MBT for BPD — MRCPsych Paper B MCQ

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EasyPersonality DisordersMBT for BPDMRCPsych Paper B

A specialist personality disorder service offers an adult with borderline personality disorder a structured 18-month psychotherapy programme combining individual and group sessions. The therapist adopts a curious “not-knowing” stance and repeatedly explores how the patient understands their own and other people's thoughts, feelings and intentions. Which psychological therapy is described?

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Correct answer: A — Mentalisation-based therapy

The correct answer is A, mentalisation-based therapy (MBT). Developed by Bateman and Fonagy for borderline personality disorder, MBT aims to strengthen the ability to understand behaviour in terms of one's own and other people's thoughts, feelings, wishes and intentions. A curious, collaborative “not-knowing” stance is characteristic, and the established programme combines individual and group sessions over approximately 18 months. DBT also commonly combines individual and group work, but principally emphasises mindfulness, distress tolerance, emotion regulation and interpersonal-effectiveness skills, particularly where recurrent self-harm is prominent. Schema therapy focuses on maladaptive schemas and schema modes, while CAT uses reformulation and reciprocal-role procedures. NICE supports structured psychological treatment for BPD but does not specifically recommend MBT by name.

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