PhD Scientific Days 2026

Mental Health Sciences 2.

Adapting Mentalization-Based Treatment for Autistic Adults: A Pilot Feasibility Study

Name of the presenter

Sörnyei, Dániel

Institute/workplace of the presenter

Department of Clinical Psychology, Semmelweis University, Budapest, Hungary

Authors

Dániel Sörnyei^1,2, Sára Bálint², Anna Nyulászi³, Márton Horváth³, Fanni Mercédesz Kovács², Kinga Farkas²
1: Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
2: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
3: Department of Crisis Intervention and Psychiatry, Péterfy Sándor Street Hospital-Specialist Clinic, Budapest, Hungary

Text of the abstract

Introduction: Autistic adults often experience difficulties in social understanding and reflective capacities. These difficulties are closely related to mentalization, which may therefore represent a relevant target for psychosocial interventions. Although Mentalization-Based Treatment (MBT) is an established approach adapted to several psychiatric conditions, its application in autism remains underexplored.
Aims: This study examined the feasibility of an MBT-informed introductory group intervention for autistic adults and identified the challenges and modifications required to support engagement in this population.
Methods: This open-label, uncontrolled feasibility study comprised two iterative pilot groups (N1 = 6; N2 = 8). Both included ten 90-minute sessions supported by visual materials, a predictable structure, and written handouts. The second pilot group also included biweekly individual sessions. Feasibility was explored using session observations, feedback, video recordings, and three-month follow-up interviews. A multidisciplinary team met regularly for reflective debriefings. Baseline and post-intervention assessments included the MZQ, SRS-2, AAS, AAQ-II, MSPSS, BDI, and STAI, as well as the AQ-50, which is currently being examined in our parallel psychometric study in a larger sample.
Results: Participants valued predictability, explicit rules, written communication, concrete examples, and extended processing time. Early group processes were limited, with sessions functioning as parallel mini-individual encounters. Individual sessions improved trust, continuity, and clarification of the material. Reflective team meetings emerged as a clinically meaningful space for processing unspoken group dynamics. Descriptively, modest changes were observed in self-reported mentalization, social communication, and depressive symptoms, whereas broader relational constructs appeared less responsive.
Conclusions: MBT-informed group interventions for autistic adults appear feasible, but require substantial adaptation in pacing, group size, communication style, and therapeutic support. Multidisciplinary team meetings may serve as a reflective container, providing a foundation for future MBT interventions for autistic adults. Larger, controlled studies are necessary to evaluate the efficacy and mechanisms of change, given the exploratory nature of our findings.