Mentalizing the therapist - Therapist experiences with short-term mentalization-based therapy for borderline personality disorder: A qualitative study

Amanda Ark Søndergaard; Sophie Juul; Stig Poulsen; Sebastian Simonsen

doi:10.3389/fpsyt.2023.1088865

Mentalizing the therapist - Therapist experiences with short-term mentalization-based therapy for borderline personality disorder: A qualitative study

Front Psychiatry. 2023 Mar 16:14:1088865. doi: 10.3389/fpsyt.2023.1088865. eCollection 2023.

Authors

Amanda Ark Søndergaard^{1

2}, Sophie Juul^{1

2}, Stig Poulsen³, Sebastian Simonsen¹

Affiliations

¹ Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark.
² Copenhagen Trial Unit, Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark.
³ Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark.

Abstract

Background: Mentalization-Based Therapy (MBT) was originally developed as a structured psychotherapy approach developed to treat borderline personality disorder (BPD) lasting up to 18 months in outpatient settings. However, a short-term (5 months) MBT program has recently been developed. No studies have investigated how MBT therapists experience the shift towards conducting short-term MBT for BPD.

Objective: The objective of this study was to explore therapist experiences with conducting short-term MBT for outpatients with BPD in the Danish mental health services.

Methods: Semi-structured qualitative interviews were conducted with seven therapists about their experiences with short-term MBT after a one-year pilot phase. The interviews were verbatim transcribed and analyzed using thematic analysis.

Results: The following four major themes from the therapists' experiences with short-term MBT were found in the qualitative analysis: (1) The longer the better, (2) Change processes can be intellectual or experiential, (3) Short-term therapy is hard work, and (4) Termination is more challenging in short-term MBT.

Conclusion: Most therapists were overall reluctant towards changing from long-term to short-term MBT. These therapist experiences could inform implementation of short-term MBT in mental health settings in the future.

Keywords: borderline personality disorder; mentalization-based therapy; short-term psychotherapy; thematic analysis; therapist experiences; treatment termination.