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Chapter 18 - Mentalizing and Emergency Care

from Part IV - Application of Mentalization-Based Treatment in Different Populations and in Different Settings

Published online by Cambridge University Press:  18 May 2023

Anthony Bateman
Affiliation:
Anna Freud National Centre for Children and Families, London
Peter Fonagy
Affiliation:
University College London
Chloe Campbell
Affiliation:
University College London
Patrick Luyten
Affiliation:
University College London
Martin Debbané
Affiliation:
University College London
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Summary

Emergency care teams need to organize their response to crises around shared assessment procedures. This chapter describes how MBT can inform emergency care when a crisis is handled by the multidisciplinary team of mental health practitioners in psychiatric emergency settings. Development of the formulation according to mentalizing principles creates compassionate care in emergency settings. The chapter outlines the key factors that commonly contribute to the development of a crisis, and includes a discussion of the centrality of loss of mentalizing and collapse of agency of the self that are part of any acute crisis. Focusing on all of these aspects of a psychiatric emergency can de-escalate an immediate crisis and pave the way for planning how to prevent a recurrence in the future. Understanding of the triggers that can lead to a crisis and development of a plan for reducing the risk of recurrence are illustrated with clinical examples, and the four steps of MBT-informed emergency care are described.

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