The journey from epistemic vigilance to epistemic trust: service-users experiences of a community mentalization- based treatment programme for Anti-Social personality disorder (ASPD)

ABSTRACT

Mentalization-Based Treatment (MBT) is a psychological intervention, delivered predominantly in a group-format, originally developed for individuals with a personality disorder. Evidence is growing for this approach as a successful model of treatment, with much of the research to date conducted within inpatient settings. This study explored service-users experiences of a community-based MBT programme in a probation setting for males, diagnosed with Anti-Social personality disorder (ASPD). Using thematic analysis, results from six semi-structured interviews revealed that individuals experienced MBT as largely positive and having had an impact on their lives. Five themes emerged; ‘Experience of the group’, ‘Attachment’, ‘Learning flexibility’, ‘Individual sessions’ and ‘Impact’ with associated categories and sub-categories. Participants appeared to reflect not only on their experiences but also the internal process that occurred during their time within MBT. This was understood as the transition from chronic epistemic vigilance to epistemic trust and implications for practice are discussed. Despite its limitations, this study contributes to the growing evidence-base for MBT and specifically its positive application within community contexts for offenders with ASPD – a traditionally ‘difficult to reach’ client group.

KEYWORDS:

• Mentalization based treatment
• Anti-Social personality disorder
• service user experience
• thematic analysis

Acknowledgments

The authors wish to thank the participants who took part in this study and provided their valuable perspectives. This paper is dedicated to one of the participants who sadly passed away before this paper was published.

Data availability statement

Dataset available on request from the corresponding author.