Creating Resilient Systems of Care for Youth, Families, and Clinicians

This chapter will consider principally the wider social context of our therapeutic work. Our premise in doing this is because mentalizing is not just a two person process, it is just as much a social, cultural, and systemic process, extending well beyond an individual therapy and out into the social connections not just of the patient but for the therapist as well. Hence this chapter pays only passing attention to the patient and what may be going on in their head and heart. It pays only a little more to what passes back and forth between the patient and their therapist. Crucial though that is, it is important to avoid the trap of believing that such obviously necessary skills and understandings on the part of a therapist are sufficient to bring about change in ways that are truly sustainable. Falling into that trap involves the therapist possibly assuming a risky role of needing to be a kind of “mentalizing ninja,” on whose personal skills and innate mentalizing powers alone meaningful change may depend.