Program Consultation

The Infant and Early Childhood Mental Health Consultation (IECMHC) Model is a preventive, relationship-based and capacity building approach that partners mental health professionals with childcare providers to improve children's social, emotional, and behavioral development.

This approach attempts to prevent and/or eliminate behavioral challenges in children by increasing the capacity all caregivers to address them. Mental health consultants meet with administrators once a week for up to 10 months to develop policies and practices that support children's mental health and program-specific needs identified by the readiness assessment (i.e. HERS-ECC-Program Readiness Assessment). Priority will be given to the development of policies and procedures to prevent preschool expulsion and increase parental engagement.

Below are examples of activities that take place in program-level consultations based on children's needs.

Program-level Consultations
Type of Activity Behavioral Group Consultant Role
Promotion Activities All children.
  1. Assess strengths and challenges within program.
  2. Support the creation of more prosocial learning environments.
  3. Promote and encourage staff wellness.
Prevention Activities Children at-risk for behavioral problems.
  1. Offer resources to teach social skills and appropriate behaviors.
  2. Offer suggestions about use ofsocial-emotional screening tools.
  3. Offer guidance on classroom management strategies.
Intervention(s) Children exhibiting challenging behaviors.
  1. Offer guidance on individualized support plans.
  2. Facilitate the connection to community services.
  3. Collaborate to develop inclusive policies.

Implementation Protocol

Program-level Consultations are implemented in accordance to the 5-steps implementation protocol of the IECMHC model:

  1. Initiation,
  2. Exploration of Concerns,
  3. Plan Development,
  4. Plan Implementation, and
  5. Transition Planning and Maintenance.

The table below details this implementation protocol.

Step 1: Initiation
  1. Introduce program services and explain the IECMHC model.
  2. Perform readiness assessment to determine eligibility.
  3. If program is eligible, program enrollment will follow.
  4. Discuss the details of the working relationship—role, data sharing, and program involvement.
Step 2: Exploration of Concerns
  1. Discuss concerns about program, staff, classrooms, and children.
  2. Concerns are linked to children's social-emotional development.
  3. Staff will seek parental consent for child-specific consultations.
  4. Discuss pre-evaluations.
Step 3: Plan Development
  1. Share evaluation outcomes.
  2. Collaboratively create goals (e.g. enhancing staff wellness) and a plan of action (e.g. training, coaching).
  3. Facilitate link to community resources to address needs.
Step 4: Plan Implementation
  1. Support the implementation of strategies and provides materials as needed.
  2. Support the implementation of evidence-based interventions.
  3. Continuously reflect, support, and monitor progress.
  4. Continuously evaluate needs, compliance, and satisfaction.
  5. Modify action plan as needed.
Step 5: Transition Planning and Maintenance
  1. Administer post-evaluation assessments.
  2. Reflect on services (e.g. most and least helpful, capacity growth) and final outcomes.
  3. Identify needs to sustain changes and address future challenges.

Effective consultations rely on the quality of the relationship between the mental health consultant and the administrator. Mental health consultants are responsible for building this relationship at every stage of implementation. Administrators are assisted in recognizing areas of improvement, maintaining progress, and brainstorming approach to future challenges. Administrators will also be encouraged to reflect on the growth and new skills of teachers and caregiver as well as any new perspectives demonstrated in consultations.

HERS-ECC-Program Readiness Assessment

Program-level consultations are guided by the HERS-ECC-Program Readiness Assessment. This tool rates the preschool environment across 5 domains and 13 indicators:

HERS-ECC-P Domains HERS-ECC-P Indicators
I. Develop and Clearly Communicate Program Practices and Procedures
  1. Established social-emotional and behavioral health promotion practices, and discipline and intervention procedures.
  1. Emergency Disaster Plan (e.g. COVID-19, hurricanes, pandemics).
II. Develop and Clearly Communicate Social-Emotional Program Practices
  1. Practices and procedures clearly communicated.
  1. Social and Emotional Promotion Practices/Challenging Behavior.
  1. Procedures for developmental and behavioral screenings and referral process.
  1. Inclusion policy and accommodations for children with special needs.
  1. Individualized behavior support plans.
III. Develop and Clearly Communicate Expulsion and Suspension Policies
  1. Policies eliminate or severely limit expulsion, suspension, and other exclusionary disciplines.
IV. Staff Support and Supervision
  1. Reflective Supervision/Staff Retention.
  1. Supporting Staff to Understand Implicit/Explicit Biases/ Staff Stress.
  1. Training of Preschool Teachers and Other Staff.
V. Program/Teacher-Parent Communication and Connection
  1. Program connection with families.
  1. Families share information and provide feedback.
Additional Required Topic (Ongoing; Unscored)

Program readiness and service preference (e.g. In-Person, Virtually, Hybrid).

Goals and Expected Outcomes

The goal of program-level consultations includes but are not limited to the following.

  1. Support administrators in implementing policies, practices, and procedures that promote of children's social emotional development, engage families, and effectively respond to children's challenging behaviors.
  2. Support and improve the administrator's capacity to enhance the emotional climate of the center including adopting trauma-informed practices.
  3. Support and improve administrator's ability to support teacher's professional development and wellness.
  4. Facilitate teacher's participation in professional development activities related to early childhood development.
  5. Facilitate teacher's implement of classroom practices that improve the emotional climate and prevent or address children's challenging behaviors.

As a result, the expected outcomes of these consultations are the development of expulsion prevention policies, access to reflective supervision for teaching staff, reduce stress and burnout to lessen attrition, fewer suspensions and expulsions, and improved school readiness.