Systemic psychotherapy for ‘harder to reach’ families; mentalization-based therapeutic interventions for families and the politics of empiricism

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In this article I explore the relationship between systemic psychotherapy and the model of mentalization-based therapeutic interventions for families (MBT-F) presented by Eia Asen and Peter Fonagy. I consider two important contextual elements in MBT-F; firstly, the influence of the empiricist tradition in which it is anchored and secondly, the political context of this work. Both elements need disentangling from theoretical and clinical concerns to facilitate greater clarity in debates about mentalization and in wider therapeutic discourse. In essence, I conclude that dialogue between systemic and mentalization perspectives can extend well beyond the empiricist framing of MBT-F in directions that are more broadly consistent with systemic concerns and interests, not least of which is the ongoing challenge to engage ‘harder to reach’ families in innovative systemic psychotherapy.

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