Mentalization-Based Treatment With a 10-Year-Old Boy
For individuals in the U.S. & U.S. territories
Mentalization is an ability that most people naturally develop in late childhood involving the ability to accept that other people's actions derive from inner states and intentions, and the ability to imagine what those inner thoughts and desires might be. Similar to the ability to empathize, mentalization is key to regulating emotions and developing relationships.
Mentalization-based treatment for children seeks to help foster this ability and keep clients aged 5–12 on track developmentally.
In this video, Norka Malberg demonstrates this approach with a 10-year old boy with attention-deficit disorder. Dr. Malberg and Karin Ensink discuss highlights from the session and key elements of this therapy.
This video features an actor portraying a client on the basis of a composite of case material.
Mentalizing involves understanding the mental states (e.g. thoughts, feelings, intentions) of oneself and others, and the operation of this capacity is referred to as reflective functioning (RF). The ability for RF can mediate affect regulation and positive interpersonal relations, while deficits in RF can drive misperceptions of others' mood and behavior.
When a child fails to develop a sufficient capacity to mentalize, they are deprived of one of the most valuable tools to maneuver relationships, a skill that is at the heart of both the capacity to self-regulate and to manage an increasingly complex interpersonal world. The capacity to mentalize creates resilience and internal resources in the face of a demanding external world.
For many clinicians, it is essential to be able to offer relatively brief interventions that can be of benefit to a wide range of children and families. By focusing on a core capacity that may promote resilience in a wide range of children, with a variety of presenting problems, a time-limited mentalization-based treatment for children (MBT-C) aims to be a generic therapy that can be adapted to the needs of a range of youths in middle childhood (ages 6–12).
The aim of MBT-C is to promote mentalizing and resilience in such a way that the developmental process is set back on track, and the child can develop a capacity to identify, regulate and express emotions in an age appropriate way. Working with parents alongside the time-limited individual therapy with the child is an essential element of MBT-C, helping parents to develop some capacity to see their own affects and behaviors from the outside, the impact of which will give parents the skills to support their child's mentalizing capacity after the therapy period has ended.
Norka T. Malberg, PsyD, is a certified child psychoanalyst. She trained at the Anna Freud Centre in London and obtained her clinical doctorate from University College London.
She is currently in private practice in New Haven, CT where she is an assistant clinical professor at the Yale Child Study Center. She is currently a member of the Western New England Psychoanalytic Institute, the Contemporary Freudian Society. She is a clinical instructor at the Massachusetts Institute for Psychoanalysis in Cambridge and the International Psychotherapy Institute in Washington DC. She serves on the board of the Association for Child Psychoanalysis and is past president of Section 2 (Children and Adolescents) of APA Division 39 (Psychoanalysis).
Dr. Malberg is co-editor a book of the Lines of Development Book Series by Karnac Books for which she co-edited the first book: The Anna Freud Tradition. She is on the editorial board for the Psychoanalytic Study of the Child and the Journal of Infant, Child and Adolescent Psychotherapy. Dr. Malberg is the co-editor of the Child and Adolescent Sections of the upcoming PDM-2 (Psychodynamic Diagnostic Manual). She is one of five authors of the APA book Mentalization-Based Treatment for Children: A Time-Limited Approach and recently featured as guest master clinician in the APA Video Series illustrating mentalization-based treatment techniques.
Karin Ensink, PhD, is a professor of child and adolescent psychology at the Université Laval in Québec, Canada, where she teaches mentalization-based treatment and psychodynamic psychotherapy with children, adolescents, and parents. She completed her PhD under the direction of Mary Target and Peter Fonagy.
Her research and clinical work continue to focus on the development and assessment of mentalization in children, adolescents, and parents. She has a particular interest in understanding failures of mentalization in the context of parent–child interactions and how this relates to psychopathology and personality, as well as treatment.
- Allen, J. G., & Fonagy, P. (Eds.). (2006). Handbook of mentalization-based treatment. London, England: Wiley.
- Fonagy, P., Gergely, G., Jurist, E. & Target, M. (2002). Affect regulation, mentalization and the development of the self. New York: Other Press
- Midgley, N. & Vrouva, I. (Eds.), (2012) Minding the child: Mentalization-based interventions with children, young people and their families. London, England: Routledge.
- Midgley, N., Ensink K., Lindquist, K., Malberg, N. T. & Muller, N. (2017). Mentalization-based treatment for children: A time limited approach. Washington, DC: American Psychological Association.
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