PETER FONAGY
Anna Freud Centre, London, UK

Treatment outcome of mentalisation-based interventions for selfpathology

This paper will describe the structure and key components of an outpatient treatment program for suicidal severely self-harming women and men with a diagnosis of borderline personality disorder. There is accumulating evidence that borderline PD responds to psychological therapies of various kinds, ncluding DBT, CBT, CAT, TFP and SFT. So far MBT has only been tested as part of a day treatment program. We have recently completed the treatment of 136 patients randomly assigned to structured clinical management or MBT. MBT was superior to structured clinical management (SCM) in reducing selfharm, hospitalization and suicide rates. The results suggest that MBT is an effective component of an outpatient as well as a partial hospital package and superior to an active control treatment. We found no specific or global predictors of treatment outcome in the first phase of data analysis and we were not able to demonstrate that improvements in mentalization explained the clinical effectiveness in MBT.

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