Research Impact


UCL-developed Mentalisation Based Therapy helps transform mental health practice

The Mentalisation-Based Therapy development at UCL has influenced the clinical practice of 14,931 mental health practitioners in 22 countries, supporting better mental health for adults and children.

Close up of mother hands covers hands of little daughter

28 April 2022

The term mentalisation describes our ability to perceive and understand others and ourselves in terms of mental states. Research at UCL has identified links between the deep emotional ties we form with others and mentalisation. The work has provided three key pieces of evidence that form the basis of a new suite of therapies to support vulnerable adults and children.

The team, led by Professors Peter Fonagy and Pasco Fearon at the UCL Division of Psychology and Language Sciences, showed that attachment plays an important role in mental health and insecurity of childhood attachment is markedly increased in adults with psychiatric disorders. They also found this tendency for insecure attachment can be passed from one generation to the next and it is a caregiver’s capacity for mentalising that drives this intergenerational process.

Quality of care and mentalising

Parents’ ability to mentalise supports their capacity to read accurately and respond sensitively to their child’s cues and communications, which then promotes security of attachment. The UCL team discovered that a caregiver’s capacity to mentalise can affect quality of care and can mean that insecure attachments develop in the next generation. Further, they discovered that childhood adversity can impact on mentalising.  

Attachment related trauma, such as neglect or other forms of abuse, impairs the development of mentalising and leads to a greater risk of behavioural problems and lower social competence across childhood. In more severe cases, Borderline Personality Disorder (BPD) associated with major problems of social understanding and emotional regulation linked to mentalising impairment, results.

Therapy that leads to change

To help people at risk to develop better mentalisation, the UCL team developed Mentalisation-based therapy (MBT). It is one of the first theoretically grounded psychotherapies to be underpinned by a clear mechanism of how therapy leads to change that can been applied right across the lifespan.

MBT has been tested in clinical trials for use in Borderline Personality Disorder (BPD), and has been shown to provide long- term positive effects on BPD symptoms. It is also effective in treating depression, self-harm, suicide risk and interpersonal problems where the regulation of emotion is a central problem.

New therapies based on the research have been developed, trialled and rolled out in practice for the treatment of other specific groups. These include:  

  • Adolescent Self-Harm (MBT-A) (now implemented in England, Scotland and N. Ireland and 15 other countries)
  • Adults with Antisocial Personality Disorder
  • Children and families (MBT-C, MBT-F)
  • Adaptive Mentalisation-Based Integrative Treatment (AMBIT) (which optimises functioning of mental health and social care teams caring for children).   

Influencing clinical practice worldwide

Through a longstanding partnership with the charity the Anna Freud National Centre for Children and Families, more than 14,000 practitioners worldwide have been trained in the MBT therapies developed at UCL and attachment-based therapies are now at the core of the national training curriculum for mental health practitioners, with almost 100 CAMHS Under 5s practitioners trained to date. 

MBT is also embedded in clinical guidelines for treatment of mental health disorders such as BPD in Denmark, Sweden and Switzerland and 13 MBT Centres have been set up across Europe, North America, Australia and New Zealand.

The research team also included Professor Anthony Bateman, Dr Camilla Rosan, Dr Liz Allison, Professor Nick Midgley and Professor Patrick Luyten.

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Research synopsis

Improved practice and better mental health for adults, children, adolescents and families through Mentalisation-Based Therapy

Research at UCL on the relationship between attachment and mentalisation resulted in the Mentalisation Based Therapy approach. This has had a transformative impact on clinical practice. 14,931 practitioners in 22 countries have been trained to use these therapies, supporting better mental health for adults, children and their families.