Containing the Anxieties of Children, Parents and Families from a Distance During the Coronavirus Pandemic

The coronavirus pandemic and the move to teletherapy has created uncertainty among both clinicians and patients. As therapists who work with children, we have heard from parents who are desperate for support and advice about how to respond to their children’s behavioral changes, as well as those who feel too overwhelmed to continue their children’s sessions at the moment and want to take a break from treatment. We have had to rethink the frame in concrete ways, reimagine how to play, and renegotiate parameters around confidentiality. At a time when fear and uncertainty make mentalizing difficult, the hallmarks of a mentalizing approach—curiosity and flexibility—are most critical. This paper will describe how the Mentalization-Based Treatment for Children (MBT-C) model offers a framework for an integrative approach that can inform treatment via teletherapy, so that clinicians can continue supporting young people and their families through this period. We will begin by describing how the mentalizing stance, particularly an awareness of our own mentalizing capacities in the moment, has become more important than ever. Ways in which clinicians maintain their mentalizing in the face of the mentalizing breakdowns will be also discussed. Finally, we illustrate with clinical vignettes how the developmental levels of mentalizing—attention control, emotion regulation, and explicit mentalizing—can inform the structure, techniques and interventions in teletherapy with children and parents.