Challenges for therapists from a mentalizing perspective in groups for drug addicted

Aims. One of the main challenges in group therapy for drug addicted patients is collective pseudomentalization (Arefjord, Morken & Lossius, 2019), e.g. a group discourse consisting of words and clichés that are decoupled from inner emotional life and poorly related to external reality (Bateman & Fonagy, 2019). This single-case and qualitative study aims to explore the phenomenology of pseudomentalization and how it was handled by the therapist in an outpatient group for drug addicted patients. Method. The group was composed of seven members and the transcripts of eight audio-recorded sessions (one for month) were rated and studied. The therapist’s interventions were measured with the mentalization-based group therapy adherence and quality scale (Karterud, 2015) by two independent raters; two sessions, one with a high and one with a low adherence, were selected, and the clinical sequences of pseudomentalization were analysed in a comparative way. Results. Findings showed that in the session with low adherence, there were more and longer clinical sequences of pseudomentalization which often involved all the group members. In the session with high adherence, the few sequences of pseudomentalization were more effectively handled by the therapist who provided short interventions focused on emotions, involved the group members in mentalizing external events, and managed group boundaries and authority. Conclusions. Pseudomentalization in group psychotherapy can be identified, as well as interventions that seems to favor it or to prevent or overcome it.