Mentalization Based Treatment (MBT) is an effective, evidence based treatment for Borderline Personality Disorder (BPD) that isn’t widely practiced in the United States.

And it’s being adapted, successfully, to treat a myriad of other mental health conditions as well, including eating disorders, PTSD, substance use disorders, and other personality disorders.

In one study comparing MBT versus treatment as usual for folks with BPD, those treated with MBT showed the following improvements that were sustained over five years after treatment had concluded:

• fewer suicide attempts

• fewer mental health services

• fewer hospitalzations

• fewer psychiatric medications

• fewer emergency room visits

• greater participation in school and employment

MBT theory views the core problem at the heart of BPD as a difficulty with consistently and accurately mentalizing. “Mentalizing” is a complicated-sounding word that refers to the basic, essentially human process of trying to understand ourselves and others in the context of mental states, such as wishes, beliefs, hopes, fears, and desires. Unlike other forms of therapy, which might prioritize the learning of coping skills, or the resolution of internal conflicts, MBT stays focused on supporting a person’s ability to mentalize, and to help them to sustain this ability in the face of distressing emotions that can arise in close relationships.