Mentalizing in psychotherapy: patients' and therapists' reflective functioning during the psychotherapeutic process

There has been a growing interest in mentalization in clinical research given its relationship with normal and psychopathological functioning and its explanatory potential as a mechanism of psychotherapeutic change. This study uses the Reflective Functioning Scale (RFS) to identify and characterize mentalization manifestations in psychotherapeutic interaction. Method: the RFS was applied to a sample of relevant episodes — 44 sessions from five different psychotherapy processes carried out with adult patients who had different diagnoses. Results: we observed a higher probability of reflective functioning (RF) passages in relevant events than in neutral segments. There were no differences in the RF passages according to episode or actor type, but there were in RF Failures, which is more likely in patients and during rupture episodes. Discussion: although certain modifications are necessary, the RFS can be applied to clinical material, and it is a promising strategy for the study of mentalization within psychotherapy.