Mentalization-Based Therapy for Children and Families: A Systematic Review and Meta-Analysis of the Recent Literature

This systematic review evaluated the impact of Mentalization-Based Therapy (MBT) parenting interventions on parental reflective functioning (PRF, the operationalized measure of the metalizing construct), child psychosocial outcomes, and parenting factors. A meta-analysis of studies measuring PRF using the Parental Reflective Functioning Questionnaire (PRFQ) indicated small, non-significant effects, with high heterogeneity across studies. Narrative synthesis of 19 studies suggested generally positive outcomes, including improvements in PRF, child emotional regulation and parental stress, though findings were inconsistent. The variability in outcomes likely reflects methodological limitations, including lack of control groups, limited fidelity reporting, and diversity in intervention protocols and outcome measures. Only a minority of studies clearly adhered to manualised MBT models. While some high-quality studies showed sustained benefits, the evidence remains inconclusive regarding PRF as a primary mechanism of change. This review highlights the need for more rigorous, high-quality trials with fidelity checks and standardised reporting to clarify the efficacy and mechanisms of MBT parenting interventions.

Plain Language Summary

• Mentalization-Based Therapies (MBT) for parenting are increasingly used in clinical practice.

• The current review provides inconsistent results in terms of whether MBT therapies actually increase parental reflective functioning (parents’ ability to understand their child’s behavior in terms of underlying mental states).

• Programs that adopt MBT principles may help with child regulation and parental stress.