What Works? A Webinar Series on Effective Early Childhood Mental Health Consultation

1. What Works? A Webinar Series on Effective Early Childhood Mental Health Consultation Presented by the Georgetown University Center for Child and Human Development with sponsorship from The A.L. Mailman Family Foundation Moderated by Kathy Hepburn, GUCCHD Technical support by Kevin Enright, GUCCHD

2. A Brief Webinar Orientation

3. If you can see this, but can’t hear the audio, dial the Call-in Number and enter the Room Code circled in red Call-in Number:  1-800-832-0736 Room Code: 2884179 What Works? A Webinar Series on Effective Early Childhood Mental Health Consultation Presented by the Georgetown University Center for Child and Human Development with sponsorship from The A.L. Mailman Family Foundation Moderated by Kathy Hepburn, GUCCHD Technical support by Kevin Enright, GUCCHD

4. Logistics • Move all electronic devices away • Close all file sharing applications and streaming music and video • If you need technical support, please contact Soumia Yesraoui at 202-687-0308 • Send questions during the webinar that will be held for Q&A periods • After the webinar: • Evaluation • Unanswered questions and access to archives

5. What Works? A Webinar Series on Effective Early Childhood Mental Health Consultation Presented by the Georgetown University Center for Child and Human Development with sponsorship from The A.L. Mailman Family Foundation Moderated by Kathy Hepburn, GUCCHD Technical support by Kevin Enright, GUCCHD

6. Webinar Series For brief descriptions of each webinar, go to http://gucchd.georgetown.edu/90642.html 6

7. Webinar #1Introduction to Effective Early Childhood Mental Health Consultation: An Overview of Study Findings Roxane K. Kaufmann, M.A. Frances B. Duran, M.P.P. Deborah F. Perry, Ph.D. Georgetown University Center for Child & Human Development April 28,2010 7

8. Today’s Webinar • Describe GUCCHD’s work in children’s mental health and the context of the study • Highlight national data on the status of ECMHC • Showcase key study findings, including an emerging model for effective consultation programs • Describe evaluation in the context of study sites • Discuss next steps for the field • Highlight resources for further guidance 8

9. Setting the Context • GUCCHD’s work in ECMH • Increased knowledge about child development and increased concerns about young children’s behavior • Lessons from the Field • 1999 Roundtable supported by SAMHSA • Expanding use of ECMHC and research • Mailman Family Foundation support 9

10. Indirect mental health intervention for infants, toddlers and preschoolers Focused on young children in ECE settings and their caregivers Collaboration between a professional consultant with mental health expertise and consultees What is Early Childhood Mental Health Consultation? 10

11. Types of ECMHC • Child/family-centered consultation: Focuses on a particular child with challenging behavior and/or the family of that child • Programmatic consultation: Focuses on a general program or classroom issue that impacts the mental health of staff, children and/or families Cohen & Kaufmann, 2000 11

12. What are the Goals of ECMHC? • Reduce the impact of mental health problems among young children in ECE settings • Build the capacity of ECE staff, programs, and families to promote young children’s healthy social/emotional development and address challenging or troubling behaviors 12

13. Setting the Context (cont’d) • Growing body of research on ECMHC, but key questions remained… • What are the essential components of effective mental health consultation? • What are the skills, competencies, and credentials of effective consultants? • What are the training, supervision, and support needs of consultants? • What level of intervention intensity is needed to produce good outcomes? • Which outcomes should be targeted and how should they be measured? 13

14. The What Works? Study • What Works? study (2009) • Targeted focus on exploring the key components of effective consultation programs • Site visits to 6 programs with positive outcomes • Participation from those delivering and receiving ECMHC services • National Scan 14

15. Study Sites • Child Care Expulsion Prevention (MI) • Early Childhood Consultation Partnership (CT) • Early Intervention Program/Instituto Familiar de la Raza (San Francisco, CA) • Early Intervention Project (Baltimore, MD) • Kid Connects (Boulder, CO) • Together for Kids (Central Massachusetts) 15

16. ECMHC: The National Picture • National Scan • Brief online survey • Sent to all states’ and territories’ Children’s Mental Health Directors and ECCS Coordinators • 35 states/territories responded 16

17. National Scan Highlights • Prevalence of ECMHC • 29 states indicated availability of ECMHC; 21 with statewide efforts • Key factors that supported ECMHC implementation: funding, research/data, leadership, state/community concerns, and/or early childhood initiatives • Top Funding Sources • State General Funds, Child Care Development Funds, Mental Health, Private Funds • Evaluation • Most (61%) have a coordinated statewide effort 17

18. National Scan Highlights (cont’d) • Consultant Qualifications • Few have state-level requirements • Common Challenges • Lack of funding, providers and/or expertise • ECMH not valued/included in systems development efforts • Lessons Learned • Collaboration and cross-agency cooperation is critical • Effective ECMHC attends to promotion, prevention & intervention • A highly trained and supported consultant workforce is crucial to effective ECMHC 18

19. Question Review and Response 19

20. An Emerging Model for ECMHC 20

21. Solid Program Infrastructure • Well-defined model • Strong leadership • Clear organizational structure • Strong hiring and training component • Supervision and support mechanisms for consultants • Strategic partnerships • Community outreach and engagement • Clear communication • Evaluation • Financing 21

22. Highly-Qualified Consultants • Content Knowledge • Infant/early childhood mental health (I/ECMH) • Typical & atypical child development • Best/evidence-based practices in I/ECMH • Cultural and linguistic competence • Service systems and community resources 22

23. Highly-Qualified Consultants (cont’d) • Skills • Work at multiple levels • Group settings and one-on-one • Children and adults • Infants, toddlers and preschoolers • Communicate effectively • Collaborator, educator, coach and cheerleader • Develop targeted & individualized strategies • Build strong, healthy relationships! • Attributes 23

24. High-Quality Services • Include both types of consultation • Provide an array of services/activities • Information gathering • Individualized service plan development • Plan implementation support • Provider/family education • Provider/family emotional support • Linkages to services beyond consultation (e.g., direct therapy) 24

25. Tips on High-Quality Service Delivery • Strong service initiation process • Collaboration • Family involvement • Cultural and linguistic competence • Individualization of services/strategies • Consistency across home & classroom 25

26. Tips on High-Quality Service Delivery (cont’d) • Utilization of hands-on, practical materials • Consistency in consultants • Availability of consultants • Integration of consultant into program routines and operations • Facilitation of ECE program requirements and goals 26

27. Catalysts for Success • Positive Relationships • Readiness for ECMHC 27

28. Additional Considerations in Developing/Refining ECMHC Models • Caseloads • Intensity of services • Use of best/evidence-based practice(s) • Local resources/capacity 28

29. Question Review and Response 29

30. Expanding the Evidence Base • Two reviews of the best available evidence • Staff & Program Level Outcomes • Child Behavioral Outcomes • Increasing rigor in state level evaluations underway • Use of valid and reliable tools • Well articulated theory of change 33

31. Evaluation • Helps answer critical questions about your program: • What is your program doing? • What effects are you having on whom? • What parts work well? • What parts need improvement? • Helps promote sustainability • Continuous Quality Improvement 32

32. Evaluation Efforts in Study Sites • All selected sites had positive outcomes • All programs have rigorous evaluations underway • Mixed methods being used: quantitative and qualitative • Variety of formative and summative outcomes • Comprehensive table of tools (p. 91-93) 30

33. Measuring Impact at Multiple Levels MD Evaluation: Logic Model 31

34. Moving Toward Fidelity • Begin with essential features: importance of clear model • Challenge of not being a manualized intervention • Approach similar to the National Wraparound Fidelity process • Key principles, then core practices • The NEST and modified Delphi process 34

35. Resources • What Works? study http://gucchd.georgetown.edu/78358.html • Early Childhood Mental Health Consultation: An Evaluation Toolkit (2007) http://gucchd.georgetown.edu/72407.html • Early Childhood Mental Health Consultation (2000; 2005) http://mentalhealth.samhsa.gov/publications/allpubs/svp05-0151/ • Center for Effective Mental Health Consultation http://www.ecmhc.org 35

36. Research Syntheses Duran, F.B.; Hepburn, K.S.; Kaufman, R.K.; Le, L.T.; Allen, M.D.; Brennan, E.M.; & Green, B.L. Research synthesis: Early childhood mental health consultation. Available at Center for Social Emotional Foundations of Early Learning (CSEFEL) website http://www.vanderbilt.edu/csefel/pdf/rs_ecmhc.pdf Brennan, E. M., Bradley, J. R., Allen, M. D., & Perry, D. F. (2008). The evidence base for mental health consultation in early childhood settings: Research synthesis addressing staff and program outcomes. Early Education and Development. Perry, D.F., Allen, M.D., Brennan, E.M., & Bradley, J.R. (in press).  The evidence base for mental health consultation in early childhood settings:  Research synthesis addressing children’s behavioral outcomes.  Early Education and Development 36

37. Question Review and Response 37

38. For More Information • Frances Duran bazazf@georgetown.edu • Deborah Perry dfp2@georgetown.edu • Roxane Kaufmann kaufmanr@georgetown.edu 38

39. Join us for next webinar…. Preparing and Supporting the Workforce, Part 1: Key Skills, Attributes, and Characteristics Wednesday, May 26, 2010 2 PM EST, 11 AM PT Presenters: Elizabeth Bicio Early Childhood Consultation Partnership, CT Pamala Trivedi Bright Beginnings, Inc., Washington DC Deborah Perry Georgetown University Center for Child and Human Development 39

40. After the Webinar • Evaluation • Unaddressed questions/archives • Technology change • For any webinar connection/participation issues, contact Kathy Hepburn, ksh@georgetown.edu Thank You 40