Evaluating the introduction module of Mentalization-Based Treatment: a naturalistic pre-post clinical cohort study

Mentalization-Based Treatment Introduction (MBT-I) is a psychoeducational group module preceding long-term Mentalization-Based Treatment (MBT) for patients with borderline personality disorder (BPD). MBT-I aims to increase knowledge of mentalizing and BPD, prepare patients for treatment, clarify diagnosis, and assess mentalizing capacities. However, empirical evidence remains limited. This study examined whether MBT-I was associated with improved mentalizing capacity and attainment of its clinical goals.

A naturalistic, non-randomized one-group pre-post study was conducted in a Dutch mental health care institute. Patients attended ten weekly MBT-I group sessions. Of 60 patients included, 51 were analyzed. Most had a primary BPD diagnosis; others had personality disorders with comparable difficulties in relational functioning, self-image, and mentalizing. Mentalizing capacity was assessed using the Reflective Functioning Questionnaire, Interpersonal Reactivity Index, and Toronto Alexithymia Scale. MBT-I goals were measured using visual analogue scales.

A trend was found for the TAS-20 subscale 'Difficulty Identifying Feelings'. No significant differences were found between pre- and posttest on the RFQ, IRI, and the remaining subscales of the TAS-20. Significant differences were found comparing pre- and post-VAS scores with regard to the goals of MBT-I.

MBT-I was not associated with statistically significant improvements across the outcome scales on mentalizing, but a promising trend emerged toward improved emotional awareness. The brief module appears to strengthen early prerequisites for mentalizing and offers clear psychoeducational value by increasing patient knowledge, rather than inducing changes in mentalizing. Future controlled studies are needed to clarify its incremental clinical benefit.