Mentalization in Children and Adolescents, and Treatment Based on Mentalization for Adolescents

Mentalization is a preconscious mental activity that enables the individual to understand themselves and others in terms of subjective states and mental processes. Impaired attachment and psychological trauma in childhood are associated with impairments and deficits in mentalization and with the development of psychopathology in youth, including borderline personality disorder. Mentalization-based treatment for adolescents (MBT-A) was developed from basic MBT modified specifically for the adolescent population. MBT-A is a psychodynamically-oriented structured psychotherapy for adolescents with features of borderline personality disorder, i.e. emotional dysregulation, self-harming behaviour and interpersonal problems. The focus of the therapeutic process is the patient's capacity for mentalization. Randomized controlled trials have demonstrated the effectiveness of this treatment for patients with borderline personality disorder. This review article aims to describe the concept of mentalization, the development of this capacity in childhood and adolescence in context of attachment relationship, the specificity of mentalization-based treatment for adolescents that primarily targets the deficits involved in the psychopathology of borderline personality disorder and summarise the evidence, supporting its effectiveness.