Is it safe outside? Tales from a home visiting service for families during the COVID pandemic

A description of a mentalization informed home-based project, an adaptation of the ECID project (Equipo Clínico de Intervención a Domicilio), into a time-limited first aid mental health team in response to heightened mental health needs during the COVID Pandemic in Barcelona, Spain is offered. ECID is a project with a developmental psychodynamic understanding of psychopathology and relational dynamics informing a highly flexible treatment approach. This paper describes a focus on the need for clinicians to take an active role whilst adapting to the specific needs and situation of each child and family, instead of continuing to ask them to adapt to what services can or are prepared to offer. Clinical examples are given to illustrate the value of an integrative community approach informed by both systemic and psychodynamic lenses. Specifically, we reflect on the benefits of a mentalization informed approach to working with families during high levels of psychosocial stress for both families and practitioners. We illustrate how of a mentalization informed clinical service can promote and support the development of a therapeutic alliance when internal safety is impacted by a very real external threat. Finally, preliminary data is presented regarding the impact of parental stress and trauma on children and adolescents' adaptation to a potentially traumatic situation as well as their capacity for returning to a progressive development pathway.