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Psychotherapy Research Volume 33, 2023 - Issue 5
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Empirical Papers

Mentalization-enhancing therapeutic interventions in the psychotherapy of anorexia nervosa: An analysis of use and influence on patients’ mentalizing capacity

Alexander Ferdinand Meier1 Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, GermanyView further author information
,
Almut Zeeck1 Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, GermanyView further author information
,
Svenja Taubner2 Institute for Psychosocial Prevention, Center for Psychosocial Medicine, University Hospital, Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0001-8058-762XView further author information
ORCID Icon,
Thorsten Gablonski3 Department for Psychology, Psychotherapy and Psychoanalysis, Institute for Psychology, University of Klagenfurth, Klagenfurth, AustriaView further author information
,
Inga Lau1 Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, GermanyView further author information
,
Romi Preiter4 Department for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, GermanyView further author information
,
Hannes Gläser4 Department for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, GermanyView further author information
,
Stephan Zipfel5 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, GermanyORCID Iconhttps://orcid.org/0000-0003-1659-4440View further author information
ORCID Icon,
Wolfgang Herzog6 Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0003-2778-4135View further author information
ORCID Icon,
Beate Wild6 Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, GermanyView further author information
,
Hans-Christoph Friederich6 Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0003-4344-8959View further author information
ORCID Icon,
Gaby Resmark5 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, GermanyView further author information
,
Katrin Giel5 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, GermanyView further author information
,
Martin Teufel7 Department of Psychosomatic Medicine and Psychotherapy, LVR Universityhospital Essen, University of Duisburg-Essen, Essen, GermanyView further author information
,
Markus Burgmer8 Department of Psychosomatics and Psychotherapy, LWL-Hospital Muenster and University Hospital Muenster, Muenster, GermanyView further author information
,
Andreas Dinkel9 Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, GermanyView further author information
,
Stephan Herpertz10 Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic, Ruhr-University Bochum, Bochum, GermanyView further author information
,
Bernd Löwe11 Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyView further author information
,
Sefik Tagay12 TH Köln, University of Applied Sciences, Köln, GermanyView further author information
,
Jörn von Wietersheim13 Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, GermanyView further author information
,
Martina De Zwaan14 Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, GermanyView further author information
&
Armin Hartmann1 Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, GermanyCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-4158-6576View further author information
ORCID Icon show all
Pages 595-607 | Received 28 Jan 2022, Accepted 31 Oct 2022, Published online: 06 Dec 2022
 
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ABSTRACT

Objective

Improvement in patients’ mentalizing capacities is considered a possible mechanism of change in psychotherapy. This improvement might take place via mentalization-enhancing interventions (MEIs) performed by psychotherapists. The study aimed to explore the use of MEIs in two evidence-based psychotherapeutic treatments for patients with anorexia nervosa (enhanced cognitive-behavior therapy, focal psychodynamic therapy) and their association with the patients’ capacity to mentalize in sessions (“in-session reflective functioning” / in-session RF). Additionally, it was explored, if the amount of MEIs used could either predict change in in-session RF or outcome (end of treatment, one year follow-up).

Method

84 audiotapes from psychotherapy sessions of 28 patients of the ANTOP-study (three sessions per patient) were transcribed and rated with both the MEI Rating Scale and the In-Session RF Scale by trained raters.

Results

MEIs were applied in both treatments. A moderate correlation between the amount of MEIs and patients’ in-session RF as well as its change over the course of treatment was found, but no relation to change in BMI or eating disorder symptoms.

Conclusion

A greater use of MEIs was related to patients’ in-session-mentalizing. However, there seems to be no simple relation between RF as shown in sessions and symptom change.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplemental data

Supplemental data for this article can be accessed https://doi.org/10.1080/10503307.2022.2146542

Additional information

Funding

The ANTOP-study was funded by the BMBF (01GV0624). There was no funding of this secondary data analysis.

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