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The purpose of this paper is to discuss a reflexive process that makes a distinction between reflection and reflexivity, two processes the authors define according to the mentalization construct. Next, it explores how the narrative mediation path (NMP), a novel multimodal counselling method addressed to underachieving college students, promotes reflection and reflexivity by enhancing student ability to mentalize their university experiences.

The authors conducted an idiographic case study on one of the ten groups of underachieving students who participated in the counselling sessions.

NMP narrative modes (metaphoric, iconographic, writing, and bodily) promoted reflection, and group-level inter-subjective steps were essential for the development of reflexivity. Furthermore, it was found that in each narrative mode, the students developed reflective and reflexive processes through the attainment of mentalization dimensions.

The adoption of the NMP has some implications for universities. Many underachieving students in higher education often have reflexive difficulties when examining their university experiences, so could be considered average mentalizers who tend to show bias in their university experience signification when under stress. Promoting mentalization development can enable students to use their resources strategically at university and improve their academic performance.

The NMP is innovative because of its multimodality: it employs different modes and media, makes use of both individual and group narrative levels, and is integrated in a single method, which enhances the development of reflexive meaning construction.

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.

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.

Mentalization is a psychodynamic concept that can help us to understand our emotional responses to others. The purpose of this paper to illustrate how the concept of mentalization may be applied in dementia care.

An autoethnographic account of the author’s experiences (first author), working as a project manager in which the author used the concept of mentalization to pay close attention to how the author’s emotional responses to people with dementia influenced thier communicative interactions.

This paper outlines how the author processed the author’s own internal experiences in both mentalizing and non-mentalizing modes, as the author wrestled with feelings of conscious incompetence. In the non-mentalizing mode, the author was pre-occupied with the author’s own anxieties. The author struggled to relate to or make sense of the experiences of the individuals with advanced dementia that the author engaged with. Moving towards a mentalizing stance helped the author to attune to the embodied experiences of the people with dementia and recognise the reciprocal nature of our communicative interactions.

This paper illustrates the role that mentalization may play in developing natural and authentic strategies to support communicative engagement in dementia care. These strategies may be of potential value to family carers. Family carers who can maintain a mentalizing stance may be more able to respond in empathic, person- centred ways to people who are living with dementia. On the other hand, non-mentalizing responses may be a root cause of mis-understanding and emotional disengagement.

Effective treatment of patients with severe psychopathy is very difficult to achieve. This conclusion may be drawn from an extensive examination into the usage of the term ‘psychopathy’ in scientific research literature, in theoretical development from various psychological schools of thought, in the practice of therapy and in assessment. The central issue for the authors of this article is the inability of severely psychopathic patients to commit to the patient‐therapist relationship. Attachment theory and mentalisation‐based treatment are used here to define the cause and nature of this inability, which is incurred in very early childhood. These two models can aid in the development of more dynamic definitions of psychopathy, better suited to dynamic therapy formats.The ways in which psychopathy is defined partly account for a number of problems encountered in the practice of therapy. The authors assume that the treatment of psychopathy should be interactional and should match patients' individual levels of psychological development and mentalisation; highly psychopathic patients often perceive others as objects, ie. as part of the context, not as subjects, ie. autonomous personalities.The authors propose to conduct further research in order to verify the validity of their hypothesis. They also put forward a number of suggestions for therapy formats with a view to establishing effective working relationships with psychopathic patients.

MBIT is a manualised mentalization-based approach to working with hard to reach young people at risk of a wide range of life adversities including severe mental illness, substance misuse, family breakdown, school exclusion, offending and homelessness. The on-line manual (www.tiddlymanuals.com) describes how Adolescent Mentalization-Based Integrative Therapy (AMBIT) is a systemic intervention requiring attention to four different domains of intervention simultaneously; much emphasis is placed on the support systems for workers to maintain this balance in what are often chaotic working conditions. The purpose of this paper is to illustrate how these four main components of the AMBIT approach link together in actual clinical practice.

The authors illustrate the core techniques of the AMBIT approach, namely, “working with your client”, “working with your team”, “ working with your network” and “learning as a team” with a series of case vignettes, demonstrating the inter-relationship of these components rather than seeing them as separate strands.

A range of mentalization-based techniques such as “thinking together”, mentalized formulation, “disintegration grids” and web-based manualising are described and illustrated in relation to a series of case vignettes in order to address barriers to effective practice. The vignettes emphasise how these components must be linked together and held in balance, and how easily they become disconnected in working with young people’s ambivalent or even hostile relationships to help.

First, developing a shared, mentalized formulation of a young person’s difficulties is an important aspect of working with highly troubled young people. Second, mentalizing is a relational process and is easily disrupted, for both workers and young people, by raised anxiety and affect, a common feature of working with this client group. AMBIT provides specific methods, for example, “thinking together” for supporting the mentalizing of individual workers in their team in an explicit way. Third, workers from different agencies may often find it difficult to make sense of each other’s behaviour and decision making. AMBIT proposes the use of a mentalizing approach to this difficulty using a technique called a disintegration grid. Finally, AMBIT proposes a new practitioner focused approach to manualising as a method by which a team can become more explicit about its methods of working in order to support systematic practice and evaluate outcomes.

The innovative AMBIT approach proposes that clinicians need to attend to team and network relationships at least as much as their relationship with the client, in addition to adopting a stance of learning as a team from their casework. A high level of clinical skill is needed to support a team to achieve this balanced approach to casework. This work is of interest to all multi-disciplinary teams working with hard to reach young people.

The mentalisation based therapeutic community (MBTC) is a group experience which promotes the acquisition of the capacity to mentalise. Members of the community gain greater emotional stability and psychological robustness. The paper aims to discuss these issues.

MBTC works with three theoretical principles: the intrapsychic, interpersonal and social. It is a slow open group where each member completes a ten-week course. The approach is deliberately non-interpretive with an emphasis on personal responsibility and accountability in order to promote clarity of mind.

The authors’ experience is that the model engages group members with few drop outs.

The combination of mentalising and the use of therapeutic community principles within in MBTC has enhanced outcomes for group members.

The purpose of this paper is to investigate whether Shared Reading (SR), a specific literature-based intervention, is transposable to a prison context and whether mental health benefits identified in other custodial and non-custodial settings were reported by women prisoners.

In all, 35 participants were recruited within an all-female maximum security prison and attended one of two weekly reading groups. Qualitative data were collected through researcher observation of the reading groups; interviews and focus group discussions with participants and prison staff; interviews with the project worker leading the reading groups; and a review of records kept by the latter during group sessions.

Attendance rates were good, with nearly half of the participants voluntarily present at =60 per cent of sessions. Two intrinsic psychological processes associated with the SR experience were provisionally identified, “memory and continuities” and “mentalisation”, both of which have therapeutic implications for the treatment of conditions like depression and personality disorder.

Limitations included the small sample, lack of control for confounding variables, and constraints imposed on data collection by the custodial setting.

Although more controlled research is required, the findings indicate that women prisoners will voluntarily engage with SR if given appropriate support, and that the intervention has potential to augment psychological processes that are associated with increased well-being.

The purpose of this paper is to examine a gap in knowledge about the interaction between mentalizing skills and social inclusion activity immediate after completing an intensive mentalization-based treatment (MBT) program.

Lived experience was explored through the use of timelines, repeated cycles of audio-recorded focus groups and inductive thematic analysis.

Destructive cycles between self-hatred and social-exclusion were first disrupted by MBT because people felt understood. Being understood reduced self-hatred which was an essential precursor for attempting new forms of mentalizing in social interactions. This process was challenging but continued as a virtuous cycle after treatment finished.

The sample was limited because at three, it was small. However, the study was co-produced between professional and service users at all stages. Lived experience was carefully explored in depth and triangulated between three people. The authors acknowledge too that they have reflected on experience within only one to three years after MBT finished. Future studies might usefully replicate the methodology to trace experience up to the eight year follow up point undertaken by Bateman and Fonagy (2008).

There is a great sense of loss for service users when therapy ends and that ending needs to be managed on both sides. Service users start to acquire powerful new skills and thought processes at the end of therapy. While this may not be overwhelming, they will not be used to them and so it helps when therapists help service users think about their plans and ideas for things they want to do or changes they might make in their lives.

While supporting quantitative data about the outcome of therapy, this study offers the type of qualitative detail about how the psychological and social interact post-therapy, which can inform the successful management of those processes by those involved.

Around 60 per cent of people with dementia in the UK live at home. The experience of caring for a family member with dementia can be rewarding and positive, but it can also be significantly stressful. Current healthcare policy is encouraging greater provision to support family carers. Along with respite-care, day-care and support group-based initiatives, there has also been a focus on developing dementia-specific communication training. The paper discusses this issue.

The authors outline a new initiative “Empowered Carers” which is being piloted in the North of England. Empowered Carers is an online support and communication training service for family carers who are caring for someone with dementia at home. It utilises online video conference-calling technology to connect carers with support workers, and also allows for simultaneous interactions involving other family members. A central tenet of the approach is a theoretically grounded support model, based on the concept of mentalisation.

The authors describe the background to Empowered Carers, and how a conventional evaluation strategy for the initiative is being used alongside a socio-linguistic approach (Conversation Analysis – CA). This aims to provide empirical evidence about how the assimilation of mentalisation is reflected in the structuring of speech patterns in carers during support sessions.

The authors explain the CA method, how it has been applied to similar talk-based therapeutic settings, and why its ability to explore sequential linguistic patterns across extremely large data-sets is particularly suited to studying interaction in emerging online arenas.

Recent evidence indicates an improving effect of the co-occurrence of autistic traits and psychotic symptoms on social cognition, but there is no agreement on the effect of the interaction between autistic traits and psychotic proneness on empathy. The aim of this study is to examine the effect of the interaction between autistic traits and positive psychotic experiences on cognitive and affective empathy.

The sample consisted of 420 adults aged between 18 and 60. Assessments were administered anonymously online. Empathic abilities were evaluated by the Interpersonal Reactivity Index (IRI). While Autism Spectrum Quotient (AQ) was applied to measure autistic traits, The Community Assessment of Psychic Experience (CAPE) was used as a measurement of positive psychotic experiences.

A series of regression analyses showed that although AQ and CAPE scores were not correlated with cognitive-IRI, the interaction between these scores predicted cognitive-IRI scores. It was found that the personal distress subscale of IRI was significantly associated with AQ, but this relationship was moderated by CAPE scores.

These findings provide a different perspective on understanding social cognitive impairments in autism, which may have potential clinical implications. Findings also contribute to explaining the individual differences in empathic abilities.