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MBT — MRCPsych Paper B MCQ

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ModeratePsychotherapyMBTMRCPsych Paper B

During psychotherapy, a patient with borderline personality disorder becomes convinced that a neutral expression on a friend's face proves that the friend is angry and intends to reject them. The therapist adopts a curious stance and explores what the patient and the friend might each have been thinking or feeling, while highlighting how certainty about the friend's intention increased during emotional arousal. Which therapeutic modality is being used?

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Correct answer: B — Mentalisation-based therapy

The correct answer is B, mentalisation-based therapy (MBT). Mentalising is the capacity to understand behaviour in terms of one's own and other people's thoughts, feelings, wishes and intentions. In borderline personality disorder this capacity may deteriorate during emotional arousal, producing rigid certainty about another person's motives. The therapist's curious stance and exploration of several possible perspectives are characteristic of MBT. CBT may examine and reappraise hostile interpretations, but its broader focus is the relationship between cognitions, emotions and behaviour. DBT primarily emphasises behavioural targets and skills in mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Schema therapy addresses enduring maladaptive schemas and associated coping modes, while cognitive analytical therapy maps recurrent relational procedures and reciprocal roles.

Reference: Royal College of Psychiatrists. Personality disorder, section 'Mentalisation Based Therapy (MBT)', 2025. https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/personality-disorder