Loading...
Loading...
Therapy role-play · MBT
Also written Mentalisation-Based Treatment
Anthony Bateman and Peter Fonagy developed Mentalization-Based Treatment to help clients keep hold of their own and other people’s minds when emotions run high. Almost everything in MBT comes down to the therapist’s stance and timing, and neither is easy to learn from a book. Simulated sessions let you rehearse both.
Why this therapy
MBT reads many relationship crises and acts of self-harm as the same event: a moment when the ability to understand minds collapses under emotional pressure. The client is certain what the other person thinks, and acts on it. MBT rebuilds the capacity to wonder instead, about one’s own mind and other people’s, so the client can stay in contact with thinking when feelings run high. Your job is to model that curiosity, not to supply the answers.
Each protocol follows its published treatment model, and so does your feedback.
Simulated clients are a training aid. They do not replace supervised work with real clients.
Each one is reviewed in your debrief, with one concrete thing to try next time.
Stay curious about the client’s mind instead of assuming you understand it. The moment you tell a client what they “really” feel, you have left the model.
When mentalizing collapses, stop. Rewind to the moment before it went, and walk through what happened slowly.
Work with the feeling in the room as it is happening, rather than the story about last week.
Explore what is happening between you and the client, including when the client is angry with you. Explaining yourself is the usual mistake.
Keep arousal in the range where thinking is possible. A clever interpretation offered to a client who is flooded adds threat and nothing else.
Recognise psychic equivalence, pretend mode and teleological thinking as they appear, and respond to the mode rather than the content. Fluent psychological talk with no feeling behind it is pretend mode, however insightful it sounds.
Agree a crisis plan early, as the MBT structure requires, and return to it whenever risk rises. If self-harm is already on the table in the first session, the plan belongs in that session.
The same client carries across modes. Start where you feel comfortable, then stretch.
Each client comes with a history, a presentation and measures. Read the referral as you would on placement, then begin.
The client responds to how you work. Make your mistakes here, where they cost nothing; hints come only if you ask for them.
A clear debrief on the core skills of your model (the CTS-R for CBT). Then take any one skill into a focused drill and work on it until it holds.
Understanding behaviour in terms of the thoughts, feelings and intentions behind it, in yourself and in other people. It is also spelled mentalisation.
Mainly clients with borderline personality disorder, self-harm and intense, unstable relationships. MBT for Adolescents (MBT-A) adapts it for young people and their families.
Practise MBT with us
Leave your details and our team will contact you on WhatsApp to set up your practice, answer your questions and find the right programme for you.