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Service user experiences of mentalisation-based treatment for borderline personality disorder

Diarmaid Ó. Lonargáin (Lancashire Care NHS Foundation Trust, Preston, UK) (Faculty of Health and Medicine, Lancaster University, Lancaster, UK)
Suzanne Hodge (Faculty of Health and Medicine, Lancaster University, Lancaster, UK)
Rachael Line (5 Boroughs Partnership NHS Foundation Trust, Warrington, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 13 March 2017



Previous research indicates that mentalisation-based treatment (MBT) is an effective therapeutic programme for difficulties associated with borderline personality disorder (BPD). The purpose of this paper is to explore service user experiences of the therapy.


Seven adults (five female and two male), recruited via three NHS trusts, were interviewed. Participants were attending intensive out-patient MBT for BPD between 3 and 14 months. Data were analysed using interpretative phenomenological analysis.


Participants experienced the group component of MBT as challenging and unpredictable. They highlighted developing trust as key to benefitting from MBT. This was much more difficult to achieve in group sessions than in individual therapy, particularly for those attending MBT for less than five or six months. The structure of MBT generally worked well for participants but they identified individual therapy as the core component in achieving change. All participants learned to view the world more positively due to MBT.

Practical implications

Enhanced mentalisation capacity may help address specific challenges associated with BPD, namely, impulsivity and interpersonal difficulties. MBT therapists are confronted with the ongoing task of creating a balance between sufficient safety and adequate challenge during MBT. Potential benefits and drawbacks of differing structural arrangements of MBT programmes within the UK are considered.


Learning about service user perspectives has facilitated an enhanced understanding of experiences of change during MBT in addition to specific factors that may impact mentalisation capacity throughout the programme. These factors, in addition to implications for MBT and suggestions for future research, are discussed.



The authors would like to thank the three NHS Trusts that facilitated this study, and especially the MBT teams through which the study was conducted. In particular the authors would like to thank Simon Graham, Keri Stephenson and Emma Hickey for their support with recruitment and other areas of the research. Finally, the authors are very grateful to those who took part in the study, for giving their time and sharing their experiences with the authors, without whom this research would not have been possible.


Lonargáin, D.Ó., Hodge, S. and Line, R. (2017), "Service user experiences of mentalisation-based treatment for borderline personality disorder", Mental Health Review Journal, Vol. 22 No. 1, pp. 16-27.



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