The Assessment of Mentalization: Measures for the Patient, the Therapist and the Interaction

  • Chloe ShawEmail author
  • Chris Lo
  • Anne Lanceley
  • Sarah Hales
  • Gary Rodin
Original Paper


Mentalization has been clearly defined in the literature as a relational concept and yet in surveys and transcript-based measures it is almost universally treated as an individual capacity. That approach has value but may not capture the emergent nature of mentalization, as it is jointly constructed within a relational context. We report here on a critical evaluation of measurement approaches commonly used to conceptualize and assess mentalization and argue for the value of conversation analysis (CA) as an alternative approach. A variety of approaches have been shown to have utility in assessing mentalization as an individual capacity. We illustrate how conversation analysis allows for an in-depth-analysis of mentalization as it is co-created across different contexts in real-life therapy sessions. This method of analysis shifts the focus from content to process. Conversation analysis is a potentially valuable tool to support training, to assess treatment integrity, and to improve outcomes with mentalization-based interventions.


Mentalizing Measures Conversation analysis Psychotherapy Mentalization-based-therapy 



This work was supported by the Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC). Funding was provided by University Health Network. Funding was provided by Canadian Institutes of Health Research with Grant No. (#MOP 106473). Funding was provided by Princess Margaret Cancer Foundation. Funding was provided by The Campbell Family Cancer Research Institute. Funding was provided by Ontario Cancer Institute. Funding was provided by Ontario Ministry of Health and Long-Term Care.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

The CALM study received approval from University Health Network Research Ethics Board #09-0855-C. Patients and therapists gave written informed consent for their conversations to be recorded for research purposes. All identifying details have been replaced with pseudonyms.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkUniversity of TorontoTorontoCanada
  2. 2.UCL EGA Institute for Women’s HealthUniversity College LondonLondonUK
  3. 3.Institute for Women’s Health, UCLLondonUK

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