Anton Hafkenscheid

Does supervision and training focused on the therapeutic relationship contribute to improved patient outcome? Only a limited number of studies have addressed this important question. This article closely reviews the results of separate studies, as well as the research designs that were used in these studies. Moreover, three recent meta-analyses are summarized. Some promising but modest evidence regarding the value of supervision or training for improved patient outcome was retrieved from the empirical literature.

Maaike Smits, Patrick Luyten Dawn Bales

Mentalization-Based Treatment (MBT) is an evidence-based treatment method for patients with borderline personality disorder. The theoretical background as well as its (cost)effectiveness and practical implementation have been described in detail elsewhere. This paper complements the existing literature on MBT by means of a case study describing the treatment of a typical MBT patient with a severe borderline personality disorder. The course and focus of the different phases of MBT are described, ranging from engaging the patient in treatment and crisis handling to the struggles in working with the therapeutic relationship, gradually moving toward reintegration in society and finally the ending of treatment. Typical MBT concepts and interventions are highlighted and discussed, with the aim of helping clinicians to translate general MBT principles to their own clinical practice.

Frans Stortelder

This article presents a contemporary neuro-psychoanalytic developmental theory of male sexual identity relating to varieties in male sexual identity development. It shows implications for psychoanalytic treatment and is illustrated with three vignettes from psychotherapeutic practice. In the neuro-psychoanalytic model psychic development starts with the constitutional self. The constitutional neurobiological factors play a decisive role in contributing to sexual identity development. The psychosocial construction of the sexual identity is determined by the contingent mirroring of the parents and peers of the constitutional self. The development of the self or personal identity is linked with the development of sexual identity, gender identity and procreative identity. Incongruent mirroring of the authentic self causes alienation in the development of the self. This can be restored in the psychoanalytic relationship.