{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:00:44Z","timestamp":1771920044099,"version":"3.50.1"},"reference-count":72,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Pretend play is considered to be of great importance in both normal and problematic child development. However, the developmental and therapeutic value of pretend play has perhaps been somewhat overshadowed by the classification of the pretend mode as a non-mentalising mode, a perspective from literature on mentalisation-based psychotherapy with personality disordered adults. In this article, we highlight this difference in emphasis. After having situated this subtle and not seldom unacknowledged difference in meaning surrounding the concept of pretend mode, we focus on psychodynamic child psychotherapy for attachment-traumatised children. Early experiences of traumatic breakdowns in attachment can severely limit a child\u2019s ability to use creative imagination in pretend play. To help the traumatised child make use of the growth opportunities of pretend play, a psychodynamic child therapist is needed who can use metaphors to integrate in an \u2018as-if\u2019 language transference-countertransference elements in their interventions, thereby creating opportunities for the child to express previously hidden trauma-related aspects. The aims of this paper are to (1) consider conceptual ambiguity of the concept \u2018pretend (play) mode\u2019 in the mentalisation literature; (2) discuss the recent diagnosis of complex relational (attachment) trauma; and (3) elucidate the role of pretend play in the psychotherapeutic process of a complexly traumatised foster child who leaves the psychic equivalent mode behind on his therapeutic journey towards moments of mentalisation.<\/jats:p>","DOI":"10.3389\/fpsyg.2026.1695144","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:18:55Z","timestamp":1771910335000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rethinking the role of the pretend play mode in mentalisation-focused psychoanalytic child therapy for adopted and foster children with attachment trauma: from a pre-mentalising mode to a developmental achievement and a milestone on the trajectory towards mentalisation"],"prefix":"10.3389","volume":"17","author":[{"given":"Patrick","family":"Meurs","sequence":"first","affiliation":[{"name":"Sigmund-Freud-Institut","place":["Frankfurt, Germany"]},{"name":"Katholieke Universiteit Leuven","place":["Leuven, Belgium"]},{"name":"Odisee vzw Kenniscentrum Hoger Instituut voor Gezinswetenschappen","place":["Brussels, Belgium"]},{"name":"Universit\u00e4t Kassel","place":["Kassel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Sigmund-Freud-Institut","place":["Frankfurt, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Hesemans","sequence":"additional","affiliation":[{"name":"Katholieke Universiteit Leuven","place":["Leuven, Belgium"]},{"name":"Ziekenhuis Oost-Limburg","place":["Genk, Belgium"]},{"name":"Group Practice and Therapy Centre \u2018Het Kompas\u2019","place":["Schilde, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilan","family":"\u00c7\u0131nar","sequence":"additional","affiliation":[{"name":"Sigmund-Freud-Institut","place":["Frankfurt, Germany"]},{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanze Christina","family":"Rickmeyer","sequence":"additional","affiliation":[{"name":"Sigmund-Freud-Institut","place":["Frankfurt, Germany"]},{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicitas","family":"Hug","sequence":"additional","affiliation":[{"name":"Sigmund-Freud-Institut","place":["Frankfurt, Germany"]},{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Fischmann","sequence":"additional","affiliation":[{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]},{"name":"Internationale Psychoanalytische Universit\u00e4t Berlin","place":["Berlin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Meyer","sequence":"additional","affiliation":[{"name":"Universit\u00e4t Kassel","place":["Kassel, Germany"]},{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]},{"name":"Heinrich-Boll-Stiftung","place":["Berlin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Lebiger-Vogel","sequence":"additional","affiliation":[{"name":"Private Psychoanalytic Psychotherapy Practice","place":["Frankfurt Region, Germany"]},{"name":"Frankfurt University of Applied Sciences","place":["Frankfurt, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"ref1","volume-title":"Mentalizing in the development and treatment of attachment trauma","author":"Allen","year":"2013"},{"key":"ref2","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9781615370887","volume-title":"Mentalizing in clinical practice","author":"Allen","year":"2008"},{"key":"ref3","year":"2013"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1521\/pedi.18.1.36.32772","article-title":"Mentalization-based treatment of BPD","volume":"18","author":"Bateman","year":"2004","journal-title":"J. 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