Understanding Mentalisation Based Therapy (MBT)

If you’ve been offered Mentalisation Based Therapy (MBT), you might have questions about what it is, how it works, and how it can help. This page explains the basics and answers some common questions.

What is MBT?

Mentalisation refers to the ability to understand and interpret what is happening in your own mind and the minds of others. This might include thoughts, emotions, and intentions. This ability can be disrupted by stress or trauma, leading to misunderstandings, emotional instability, and difficulties in relationships. 

MBT is an evidence-based therapy, recommended for use in the NHS. MBT was designed to help people with complex emotional and relational needs, including those with a diagnosis of borderline personality disorder (BPD) or emotionally unstable personality disorder (EUPD).

Why is MBT helpful?

MBT is a type of talking therapy that can help you to:

  • Understand your own thoughts and feelings.
  • Better interpret other people’s behaviour.
  • Help you feel more connected and understood in relationships.
  • Help you to feel more grounded and resilient.
  • Improve self-awareness and confidence in handling challenges.

MBT has been shown to help people cope with these difficulties and improve their quality of life.

Your therapist will discuss if MBT is suitable for you, based on your situation and experiences.

What happens in MBT?

MBT is usually a long-term therapy, often lasting 12-18 months, depending on your needs. Regular reviews ensure it remains helpful and relevant to your progress. MBT typically involves:

  • Individual sessions: One-to-one meetings with a trained therapist to explore your thoughts, feelings, and behaviours. Your therapist(s) will initially spend time with you getting to know the kind of situations which have tended to provoke strong emotional reactions in you, or which have led to shifts in your mood. They will also work with you to develop a shared understanding (formulation) of your key difficulties. This will include looking at how these difficulties affect and are affected by your relationships. This formulation is designed to help you focus your therapy but is meant to be flexible and can be reworked throughout your therapy. 
  • Group sessions: Opportunities to learn about and practice mentalising in a supportive group setting with other people who share similar challenges.

 

Therapy is structured but flexible. Sessions may focus on identifying and exploring situations where misunderstandings and assumptions affect relationships. MBT encourages reflection and exploration rather than finding “right” answers or solutions. The aim is to develop curiosity about your own and others’ thoughts and feelings.

Mentalisation therapists provide little direct advice, instead they encourage you to take a mentalising stance. This means helping you to work out your own solutions which will take time and practice. 

Common questions

How is MBT different from other types of therapy?

Unlike therapies that focus on changing behaviours or past experiences, MBT emphasises understanding your thoughts and feelings in the present and how they influence your relationships.

What if I find it challenging?

MBT can feel difficult because it involves examining thoughts and emotions. Your therapist will support you through the process and work at a pace that feels manageable. 

Is MBT suitable for me?

MBT can be helpful for people with complex emotional and relational needs, including those with a diagnosis of borderline personality disorder (BPD) or emotionally unstable personality disorder (EUPD). However, it’s not the right fit for everyone. Your therapist or mental health team will work with you to assess if it’s a good fit for your needs. 

How do I access MBT?

Speak to your mental health practitioner about how to access MBT or other psychological therapies that may suit your individual needs and circumstances.

Where can I learn more?

Remember, you are not alone.

MBT can be a valuable tool in coping with mental health problems and improving your overall wellbeing.

As a patient

As a service user, relative or carer using our services, sometimes you may need to turn to someone for help, advice, and support. 

Find resources for carers and service users  Contact the Trust