Skip to main content Accessibility help

Running a mentalization-based treatment (MBT) programme within a public community adult mental health service setting: a feasibility study

  • D. Beattie (a1), S. Murphy (a1), S. Jamieson (a1) and A. Lee (a1)

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.


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.


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.


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.

Corresponding author
*Address for correspondence: S. Murphy (DClin), HSE Kildare/West Wicklow Mental Health Service, St. Mary’s, Naas, Kildare, Ireland (Email:
Hide All
Bateman, A, Fonagy, P (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. American Journal of Psychiatry 156, 15631569.
Bateman, A, Fonagy, P (2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up. American Journal of Psychiatry 158, 3642.
Bateman, A, Fonagy, P. (2006). Mentalization-Based Treatment for Borderline Personality Disorder: A Practical Guide. Oxford University Press: Oxford.
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, 631638.
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, 13551364.
Bales, D, Timman, R, Andrea, H, Busschbach, JJV, Verheul, R, Kamphuis, JH (2014). Effectiveness of day hospital mentalization-based treatment for patients with severe borderline personality disorder: a matched control study. Clinical Psychology & Psychotherapy 22, 409417.
Bales, D, Verheul, R, Hutsebaut, J (2017). Barriers and facilitators to the implementation of mentalization-based treatment (MBT) for borderline personality disorder. Personality and Mental Health 11, 118131.
Bales, D, Timman, R, Luyten, P, Busschbach, J, Verheul, R, Hutsebaut, J (2017). Implementation of evidence-based treatment for borderline personality disorder: the impact of organizational changes on treatment outcome of mentalization-based treatment. Personality and Mental Health 11, 266277.
Bender, DS, Dolan, RT, Skodol, AE, Sanislow, CA, Dyck, IR, McGlashan, TH, Shea, MT, Zanarini, MC, Oldham, JM, Gunderson, JG (2001). Treatment utilization by patients with personality disorders. American Journal of Psychiatry 158, 295302.
Blais, MA, Lenderking, WR, Baer, L, deLorell, A, Peets, K, Leahy, L, Burns, C (1999). Development and initial validation of a brief mental health outcome measure. Journal of Personality Assessment 73, 359373.
Carr, A, Keenleyside, M, Fitzhenry, M, Harte, E, White, MD, O’Hanrahan, K, Hayes, J, Cahill, P, Noonan, H, O’shea, H, McCullagh, A, McGuinness, S, Rodgers, C, Whelan, N, Sheppard, N, Browne, S (2015). Personality disorders in an Irish mental health service: the Waterford Mental Health Survey. The Irish Journal of Psychology 36, 311.
Derogatis, LR (1994). Symptom Checklist-90-R: Administration, Scoring and Procedures Manual. Pearson: Bloomington.
Dyson, H, Brown, D (2016). The experience of mentalization-based treatment: an interpretative phenomenological study. Issues in Mental Health Nursing 37, 586595.
Expert Group on Mental Health Policy (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. The Stationery Office: Dublin.
Fonagy, P, Luyten, P, Moulton-Perkins, A, Lee, Y-W, Warren, F, Howard, S, Ghinai, R, Fearon, P, Lowyck, B (2016). Development and validation of a self-report measure of mentalizing: the reflective functioning questionnaire. PLoS ONE 11(7), e0158678. doi: 10.1371/journal.pone.0158678.
Horowitz, LM, Alden, LE, Wiggins, JS, Pincus, AL (2000). Inventory of Interpersonal Problems Manual. The Psychological Corporation: San Antonio.
Johnson, EL, Mutti, M, Springham, N, Xenophontes, I (2016). Mentalizing after mentalization based treatment. Mental Health and Social Inclusion 20, 4451.
Jorgensen, CR, Freudn, C, Boye, R, Jordet, H, Andersen, D, Kjolbye, M (2012). Outcome of mentalization-based and supportive psychotherapy in patients with borderline personality disorder: a randomized trial. Acta Psychiatrica Scandinavica 127, 305317.
Katsakou, C, Marougka, S, Barnicot, K, Savill, M, White, H, Lockwood, K, Priebe, S (2012). Recovery in borderline personality disorder (BPD): a qualitative study of service users’ perspectives. PLoS ONE 7(5), e36517. doi: 10.1371/journal.pone.0036517.
Kvarstein, E, Pedersen, G, Urnes, Ø, Hummelen, B, Wilberg, T, Karterud, S (2015). Changing from a traditional psychodynamic treatment programme to mentalization-based treatment for patients with borderline personality disorder – Does it make a difference?. Psychology and Psychotherapy: Theory, Research and Practice 88, 7186.
Laurenssen, EMP, Luyten, P, Kikkert, MJ, Westra, D, Peen, J, Soons, MBJ, van Dam, AM, van Broekhuyzen, AJ, Blankers, M Busschbach, JJV, Dekker, JJM (2018). Day hospital mentalization-based treatment v. specialist treatment as usual in patients with borderline personality disorder: randomized controlled trial. Psychological Medicine 48, 18. doi: 10.1017/S0033291718000132.
Mental Health Division, HSE (2017). A national framework for recovery in mental health—A national framework for mental health service providers to support the delivery of a quality, person-centred service 2018–2020. HSE.
Millon, T, Millon, C, Davis, R, Grossman, S (2009). MCMI-III Manual, 4th edn. Pearson Education Inc.: Minneapolis.
Mundt, JC, Marks, IM, Shear, MK, Greist, JH (2002). The work and social adjustment scale: A simple measure of impairment in functioning. British Journal of Psychiatry 180, 461464.
National Institute for Clinical Excellence (2009) Borderline personality disorder: recognition and management. NICE.
O’Lonargain, D, Hodge, S, Line, R (2017). Service user experiences of mentalization-based treatment for borderline personality disorder. Mental Health Review Journal 22, 1627.
Orsmond, GI, Cohn, ES (2015). The distinctive features of a feasibility study: objectives and guiding questions. OTJR: Occupation, Participation and Health, 35, 169177.
Vogt, KS, Norman, P (2018). Is mentalization-based therapy effective in treating the symptoms of borderline personality disorder? A systematic review. Psychology and Psychotherapy: Theory, Research and Practice. doi: 10.1111/papt.12194.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed