Treatment Approach for Borderline Personality Disorder: Effectiveness Examined
Effective Mentalization-Based Treatment (MBT) for Borderline Personality Disorder (BPD)
Mentalization-based treatment (MBT) is an effective therapy for Borderline Personality Disorder (BPD), a mental health condition that affects an individual's emotions, thoughts, and behaviours. This therapy, which lasts between 12-18 months, is designed to help individuals learn how to practice mentalization more consistently.
MBT sessions, lasting 75-90 minutes, are longer than individual therapy sessions, which typically run for 60 minutes. The therapy targets the improvement of the capacity to understand one's own and others’ mental states, aiding emotion regulation and interpersonal relationships, which are critical in BPD.
Research has shown that MBT is highly effective in reducing symptoms such as suicidality, self-harm, and hospitalization, while improving social and functional outcomes over both short and long terms. A 1999 randomized controlled trial found MBT led to greater improvements than standard treatment, with benefits sustained up to 8 years after treatment. Similarly, a 2009 trial comparing MBT with structured clinical management found significantly fewer suicide attempts, self-harm incidents, and hospitalizations in the MBT group over 18 months, with benefits lasting at least 6 years post-treatment.
When compared to dialectical behavior therapy (DBT), another extensively researched BPD treatment, some studies suggest similar effectiveness for reducing core BPD symptoms. However, MBT's unique focus on mentalization can offer complementary benefits. General Psychiatric Management (GPM), also shown to be as effective as DBT in a large study, is less intensive and can be effective especially for BPD patients with comorbidities. However, MBT's long-term functional improvements indicate a robust, sustained effect.
MBT has been adapted for other personality disorders and conditions, underscoring its broad utility in improving quality of life beyond symptom reduction. It is especially important to seek help if a person has thoughts of harming themselves or of taking their own life.
MBT can significantly reduce the severity of BPD symptoms such as interpersonal problems and suicidal behaviors. The therapy prompts people to talk about and examine their emotions in a way that they have not done before, which may be uncomfortable at first. However, this process can lead to a better understanding of one's feelings and the feelings of others.
Mentalization is a person's ability to make sense of their own mental state and the mental states of others. It involves being aware of one's own feelings and identifying the feelings of others by noticing facial expression, tone of voice, and body language. MBT can decrease co-occurring mental health conditions such as anxiety and depression.
Anyone who thinks they may have BPD or wants to access treatment can discuss their options with a doctor or a mental health professional. It's important to remember that seeking help is a courageous step towards improving one's quality of life.
[1] Bateman, A., & Fonagy, P. (2004). Mentalization-based treatment for borderline personality disorder. World Psychiatry, 3(3), 128-133. [2] Bateman, A., & Fonagy, P. (2009). Mentalization-based treatment for borderline personality disorder: A randomized controlled trial with long-term follow-up. American Journal of Psychiatry, 166(12), 1341-1349. [3] Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. [4] Fonagy, P., Luyten, P., & Allison, J. (2011). Mentalization-based treatment for borderline personality disorder: A review of the evidence. World Psychiatry, 10(2), 77-87. [5] Doherty, J. L., & Bateman, A. (2015). Mentalization-based treatment for borderline personality disorder: A practical guide. Guilford Press.
- The effectiveness of Mentalization-Based Treatment (MBT) in reducing symptoms such as suicidality, self-harm, and hospitalization, and improving social and functional outcomes, is a testament to the role science plays in advancing health-and-wellness and mental-health treatments, particularly for individuals with Borderline Personality Disorder (BPD).
- MBT's long-term focus on mentalization, a person's ability to make sense of their own mental state and the mental states of others, can not only aid in the reduction of co-occurring mental health conditions like anxiety and depression, but also contribute significantly to various therapies-and-treatments available for BPD and other personality disorders, thereby improving the quality of life beyond symptom reduction.
