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Objectives  Few studies outside  United Kingdom  have documented effects of mentalization‐based treatment ( MBT ) for patients with borderline personality disorder ( BPD ). This study aimed to investigate outcomes for  BPD  patients treated in an  MBT  programme in a Norwegian specialist treatment unit and compare benefits of the implemented  MBT  with the unit's former psychodynamic treatment programme.    Design  A naturalistic, longitudinal, comparison of treatment effects for  BPD  patients before and after transition to  MBT .    Methods  The sample consisted of 345  BPD  patients treated in the period 1993–2013. Before 2008, patients were admitted to a psychodynamic treatment programme ( n  = 281), after 2008 patients received  MBT  ( n  = 64). Symptom distress, interpersonal problems, and global functioning were assessed repeatedly throughout the treatment. Suicidal/self‐harming acts, hospital admissions, medication, and occupational status were assessed at the start and end of treatment. Therapists' competence and adherence to  MBT  was rated and found satisfactory. The statistical method for longitudinal analyses was mixed models.    Results   BPD  patients in  MBT  and in the former psychodynamic treatment programme had comparable baseline severity and impairments of functioning.  BPD  patients in  MBT  had a remarkably low drop‐out rate (2%), significantly lower than the former treatment. Improvements of symptom distress, interpersonal, global and occupational functioning were significantly greater for  MBT  patients. Large reductions in suicidal/self‐harming acts, hospital admissions, and use of medication were evident in the course of both treatments.    Conclusions  The study confirms the effectiveness of  MBT  for  BPD  patients and indicates greater clinical benefits than in traditional psychodynamic treatment programmes.    Practitioner pointsMBT  is an effective treatment for patients with  BPD .   MBT  can successfully be implemented in therapeutic settings outside  United Kingdom  and may be more beneficial than psychodynamic treatment programmes for  BPD  patients.

psychology and psychotherapy: theory, research and practice

Changing from a traditional psychodynamic treatment programme to mentalization‐based treatment for patients with borderline personality disorder – Does it make a difference?