2 - (SYM 113) Mechanisms of Change During a Randomized Controlled Trial of a Web-based Mentalization Intervention

Mentalization (the process by which we understand others and our own mental states) is closely tied to emotion and interpersonal functioning. Mentalizing ability has proven to be responsive to treatment and to improve a variety of domains such as risky behaviors and social functioning. Given Mentalization Based Treatment is manualized and takes several months to complete, one aim of the present study was to determine if mentalization skills may be taught in a short-term self-guided manner. An additional aim is to examine emotion regulation and mentalization as mechanisms of change.

Participants were randomized to receive the intervention (n=30) or wait-list control (n=36). The intervention consisted of 4, 25-30min self-guided web-based modules and weekly homework. Participants in the intervention group completed at least 3 of the 4 modules. Assessments including the DERS, RFQ-Uncertainty, and IIP were completed at baseline, end of intervention, and 1-month follow-up.

            The intervention was highly acceptable on the Client Satisfaction Questionnaire (M=26.57). On average participants took 31 days to complete the intervention (Range= 27-42). Across conditions, repeated measures ANOVA indicated significant reductions in DERS during treatment and in IIP after treatment. The RFQU also declined during treatment, though this decline was greater for the intervention group. While both change in RFQU and DERS predicted change in IIP during treatment, only change in RFQU predicted change in IIP after treatment. Moderated mediation analysis indicated that reduction in DERS predicted reduction in RFQU during treatment across conditions, this reduction in RFQU resulted in improvements in interpersonal problems at follow-up only for those in the intervention condition.

Findings suggest that a brief web-based self-guided intervention is a feasible and acceptable way to teach mentalization skills. Mentalization was supported as a mechanism of change during treatment, that may have lasting effects on reductions in interpersonal problems after treatment. Findings on the relationship between emotion regulation and mentalization during the treatment intervention will be discussed.