Tavistock MBT-PP

What does this project involve?

Mentalization Based Therapy for Parenting Under Pressure (MBT-PP) provides 10 sessions of psychotherapy for parents who are experiencing ongoing conflict with one another. It aims to reduce this conflict and, indirectly, reduce the social and emotional difficulties their children may experience. Sessions focus on improving parents’ capacity to ‘mentalise’, or make sense of their own and others’ thoughts, beliefs, and emotions in real time.

Why did YEF fund this project?

Frequent and intense conflict between parents is consistently linked to social and emotional difficulties in their children. Social and emotional difficulties can put children at risk of involvement in violence. However, there are few evidence-based interventions designed to reduce interparental conflict and there is no established referral pathway for families experiencing such conflict to access support. MBT’s focus on understanding one’s own and others’ thoughts and feelings amid difficult interactions could be beneficial in helping parents to understand one another’s perspectives and grasp the impact that their conflict has on their child. A small-scale feasibility study of 30 separated parents found that MBT-PP may be feasible and suggested that a larger evaluation would be useful.

YEF funded an efficacy trial of MBT-PP, including an internal pilot study which is reported on here. The pilot phase sought to test out the research processes involved in conducting a randomised controlled trial of the programme. This included examining how well the referral pathways, data collection, and data linking processes worked, and whether the processes required for a trial were acceptable to families. It also aimed to assess whether the drop-out rate was too high, estimate how many families would need to be recruited for a full efficacy trial, and explore whether there were very early indications to support the theory that MBT-PP reduces parents’ conflict and improves children’s social and emotional difficulties.

To be eligible for the study, parents either had to have been referred by local authority staff or, if they self-referred, had to be classified as a distressed couple by one or both of their scores on the Dyadic Adjustment Scale (a measure of relationship quality). Families were then randomised to either receive MBT-PP or treatment as usual (TAU). Interviews were conducted with the three local authority referral leads, who were responsible for recruiting families and coordinating the project. Parents and children completed several quantitative surveys before the therapy started and after it was completed, including the parental-report version of the Strengths and Difficulties Questionnaire (SDQ, a measure of children’s social and emotional difficulties).

149 parents of 132 children in three local authorities (Bristol, Dorset, and Bournemouth, Christchurch & Poole) were recruited and randomised during the pilot phase which ran from June 2023 to April 2024. By the end of the pilot phase, post-intervention SDQ data were available for 45 children, with the majority still undergoing treatment (MBT vs TAU). 94% of the children who took part in the study identified as White, 5% as Mixed, 1% as Asian, and 1% as Other.

Key conclusions

What will YEF do next?

YEF is proceeding with the efficacy trial of MBT-PP to which this pilot contributes. This is due to report in 2026.

Download the report