Mentalization-Based Treatment for Children on the Autism Spectrum

Autism today is widely recognized as a common, lifelong neurodevelopmental difference. Although the neurodiversity movement has helpfully reframed autism as a difference to be respected, not a disorder to be cured, many psychotherapeutic approaches today still focus on behavioral normalization rather than emotional well-being and relational development. Therapies that address the emotional and relational needs of autistic children while respecting their neurological differences are still desperately needed.This book is a clinical guide to applying mentalization-based treatment (MBT) to children on the autism spectrum. MBT offers a framework for enhancing emotional regulation and social connection by linking behavior to mental states, and thereby shifting the clinical focus from categorical diagnoses to a dynamic, strengths-focused perspective seeking to understand behavior. The approach, grounded in robust empirical evidence, extends mentalization-based treatment for children (MBT-C) to autistic children and their families, validating autistic perspectives and fostering mutual understanding between autistic and non-autistic individuals. The authors explore the background and theory of MBT-C, offer clinical case examples to show how clinicians can approach assessment, develop a focus formulation and mentalization profile, and adopt a mentalizing stance. They also discuss common challenges realted to collaborating with parents, siblings, schools, and other systems. This developmental, relational, and neurodiversity-informed approach promotes epistemic justice by positioning autistic children as intentional agents whose perspectives, reasoning processes, and lived experiences are meaningful and worthy of collaborative exploration.