Mentalization-based treatment for borderline personality disorder in adults and adolescents: For whom, when, and how?

Borderline personality disorder (BPD) is common in clinical practice. Psychotherapy is the treatment of choice, and mentalization-based treatment (MBT) is one of the empirically supported treatments that are currently available. For adults, two variants of MBT (MBT day hospital [MBT-DH] and MBT intensive outpatient [MBT-IOP]) have been developed and empirically evaluated. The authors review research on the development, efficacy, and implementation of MBT. In conclusion, the authors focus on the implementation of treatment programs for BPD patients. Although there are now different effective treatments, their implementation in routine clinical practice has proven to be much more complex than initially thought. In addition, treatments such as MBT are multimodal and long term. Both societal pressures to increase the cost-effectiveness of treatments and new theoretical insights into the role of social learning and salutogenesis in the development of BPD force a reconsideration of some assumptions concerning the nature of treatment for individuals with BPD.