Background:
Positive relationships between physicians, children, and parents are essential in neurodevelopmental care. Awareness of the patient's internal world and the ability to recognize and understand their emotional needs are central to establishing a beneficial therapeutic alliance. Studies suggest that mentalization and coherent perceptions in parents and educators reflect supportive relationships with children. However, little is known about these capacities among physicians in triadic encounters with children and parents.
Objective:
This study examined the mentalization and coherence of perceptions regarding child patients and their parents among neurodevelopmental physicians.
Method:
Thirteen physicians were interviewed twice, once regarding a child patient and once regarding one of the child's parents, using the Reflective Functioning Five-Minute Speech Sample procedure (Adkins & Fonagy, 2019). Interviews were coded using eight standard seven-point rating scales. These included one mentalization scale and seven coherence scales, which included six subscales that assess aspects of coherence (focus, elaboration, separateness, concern, acceptance, and complexity) and a global coherence scale.
Findings:
Physicians generally demonstrated high levels of mentalization and coherence, although consistency between their scores regarding children and parents was limited. Two physicians scored high across both, while three scored consistently low. In 26.9% of the interviews, difficulties in separateness, particularly boundary dissolution with the parent, emerged.
Conclusions:
Physicians demonstrate intervariability and intravariability in their capacity to mentalize the internal worlds and construct coherent perceptions of children with neurodevelopmental disabilities and their parents. Specialized training may strengthen these capacities and improve the quality and consistency of neurodevelopmental care.