Mentalization for Offending Adult Males (MOAM)

A randomised controlled trial known as Mentalization for Offending Adult Males (MOAM), led by Professor Peter Fonagy at University College London is being implemented across 13 sites. The research trial is a five year project which started in January 2016 and is funded by the National Institute for Health Research, HTA (14/186/01).

The study aims to establish the usefulness of mentalization-based treatment (MBT) in helping violent men with a diagnosis of antisocial personality disorder (ASPD) to control their aggressive behaviour compared to usual services offered through the National Probation Service.  

This study was developed following a pilot study across two sites; Professor Anthony Bateman leading in Barnet, Enfield and Haringey Mental Health Trust; and Dr Jessica Yakeley at the Portman Clinic, Tavistock and Portman NHS Foundation Trust. Subsequently NHS England commissioned the Tavistock and Portman NHS Foundation Trust to develop MBT ASPD services at 13 sites across the country as part of the Offender Personality Disorder Pathways Strategy, led by Dr Yakeley with training and supervision from Professor Bateman at the Anna Freud Centre.

Project detail

Background

Mentalization is the capacity to think about and reflect upon the workings of one’s own and others minds. The ability to mentalize is thought to be impaired in people with certain personality disorders. Impairments can lead to problematic, distressing and often harmful behaviour, putting both the person themselves and others around them at risk.

The aim of this study is to establish the usefulness of mentalization-based treatment (MBT) in helping violent men to control their aggressive behaviour.

Methods

A multi-site, two-arm, randomised controlled trial, with participants randomly allocated in a 1:1 ratio to receive either probation as usual (PAU) only or MBT plus PAU. The treatment intervention is weekly group MBT therapy is provided for 12 months to men diagnosed with antisocial personality disorder. Participants are offenders with problems controlling their anger and aggression. Participants are all under the supervision of the National Probation Service and the treatment is delivered in probation premises.

Outcome measures will be collected throughout the 12 months of intervention delivery and the 12 month follow-up period. The primary outcome will be frequency of aggressive antisocial behaviour as measured by the Overt Aggression Scale–Modified (OAS-M), and will be collected every 3 months. Secondary outcomes will include physical health, mental health, and quality of life, and will be collected every 6 months. Outcome measure assessments will be conducted by User Voice Peer Researchers with lived experience of the Criminal Justice system and UCL Research Assistants.

Key findings

Findings will be presented when they are available.

Publications

Bateman A, Bolton R, Fonagy P (2013). Antisocial Personality Disorder: A Mentalizing Framework. FOCUS: Journal of Lifelong Learning in Psychiatry, 11(2): 178 - 186.

Bateman A, Fonagy P (2008). Co-morbid antisocial and borderline personality disorders: mentalization-based treatment. Journal of Clinical Psychology: In Session 64: 181-94.

Bateman AW, Fonagy P (2011). Antisocial personality disorder. In Handbook of Mentalizing in Mental Health Practice. (Eds AW Bateman, Fonagy P): 289-308. American Psychiatric Publishing.

Bateman A, Fonagy P (2016). Mentalization-based Treatments for Personality Disorders. Oxford: Oxford University Press.

Yakeley J, Williams A (2010). Antisocial personality disorder: New directions. Advances in Psychiatric Treatment, 20: 132-143.

Yakeley J (2010). Working with Violence: A Contemporary Psychoanalytic Approach. London: Palgrave Macmillan.