1. TRAINING GENERAL PRACTITIONERS IN MENTALIZATION BASED THINKING Annette Sofie Davidsen

2. Special conditions in general practice Unorganized problems Direct access Time constraint 12-06-2014 2 Annette Sofie Davidsen

3. Special conditions in general practice Unorganized problems Direct access Time constraint Same psychodynamic conditions as in specialist psychotherapy Often not realized Need of training and supervision 12-06-2014 3 Annette Sofie Davidsen

4. Training Imported models No formulated theory for general practice Left to folk psychology 12-06-2014 4 Annette Sofie Davidsen

5. Balints theory Importance of: The process of understanding and the relationship The therapists reflexive insight into him/herself 12-06-2014 5 Annette Sofie Davidsen

6. Mentalization The capacity to understand other peoples thoughts, feelings, imaginations, wishes, desires and so on – also realizing your own thoughts and feelings and their contribution to the relationship Similar to Balints thoughts about the process of understanding Active process Linked to attachment theory 12-06-2014 6 Annette Sofie Davidsen

7. Connection between concepts and theories Attachment theory Balint Psychotherapy in general practice Balint anticipated attachment theory – basic fault (Holmes 2001) Mentalization

8. The tradition of training and supervision disappeared with the academic specialization 12-06-2014 8 Annette Sofie Davidsen

9. PhD. study of psychological interventions in general practice GPs differ greatly in the form of relationship they form with the patient Both in psychological interventions and in normal consultations Difference in propensity to mentalize Need of training mentalizing capacity Ref.: Davidsen, A.: Psychology and Psychotherapy, theory, research and practice, in press (June 2009) 12-06-2014 9 Annette Sofie Davidsen

10. We propose that therapists mentalizing skills are central to establishing and maintaining an effective treatment relationship and a therapeutic alliance. Thus, we are developing a training programme to foster therapists mentalizing capacities in the treatment process. We aim not only to promote therapists attentiveness to mental states in their patients but also to increase their awareness of their own mental states in the conduct of psychotherapy. (Williams et al., 2006) p. 224-225. 12-06-2014 10 Annette Sofie Davidsen

11. General therapeutic approach Cannot be manualized Manuals cannot teach skillful use and creativity Need for theory and agreed concepts Mentalization a possible concept Dialectic about structure Firm structure can impede mentalization 12-06-2014 11 Annette Sofie Davidsen

12. Therapeutic relationship Mentalizing central for establishing relationship Association between therapeutic relationship and outcome in psychotherapy – and in general practice 12-06-2014 12 Annette Sofie Davidsen

13. Problems with mentalizing Be aware of pseudo-mentalizing Apparent understanding 12-06-2014 13 Annette Sofie Davidsen

14. Training Supervision in groups Illustrative videos Role-playing Own video-clips Shifting between watching an expert and practicing Therapists mentalizing capacity in the forefront Active, inquisitive stance 12-06-2014 14 Annette Sofie Davidsen

15. Problems with mentalizing We allready do that – but it is Difficult to mentalize under emotional stress 12-06-2014 15 Annette Sofie Davidsen

16. Purpose of training GPs Training the mentalizing capacity To train GPs handling of emotional problems To train GPs in talking therapy Carrying out therapy sessions under supervision trains the mentalizing capacity in normal consultations 12-06-2014 16 Annette Sofie Davidsen

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