Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial

Area of Science:

• Psychiatry
• Adolescent Mental Health
• Psychotherapy Research

Background:

• Adolescent self-harm is a significant public health concern.
• Comorbid depression frequently accompanies self-harm in adolescents.
• Current treatments for adolescent self-harm, such as treatment as usual (TAU), have variable efficacy.

Purpose of the Study:

• To compare the effectiveness of mentalization-based treatment for adolescents (MBT-A) against TAU in reducing self-harm among adolescents.
• To investigate the mechanisms underlying any observed treatment effects.

Main Methods:

• A randomized controlled trial involving 80 adolescents presenting with self-harm and depression.
• Participants were allocated to either MBT-A or TAU.
• Assessments included self-harm, risk-taking, mood, attachment style, mentalization ability, and borderline personality disorder (BPD) features over 12 months.

Main Results:

• MBT-A demonstrated greater effectiveness than TAU in reducing both self-harm and depressive symptoms.
• The positive outcomes of MBT-A were mediated by improvements in mentalization and reductions in attachment avoidance.
• Observed improvements in emergent BPD symptoms and traits were also noted.

Conclusions:

• Mentalization-based treatment for adolescents (MBT-A) shows promise as an effective intervention for reducing self-harm.
• The findings suggest that enhancing mentalization and addressing attachment issues are key targets for treating self-harming adolescents.