MBT — MRCPsych Paper B MCQ

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ModeratePsychotherapyMBTMRCPsych Paper B

A specialist personality disorder service offers a manualised 18-month psychotherapy programme comprising both individual and group sessions. The therapist adopts an active, curious, ‘not-knowing’ stance and helps patients understand their own and other people's behaviour in terms of underlying thoughts, feelings and intentions. Which psychotherapy is being described?

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Correct answer: C — Mentalisation-based therapy

Mentalisation-based therapy (MBT) is the Bateman and Fonagy treatment described. It aims to strengthen the capacity to understand behaviour in terms of one's own and other people's mental states. Characteristic features include an active, curious, ‘not-knowing’ therapeutic stance and a structured programme combining individual and group work, classically delivered over 18 months. DBT also commonly combines individual and group sessions, but its distinguishing components are mindfulness, distress tolerance, emotion regulation and interpersonal-effectiveness skills. Schema-focused therapy targets maladaptive schemas and modes, while CAT uses a collaborative reformulation and reciprocal-role procedures, often within a defined shorter course. Standard CBT primarily examines links between cognitions, emotions and behaviour rather than making restoration of mentalising its central therapeutic mechanism.

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