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The primary aim of this article is to give a theoretical and empiricalbackground for clinical interventions in family-oriented treatment for substanceuse disorders. The article refers to an ongoing research project, which is basedon the concepts of mentalization and parentalreflective functioning. Theory of mentalization and attachmenttheory is explored as explanatory tools of both addictive problem andrisk/resilience factors in offspring. Mentalization is defined as thecompetence to envision mental states in self and others and to understandbehaviour in terms of mental states. Substance use is discussed as clinicalexpressions of impaired mentalizing skills and disorders of state- and affectregulation. Parental reflective function particularly refers toparents’ competences to interpret the mind of their own infant orchild. Parental reflective functioning, as ‘minding thebaby’, promotes sensitive care, which again serves to protect theinfant and the immature brain from potentially dangerous stress andphysiological arousal. Substance use often makes the parent‘absent-minded’ and thus imposes a risk of impairedinteractions between caregivers and the extra vulnerable substance exposedchild.Without a lifeline to the caregivers’ mind, the development of selfregulation and social competences is endangered. High-risk families needsubstantial support to break the burden of intergenerational transmission ofinternal representations of caregiving experiences, and to promote good enoughcare for the infant. The mentalization-based treatment programs (MBT) brieflyoutlined here, propose a long-term multidisciplinary treatment andfollow-up.
Nordic Psychology – American Psychological Association
Published: Nov 1, 2009
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