Mentalization-Based Treatment for Children

Nick Midgley, PhD, is a child and adolescent psychotherapist, and professor of psychological therapies with children and young people at University College London and the Anna Freud Centre in London, where he is the director of the Child Attachment and Psychological Therapies Research Unit. Nick has been involved in the development of mentalization-based treatments for children and families and has a particular interest in evaluating therapy for children in foster care. Karin Ensink, PhD, is a professor of child and adolescent psychology at the University Laval in Quebec, Canada, and teaches mentalization-based therapy and psychodynamic psychotherapy with children, adolescents, and parents. She completed her PhD under the direction of Mary Target and Peter Fonagy. Her research and clinical work focuses on the development and assessment of mentalization in children, adolescents, and parents. She has a particular interest in understanding failures of mentalization in the context of parent-child interactions, and in how these failures relate to psychopathology, personality, and treatment. Karin Lindqvist, PhD, is a clinical psychologist and psychotherapist with a PhD in clinical psychology from Stockholm University. She is trained in mentalization-based work with children (MBT-C) and parents at the Erica Foundation in Stockholm. Karin's research concerns different areas of psychodynamic psychotherapy with children, adolescents, and adults. Norka Malberg, PhD, is an adult, child, and adolescent psychoanalyst and psychotherapist who trained at the Anna Freud Centre in London and the Western New England Psychoanalytic Institute in New Haven, Connecticut. She obtained her clinical doctorate at University College London. She is an assistant clinical professor at Yale's Child Study Center in New Haven, Connecticut, and clinical instructor at the Fundación Vidal y Barraquer Institute of Ramon Lllul University in Barcelona, Spain. She is the founder and director of IMAGINA: Centro de Aplicaciones de la Mentalización in Barcelona, Spain, a teaching and private practice organization. Nicole Muller, MSc, is a child and adolescent psychotherapist and family therapist at Centrum Hecht in Holland, a specialist centre for the treatment of children, youth, and their families with attachment and trauma problems. She is a mentalization-based treatment (MBT) practitioner with children and young people (CYP) and a supervisor and trainer for the Anna Freud Centre in London. With her colleagues, she runs Centrum Hecht Opleidingen in Holland, a training center specializing in MBT-CYP. She has written many articles on MBT and is co-editor of Mentalization-Based Treatment for Developmental Trauma: A Casebook for Working with Children and Their Families (2025).

"Mentalization-Based Treatment for Children, Second Edition stands as a compelling articulation of how reflective functioning and mentalization can be cultivated in children whose early relational experiences have disrupted their capacity to make sense of minds—their own and those of others. Grounded in developmental and psychodynamic theory, and animated by careful clinical attention, this volume shows how thoughtfully held therapeutic relationships can restore meaning and emotional coherence, and encourages psychological growth. It is an indispensable work for clinicians committed to igniting children's curiosities about their internal worlds in the service of relationship building and repair." - Miriam Steele, PhD, Alfred J. and Monette C. Marrow Professor in Psychology, New School for Social Research, New York, NY, United States"I very warmly recommend this book to clinicians, and to anyone interested in learning about helping troubled children. It is very clearly written and organized, with reference to the broader background of theory and work with adults, and presents the great progress made in working with children, since the first edition. The authors are international leaders in this field, and this book is a major contribution." - Mary Hepworth (formerly Mary Target), PhD, Professor, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom"This second edition offers a wonderfully nonstigmatizing and deeply respectful look into the inner worlds of children, especially at a time when COVID's aftereffects and rapid technological change make reflective thinking harder to sustain. The authors bring the model to life through rich case studies and thoughtful attention to cultural context, giving clinicians a clear and robust framework they can trust. It's a timely, humane, and genuinely practical guide for anyone who wants to help children reclaim their capacity to make sense of themselves and others." - Francine Conway, PhD, Distinguished Professor, Rutgers University, New Brunswick, NJ, United States"This inspiring second edition of Mentalization-Based Treatment for Children transforms cutting-edge science into a practical, developmentally attuned response to today's urgent child and family mental health needs. It stands out through its vibrant synthesis of developmental theory, attachment research, mentalization-based treatment scholarship, and the realities of everyday clinical work—all held within a flexible and evidence-informed framework. With its focus on the building blocks of mentalizing, the role of parents, and time-limited goals, this manual becomes an indispensable resource for clinicians committed to nurturing children's emotional growth and resilience." - Nicole Vliegen, PhD, clinical psychologist and psychodynamic child psychotherapist; Professor of Clinical Psychology, Leuven University, Leuven, Belgium"This book provides a very clear, well-organized, and integrated presentation of how and why to practice a brief, structured approach of mentalization-based treatment with children. It demonstrates the utility of a developmental approach to therapy and is brought to life with vivid examples. It should be an invaluable resource to any clinician or educator involved in the care of children." - Efrain Bleiberg, MD, Professor of Psychiatry and Child and Adolescent Psychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States; Educational Consultant, Houston Center for Psychoanalytic Studies

• Acknowledgments.ForewordBy Peter Fonagy Introduction: Why We Developed Time-Limited MBT for ChildrenPart I. Theoretical Framework and Evidence BaseChapter 1. The Development of MentalizingChapter 2. When the Capacity for Mentalizing Is Underdeveloped or Breaks DownChapter 3. The Evidence Base for MBTPart II. The Therapeutic ApproachChapter 4. The Structure and Aims of Time-Limited MBT-CChapter 5. The “Therapist Stance”Chapter 6. The Process of AssessmentChapter 7. Working With Children on the Building Blocks of MentalizingChapter 8. Working With Children on Explicit Mentalizing and Breakdowns in MentalizingChapter 9. Working With Parents From a Mentalization-Based FrameworkChapter 10. Moving Toward Goodbye: Endings in Time-Limited MBT-CChapter 11. A Case Study Conclusion: Looking ForwardReferencesAppendix A. Measures of Mentalization in Children and ParentsAppendix B. The MBT-C Adherence ScaleAbout the Authors