may inform future applications of teletherapy. Method Semi‐structured telephone interviews about participants' experiences with teletherapy were conducted, the transcripts of which were analysed using reflexive thematic analysis. Results Six themes were generated: Early Apprehensions, Adaptations Improving Experiences, The Therapeutic Space, Seeing and Being Seen, Technical Difficulties: The Loss of “The Moment,” and The Security of a Pre‐Existing Relationship. Conclusion Generated themes highlight both the range of experiences that clients can have during teletherapy, and some of the most significant factors which influence these experiences. The quality and effectiveness of teletherapy are often susceptible to factors outside of therapists' and clients' control. In most cases, it may be best considered as a supplement to, rather than a replacement for, traditional in‐person services.
Objectives:This article aimed to address the feasibility of mentalization-based treatment (MBT) for patients with personality disorder in a non-specialist setting. The development and implementation of an MBT Programme is described.Methods:A multidisciplinary Consult Group met to plan the implementation of the programme. Participants attended a psychoeducation group (MBT Introductory Group), then weekly individual and group therapy. Fourteen participants started the full programme with eight completing at least 9 months, complete data are available for five participants who completed 27 months (first cohort) and 21 months (second cohort). Data include quantitative measures and qualitative questionnaires/interviews. All had a diagnosis of personality dysfunction with co-morbid disorder including anxiety/depressive disorder, post-traumatic stress disorder and eating disorder.Results:Data on five participants revealed reductions in global level of distress, improvements in psychological well-being, less interpersonal difficulties and better work and social functioning. Qualitative data from feedback questionnaires (n = 18) and in-depth interview (n = 2) are discussed under the themes of mentalizing, treatment feedback/outcomes and group factors. Therapist reflections on the process identify the challenges involved in implementing a specialist psychotherapy programme within a general service and learning points from this are discussed.Conclusions:MBT is an acceptable treatment for patients with personality dysfunction. Prior to the implementation of a programme, factors at the therapist, team and organizational level, as well as the wider context, need to be examined. This is to ensure that conditions are in place for proper adherence to the model to achieve the positive outcomes demonstrated in the RCT studies.
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