• Classical psychoanalysis is no longer reimbursed by the Dutch health insurance system because its effectiveness is questioned. The longing for evidence is due to a tendency in psychiatry and psychotherapy to be part of the so-called evidence-based movement. Mental health care needs other ways to prove its efficiency than those used in general health care because of the different scientific status of psychiatry and psychotherapy. A rather different methodology is needed to establish the effectiveness or rather value of psychoanalysis and do justice to psychoanalysis as a hermeneutic discipline in between understanding and explanation.
• Mentalization-based therapy proves to be a helpful source of inspiration to change an existing psychodynamic group treatment of personality disorders (cluster B and C) into a mentalization enhancing treatment program. Whilst maintaining the structure of the program, we made adaptations in both the content of the treatment and in the functioning of the team. By applying specific structured forms of explicit mentalization both in the treatment of the patient and the functioning of the team, the development of their implicit mentalization is stimulated. In this article we describe how this works out in the daily reality of outpatient and inpatient group therapy.
