Holding a Foster Child’s Mind in Mind: Study Protocol for a Cluster-Randomized Controlled Trial of Mentalization-based Therapy (MBT) for Foster Families

Nina Thorup Dalgaard, Anne Marie Villumsen, Kresta Munkholt Sørensen, Nick Midgley, Mette Skovgaard Væver, Mathilde Almlund, Maiken Pontoppidan

Research output: Contribution to journalJournal articleResearchpeer-review


Background Children in foster care are psychologically vulnerable and show more social, developmental, and behavioral problems than those living with their family of origin. Many foster parents struggle to care for these children, some of whom have experienced severe adversity. Research and theory suggest that developing a strong and supportive foster parent–child relationship is essential for foster children to become more well-adjusted and experience a decrease in
behavioral problems and emotional maladjustment. Mentalization-based therapy
(MBT) for foster families aims at increasing the refective functioning of the foster parents, thus promoting the development of more secure and less disorganized child attachment representations, which is subsequently proposed as a factor that reduces behavioral problems and emotional maladjustment in children and promotes their overall well-being.

Methods This is a prospective cluster-randomized controlled trial with two conditions: (1) the intervention group participating in MBT, and (2) the control group who receive usual care. Participants are 175 foster families with at least one foster child aged 4–17 years with emotional or behavioral problems. The intervention will be ofered to foster families by 46 foster care consultants from 10 municipalities in Denmark. The foster care consultants will be randomized to MBT training (n=23) or usual care (n=23). The primary outcome is the psychosocial adjustment of the foster child measured by the Child Behavior Checklist (CBCL) as reported by foster parents. Secondary outcomes include child well-being, parental stress, parent mental health, parent refective function and mind-mindedness, parent/child relations, child attachment representations, and placement breakdown. In order to explore implementation fdelity as well as practitioner experiences, we will administer questionnaires designed for this study and conduct qualitative research exploring the practice of the MBT

Discussion This trial is the frst experimental study of a family therapeutic intervention based on attachment theory for foster families within the Scandinavian context. This project will contribute with novel knowledge on attachment representations in foster children and the efects of an attachment based intervention on essential outcomes for foster families and children.

Trial registration ClinicalTrials.gov NCT05196724. Registered on January 19, 2022.
Original languageEnglish
Article number62
JournalBMC Psychology
Issue number1
Pages (from-to)1-13
Number of pages13
Publication statusPublished - 2023


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  • Plejefamilien i centrum

    Sørensen, K. M., Pontoppidan, M., Dalgaard, N. T. & Villumsen, A. M.


    Project: Research

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