Mentalization in Child Psychodynamic Psychotherapy

Abstract

Mentalization has been considered a common factor across therapeutic processes, inherent to all effective treatment models. However, empirical findings and evidence about the presence and relevance of the construct for use in child psychodynamic psychotherapy processes are scarce. To contribute to filling this gap, the aim of this study was to analyse three children's psychotherapies in regards to the similarity of the treatments to the mentalization process prototype. This study is exploratory, longitudinal and descriptive, and is based on the systematic case studies procedure. Three school‐age children and their therapists participated. Two hundred and seventy‐three sessions were coded with the Child Psychotherapy Process Q‐Set and analysed according to their similarity to the mentalization process prototype. The results showed that it was possible to identify the presence of elements based on the mentalization approach in child psychodynamic psychotherapy. In addition, the presence of the therapist's mentalizing attitudes was associated with increased feelings of security and a greater connection of emotions to experiences. The results corroborated the propositions that enhancing mentalization is an implicit process in child psychodynamic psychotherapy, and suggested the importance of acknowledging and understanding the essential elements that compose the treatment models.

Dynamic relations between mentalization techniques and therapeutic alliance in psychodynamic child therapy: An evidence-based case study.

“…Goodman et al (2016) found that mentalization is a common process factor in psychodynamic and cognitive-behavioral child treatments. Several single-case studies have identified elements related to mentalization in psychodynamic therapy (Carvalho et al, 2019; Goodman, 2015; Muñoz, Specht et al, 2016). Mentalization is associated with better outcomes and improves affect regulation, reflective functioning, and the quality of attachment relationships in child psychotherapy (see Oehlman Forbes et al, 2021, for a review).…”

Session adherence to prototypical psychotherapy process as a correlate of outcome in a naturalistic study of child mentalization-informed psychodynamic play therapy.

“…The sessions reported on here were conducted using a PDT model informed by principles of mentalization (Verheugt-Pleiter et al, 2008; Zevalkink et al, 2012). Mentalization-informed PDT, though designed especially for “complex problems in children” (p. 1), has also been used for less complex problems, including adjustment disorder (Carvalho et al, 2019). The central technical principles of this PDT model include staying in the here and now, linking feelings and behaviors in session, rewinding to understand what happened when the therapist said or did something, and acknowledging ruptures in the relationship and understanding them as emanating from differing mental states (see Perepletchikova & Goodman, 2014; Verheugt-Pleiter et al, 2008; Zevalkink et al, 2012).…”