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MBT Identification — MRCPsych Paper B MCQ

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ModeratePsychotherapyMBT IdentificationMRCPsych Paper B

A 28-year-old with borderline personality disorder enters a structured outpatient psychotherapy programme. It lasts 18 months and combines weekly individual and group sessions. The therapist adopts a curious, 'not-knowing' stance and explores misunderstandings about the patient's own and other people's thoughts, feelings and intentions, particularly when attachment-related arousal disrupts this capacity. Which psychotherapy is described?

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Correct answer: C — Mentalisation-based therapy

The answer is C, mentalisation-based therapy (MBT). Its central aim is to strengthen the capacity to understand behaviour in terms of one's own and other people's thoughts, feelings and intentions. The therapist uses an active, curious and not-knowing stance, especially when intense attachment-related affect causes mentalising to fail. The standard programme described by the Royal College of Psychiatrists combines individual and group work over 18 months. DBT may also combine individual and group sessions, but it is distinguished by behavioural target hierarchies and explicit training in mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Schema therapy targets maladaptive early schemas; CAT uses reformulation and reciprocal-role procedures; standard CBT focuses principally on relationships among thoughts, emotions and behaviour.

Reference: Royal College of Psychiatrists. Personality disorder, section 'Mentalisation Based Therapy (MBT)'. Accessed 19 August 2026. https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/personality-disorder