Costa-Cordella, Stefanella; Luyten, Patrick; (2024) Mentalizing-Based Healthcare: Towards a Relational Paradigm for Chronic Illness Management. Journal of Infant, Child, and Adolescent Psychotherapy 10.1080/15289168.2024.2344397. (In press).

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Abstract

This paper introduces a contemporary psychodynamic attachment approach for managing chronic illnesses with a focus on the role of impairments in mentalizing, attachment, and epistemic trust. This approach emphasizes the significance of relational dynamics in healthcare settings and may thus provide a complementary approach in health psychology which currently primarily targets individual and behavioral aspects of chronic illness by addressing the relational dynamics that are typically involved in chronic illness management. We review empirical evidence highlighting the roles of mentalizing, attachment, and epistemic trust in chronic illness. We propose an attachment and mentalizing-based healthcare paradigm that prioritizes relational dynamics that aligns with emerging health psychology trends, offering a holistic approach to patient care. Finally, we present some practical implications of this approach, underscoring the importance of psychologists working in health in fostering secure attachment, epistemic trust and mentalizing within patient-provider relationships. This involves tailoring patient interactions and psychoeducation to individual needs and narratives, enhancing treatment adherence and well-being.

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