The role of therapists’ mentalizing interventions in facilitating narrative change in group psychotherapy

Introduction: Research suggested that the implementation in the therapeutic process of mentalization-based interventions, such as exploration of mental states, is associated with patients’ in-session improvement of mentalizing. Moreover, adherence, but preeminently competence in performing interventions according to the mentalization-based manual, has been found associated with narrative change of patients, both in the individual and group psychotherapy. Aim: This study aims at analyzing the association between adherent and competent mentalization-based interventions and group members’ narrative change as measured by the newly developed Innovative Moments Coding System for Groups (IMCS-G), which allows to track, among group members, meaningful interactions (i.e., Innovative Moments, IMs), that represent narrative exceptions to their dominant problematic narratives. Methods: Three different group treatments, counselling for university students (N = 6), short-term psychotherapy for addicted patients (N = 8) and short-term psychotherapy for patients with chronic illness (N = 10) are considered for this study. A total of 22 group sessions were transcribed verbatim and analyzed. To code therapist’s mentalizing interventions, the Mentalization-Based Treatment for Group Adherence and Competence Scale was used, that allows to obtain an index for adherence (i.e., the percentage of mentalizing interventions on the total of the therapist’s interventions) and for competence (on a Likert scale from 1 – low – to 7 – excellent). To track group members’ narrative change, it was used the IMCSG, that allows to identify IMs on 3 levels of increasing complexity in terms of meaning elaboration, and 7 IM categories (Self-directed, Other-directed, Explicit Mirroring, Prompting Change, Reinforcing Change, Collective and Voice of Group IMs) that are organized into 2 macro-categories, Individual and Group IMs. Results: Results showed that the MBT-G adherent and competent therapist’ interventions are crucial for the emergence of both Individual and Group IMs at level 3, namely the ones with the higher reflective complexity. Conclusion: A mentalizing stance of the group therapist could facilitate a complex and reflective narrative change for the group members.