Evidence map›Paper›PMID 42467399›Full record

ReviewClinical child and family psychology review2026

The Efficacy of Mentalization-Based Interventions Among Autistic Individuals and Their Families: A Systematic Review.

Natalia Kirsman, Lee Barel Refaeli, Yael Enav, Yael Mayer

Abstract readReview
PubMed Publisher
In one paragraph

Review in Clinical child and family psychology review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Natalia KirsmanSchool of Therapy, Counseling, and Human Development, Faculty of Education, University of Haifa, Haifa, Israel. nkirsman@gmail.com.ORCID https://orcid.org/0009-0000-9969-154X
Lee Barel RefaeliSchool of Therapy, Counseling, and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.
Yael EnavSchool of Therapy, Counseling, and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.
Yael MayerSchool of Therapy, Counseling, and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Autistic individuals often experience differences in social-cognitive processing, including mentalization, the capacity to understand one's own and others' mental states, which may influence social and emotional functioning. This systematic review synthesizes the current evidence base on interventions targeting mentalization and Theory of Mind (ToM), conceptualized here as related but distinct constructs, with ToM reflecting more specific cognitive perspective-taking skills within the broader mentalization framework. A comprehensive search across multiple databases, without restrictions on language or year of publication, identified 19 eligible studies involving autistic individuals and their caregivers. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT), providing an indication of methodological rigor across diverse designs, though not a formal assessment of risk of bias. Across studies, interventions were generally associated with improvements in reflective functioning and performance on structured ToM tasks (e.g., false-belief understanding). However, these gains were predominantly observed in proximal, task-based measures, with limited and inconsistent evidence for generalization to real-world social functioning. This pattern raises important questions regarding the ecological validity of commonly used ToM assessments and whether observed improvements reflect meaningful changes in everyday social interaction or task-specific learning. Substantial heterogeneity in study design, intervention characteristics, outcome measures, and participant profiles further limits comparability and precludes firm conclusions regarding effectiveness. Overall, while mentalization- and ToM-based interventions show promise, the current evidence base remains methodologically and conceptually constrained. Future research should prioritize ecologically valid outcome measures, clearer specification of intervention mechanisms, and more rigorous study designs, including long-term follow-up, to better determine whether these interventions support meaningful, real-world social and relational outcomes for autistic individuals and their families.

Indexed as

AutismInterventionsMentalizationTheory of mind

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.