Training in mentalizing skills for psychiatric staff

Research idea and purposeMore research is needed into which educational interventions aimed at psychiatric staff are needed to improve care for patients with severe mental disorders.

Some previous studies show good results for interventions in which healthcare staff were trained in mentalizing skills, i.e. skills to communicate in an alliance-building way with a focus on increased understanding of the patient’s mental processes.

However, to date no large randomized controlled trial has been conducted regarding mentalizing skills training for psychiatric staff.

The aim of the requested planning grant is to prepare such a large study at Swedish psychiatric clinics.Work plan, methods and project realisationThe plan för 2025 is to translate a British training program into Swedish, initiate collaborations with psychiatric clinics around Sweden, and conduct a pilot study at a psychiatric ward in Stockholm County.

The pilot study in autumn 2025 for 20–30 participants is aimed at testing the feasibility of the training program and the measurement methods.

Self-ratings from participants are collected immediately before and after the training, as well as one month after completion. Objective health care data are collected the month before, the month after and two months after the intervention. In the pilot study, we will use measures that we tentatively regard as suitable for the upcoming randomized study.

The measures concern working alliance, mentalizing capacity, knowledge of mentalizing techniques, attitude to patients with severe mental disorders, stress and workload.

Objective data is collected regarding threats, violence and work-related injuries, as well as the frequence of compulsory psychiatric treatment, compulsory injections and episodes of physical restraint. In addition, we will conduct at qualitative interview study with twelve participants.

The planned randomized controlled trial from 2026 onwards is intended to include 400 participants from 16 psychiatric wards and emergency rooms in Sweden.

That study is also planned to include a six-month follow-up.Societal relevance and project utilisation If a future randomized trial shows that the training program is effective, it could mean major positive consequences for both patients and staff.

This intervention requires relatively little time and financial resources, while access to competent teachers is good, which means that national implementation can take place.