Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial

J Am Acad Child Adolesc Psychiatry. 2012 Dec;51(12):1304-1313.e3. doi: 10.1016/j.jaac.2012.09.018.


Objective: We examined whether mentalization-based treatment for adolescents (MBT-A) is more effective than treatment as usual (TAU) for adolescents who self-harm.

Method: A total of 80 adolescents (85% female) consecutively presenting to mental health services with self-harm and comorbid depression were randomly allocated to either MBT-A or TAU. Adolescents were assessed for self-harm, risk-taking and mood at baseline and at 3-monthly intervals until 12 months. Their attachment style, mentalization ability and borderline personality disorder (BPD) features were also assessed at baseline and at the end of the 12-month treatment.

Results: MBT-A was more effective than TAU in reducing self-harm and depression. This superiority was explained by improved mentalization and reduced attachment avoidance and reflected improvement in emergent BPD symptoms and traits.

Conclusions: MBT-A may be an effective intervention to reduce self-harm in adolescents.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Borderline Personality Disorder* / diagnosis
  • Borderline Personality Disorder* / psychology
  • Borderline Personality Disorder* / therapy
  • Cognitive Behavioral Therapy / methods*
  • Comorbidity
  • Depression* / diagnosis
  • Depression* / psychology
  • Depression* / therapy
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Risk-Taking*
  • Self-Injurious Behavior* / diagnosis
  • Self-Injurious Behavior* / psychology
  • Self-Injurious Behavior* / therapy
  • Theory of Mind*
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN95266816