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Herts and Minds: mentalization based treatment for children in foster care

Approximately 60,000 children and young people are in foster care in England. In over 50% of cases, this is due to abuse and neglect. Consequently, a large number of fostered children present with emotional and behavioural difficulties. The most effective treatment for this group is currently unknown. 

Herts and Minds is a trial of a therapy for children in foster care adapted from mentalization based treatment (MBT). In working with children in foster care and their foster carers, MBT aims to promote the quality of relationships, support effective and sensitive foster care and help carers to help the child in their care understand and manage emotions better. The focus is on improving the core components of secure attachment, including collaboration and parental (or carer) reflective capacity. The approach also pays attention to developing reflective practice for all professionals working with children in care. 

There is a growing body of evidence for the use of MBT in the treatment of adults with a diagnosis of ‘borderline personality disorder’1 and some evidence that this is an effective treatment for adolescents who self-harm. To date, there has been no systematic test of MBT as an intervention for children in foster care with emotional and behavioural difficulties. 

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1. The term 'borderline personality disorder' is widely recognised, but this language (and other diagnostic terminology) is felt to be deeply stigmatising by many people. There is no consensus within the community as to how these groups of symptoms should be described.