Systemic psychotherapy for ‘harder to reach’ families; mentalization‐based therapeutic interventions for families and the politics of empiricism

Abstract

In this article I explore the relationship between systemic psychotherapy and the model of mentalization‐based therapeutic interventions for families (MBT‐F) presented by Eia Asen and Peter Fonagy. I consider two important contextual elements in MBT‐F; firstly, the influence of the empiricist tradition in which it is anchored and secondly, the political context of this work. Both elements need disentangling from theoretical and clinical concerns to facilitate greater clarity in debates about mentalization and in wider therapeutic discourse. In essence, I conclude that dialogue between systemic and mentalization perspectives can extend well beyond the empiricist framing of MBT‐F in directions that are more broadly consistent with systemic concerns and interests, not least of which is the ongoing challenge to engage ‘harder to reach’ families in innovative systemic psychotherapy. Practitioner points A focus on mentalization draws us towards the common ground between the different therapies and their shared challenges. Thinking about mentalization has the potential to enhance the systemic practitioner's engagement with ‘harder to reach families’. Thinking systemically has much to offer the mentalization debate. Creative dialogue between systemic and mentalization perspectives can take many pathways beyond the empiricist framing of the MBT‐F model.

Conceptualisation and Measurement of Reflective Process in Psychotherapy: A Systematic Scoping Review

“…How we understand this process has significant implications for psychotherapy practice and training. Viewing problems and potential solutions as relational or systemic is not new in the family therapy field (Dallos & Draper, 2010;Donovan, 2015) and critiques of individualism in mental health care are increasing (Henderson, 2008), however our results suggest further research may contribute to understanding this process from a relational perspective. To do this a clear description of replicable analysis of intersubjective therapeutic talk will be important, along with uncovering how such talk supports recovery.…”

Theoretical frameworks for working with harder to reach families: lines, curlicues, and spirals: comment on Donovan and Pocock

“…David Pocock's ‘A philosophy of practice for systemic psychotherapy: the case for critical realism’ (2015) and Mary Donovan's ‘Systemic psychotherapy for ‘harder to reach’ families; mentalization – based therapeutic interventions for families (MBT‐F) and the politics of empiricism’ (2015) add substantial weight to this shift. Both offer rich discussions and examples of integrating theoretical and practice worlds in ways that are useful to practitioners in today's political context.…”

“…While Pocock offers an integrative theoretical frame, Donovan (2015) offers an integration of mentalization-based therapeutic interventions for families (MBT-F) and systemic therapies as a way to work with 'harder to reach families'. She eloquently delineates the narrowing effects of the empiricist tradition from which mentalization comes, and identifies areas of commonality between systemic practice and MBT-F. She speaks of crossing boundaries and bridging gaps, and the Kantian philosophical system, which 'left space for that which cannot be known ' (p. 16).…”