Developing Infant Family & Early Childhood Mental Health Competency: Approaches & Resources

1. Developing Infant Family & Early Childhood Mental Health Competency: Approaches & Resources California Mental Health Directors Association Children’s System of Care Committee Meeting June 19, 2014 Virginia Reynolds and Patsy Hampton WestEd Center for Prevention and Early Intervention

2. Mission of California Center The California Center for Infant-Family and Early Childhood Mental Health assists policymakers, funders and organizations to design and implement high quality practices that promote the healthy social and emotional development of children under the age of five.

3. The Focus of Our Work • Build capacity within the mental health system to deliver best practices and knowledge-based competencies specific to children birth to five and their families. • Provide training, product and model development, technical assistance and support to counties

4. Purpose of the Guidelines: • Define California’s standards for IFECMH specialty training to help ensure personnel have the competencies to support the social-emotional and developmental well-being of infants and very young children and their families

5. Process for Development of the Competencies • Inclusive process involving interagency and interdisciplinary partnerships • Included: service providers, researchers, state agency personnel, training and technical assistance providers, administrators, advocates, and parents

6. Three Areas of Endorsement • Three IFECMH Concentration Areas • Transdisciplinary Practitioners • IFECMH Specialists • IFECMH Reflective Practice Facilitators

7. Domains of Knowledge: • Parenting, Family Functioning & Parent-Child Relationships • Infant, Toddler, & Preschool Development • Biological & Psychosocial Factors • Risk & Resilience • Observation, Screening & Assessment • Diagnosis & Intervention/Treatment • Interdisciplinary Collaboration • Ethics

8. Roles for theIFECMH Transdisciplinary Practitioner, Specialist andReflective Practice Facilitator

9. Role of the IFECMH Transdisciplinary Practitioner • Transdisciplinary Practitioners are early childhood professionals from multiple disciplines who provide direct services to young children and their families, prenatally to age 5 • IFECMH training and clinical experience complement their disciplinary preparation and scope of practice for work with young children and families • Role allows for the promotion of early childhood mental health and preventive mental health intervention, with the support of reflective practice facilitation

10. Role of the IFECMH Specialist • Master’s Degree or higher and a license/certificate/credential allowing provision of mental health services • IFECMH Specialist training and clinical experience complement disciplinary preparation and scope of practice for specialty early childhood mental health • Role allows for the promotion, intervention and treatment of mental health difficulties, within their disciplinary Scope of Practice, and with the support of reflective practice facilitation.

11. Role of the IFECMH Reflective Practice Facilitator • The endorsement category is for those who are trained in the provision of Reflective Practice Facilitation, and can meet the facilitation requirements for Transdisciplinary Practitioners and/or Specialists.

12. Endorsement System – California Center for Infant-Family & Early Childhood Mental Health at WestEd CPEI

13. Personal Portfolio of IFECMH Professional Qualifications • Tool for documenting qualifications for endorsement • Helps self-evaluation of training needs and readiness for endorsement

14. California IFECMH Competency Endorsement System • Voluntary • Based on review of portfolio of training, clinical experience and professional recommendations • Recognized and promoted by agencies that fund and/or provide a broad range of health, educational, social service and mental health services for children prenatal to age five and their families

15. California Center Training Models Cohort Model Based on a series of trainings over a 2 to 3 year period. Includes face-to-face sessions as well as required outside assignments Post-Graduate Training Program Developed as an applied training program for clinicians, along with other practitioners from a variety of disciplines. Provides in-depth training for individuals committed to relationship-based services Drop-In Model Offers full and half day sessions, featuring state and national experts

16. Issues In Going To Scale With Evidence-Based Programs For Very Young Children

17. Summary • We are attempting to implement evidence-based programs with non-evidence-based procedures • We should build in decision-making frameworks that address the realities of resources, personnel, community needs, implementation concerns and fidelity to standards.

18. Some of the Challenges • Training schedules, quick hiring • Getting release time for existing staff to be trained in EB programs, leading to billing and cost issues for agencies • EB program trainers overwhelmed by training needs across state and country • Limited time in training for attention to critical issues such as special health care needs of infants • Cost issues unforeseen at time of adoption or selection of EBP

19. Lessons Learned • Need for ongoing support, continuous training that is more in-depth that initial training on the EBP. • Development of mechanisms to reward excellent work, bilingual incentives, educational incentives, rural hiring bonuses and similar methods to develop the workforce • Family attrition must be examined as an outcome – serving the highest risk and acuity families with a program with intensive and organized protocols may not be a good fit

20. Lessons Learned • Include concepts of family and community engagement in the training and implementation processes • Support the full level of reflective supervisorial engagement required to fully implement relationship-based clinical practices • Include infrastructure funding for ongoing support for staff development in the areas of vicarious trauma, personal safety, and staff burnout

21. Thank You Virginia Reynolds, Program Director WestEd Center for Prevention and Early Intervention vreynol@wested.org Patsy Hampton, Project Director WestEd Center for Prevention and Early Intervention phampto@wested.org California Center for Infant-Family and Early Childhood Mental Health www.cacenter-ecmh.org