Beyond Theory of Mind: mentalization as a relational and developmental framework for autism
By
Assia Riccioni
Cristina Di Vincenzo
Alessia Sabina De Frenza
Carola Leone
Ilaria Bertoncini
Lucrezia Arturi
Luigi Mazzone
Stefano Vicari
Maria Pontillo
July 15, 2026
Clinical Scorecard: Expanding the Concept of Mentalization: A Relational and Developmental Approach to Understanding Autism
At a Glance
Category Detail
Condition Autism Key Mechanisms Mentalization as a multidimensional, relational, and developmental process. Target Population Autistic individuals and their caregivers. Care Setting Clinical and therapeutic environments focusing on emotional and social understanding.
Key Highlights
Mentalization encompasses self-related, other-related, cognitive, and affective processes. Caregiver mentalization, particularly parental reflective functioning, is crucial for interpreting children's behavior. Mentalization-based approaches may improve emotional outcomes for children with autism. Guideline-Based Recommendations
Diagnosis
Consider mentalization profiles rather than solely Theory of Mind deficits. Management
Utilize mentalization-informed interventions to support social understanding and emotional regulation. Monitoring & Follow-up
Assess caregiver mentalization as a factor influencing child behavior and emotional outcomes. Risks
Avoid framing autism solely through generalized mindreading deficits. Patient & Prescribing Data
Children and adolescents with autism and their caregivers.
Interventions should target specific mentalizing components to enhance emotional regulation and social functioning.
Clinical Best Practices
Adopt a relational-developmental framework for understanding mentalization in autism. Clarify definitions and components of mentalization to improve treatment precision. Related Resources & Content
