Mentalizing after mentalization based treatment

Date14 March 2016
Published date14 March 2016
AuthorEmma Louise Johnson,Marie-France Mutti,Neil Springham,Ioanna Xenophontes
Subject MatterHealth & social care,Mental health,Social inclusion
Mentalizing after mentalization based
Emma Louise Johnson, Marie-France Mutti, Neil Springham and Ioanna Xenophontes
Emma Louise Johnson is
ResearchNet Volunteer
at Oxleas NHS Foundation
Trust, London, UK.
Marie-France Mutti is based at
Oxleas NHS Foundation Trust,
London, UK.
Neil Springham is Consultant
Art Therapist at Oxleas NHS
Foundation Trust, London, UK.
Ioanna Xenophontes is
Student/Lived Experience
Researcher at ResearchNet,
Oxleas NHS Foundation Trust,
London, UK.
Purpose The purpose of this paper is to examine a gap in knowledge about the interaction between
mentalizing skills and social inclusion activity immediate after completing an intensive mentalization-based
treatment (MBT) program.
Design/methodology/approach Lived experience was explored through the use of timelines, repeated
cycles of audio-recorded focus groups and inductive thematic analysis.
Findings Destructive cycles between self-hatred and social-exclusion were first disrupted by MBT
because people felt understood. Being understood reduced self-hatred which was an essential precursor for
attempting new forms of mentalizing in social interactions. This process was challenging but continued as
a virtuous cycle after treatment finished.
Research limitations/implications The sample was limited because at three, it was small. However, the
study was co-produced between professional and service users at all stages. Lived experience was carefully
explored in depth and triangulated between three people. The authors acknowledgetoo that they have reflected
on experience within only one to three years after MBT finished. Future studies might usefully replicate the
methodology to trace experience up to the eight year follow up point undertaken byBateman and Fonagy (2008).
Practical implications There is a great sense of loss for service users when therapy ends and that ending
needs to be managed on both sides. Service users start to acquire powerful new skills and thought
processes at the end of therapy. While this may not be overwhelming, they will not be used to them and so it
helps when therapists help service users think about their plans and ideas for things they want to do or
changes they might make in their lives.
Originality/value While supporting quantitative data about the outcome of therapy, this study offers the
type of qualitative detail about how the psychological and social interact post-therapy, which can inform
the successful management of those processes by those involved.
Keywords Qualitative research, Lived experience, Recovery, Art therapy, Borderline personality disorder,
Paper type Research paper
This paper explores what three people experienced immediately after they completed an
intensive mentalization-based treatment (MBT) program. The intervention was undertaken in
an NHS mental health community setting in London and lasted for 18 months and consisted
of weekly verbal individual sessions and group-based art therapy.
At the point of writing three authors, Emma Johnson, Marie-France Mutti and Ioanna
Xenophontes (EJ, M-FM and IX) had finished MBT between one and two years previously.
They had undertaken new roles in order to increase their social inclusion. All were members of
ResearchNet (Springham et al., 2011) as lived experience researchers (hereafter referred to as
LERs). Two were also studying psychology degrees. Two took part in shadowing members of
Emergence, a service user led community interest company which aims to improving
PAG E 44
VOL. 20 NO. 1 2016, pp. 44-51, © Emerald Group Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-11-2015-0042

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