1. What is Infant Mental Health Endorsement® And Why Should I Care? Starting Strong Conference Tacoma, WA August 5.2015 Stacey Frymier, MA, LMHC, ATR, IMH-E®(IV-C) WA-AIMH Endorsement and Training Coordinator

2. What is Infant Mental Health?

3. What is IECMH? Infant and Early Childhood Mental Health (IECMH) is the developing capacity of the child from birth to three to: Experience, regulate, and express emotions; Form close and secure interpersonal relationships; Explore the environment and learn, all in the context of family, community, and cultural expectations. Infant mental health is synonymous with healthy social and emotional development. Zero to Three, the National Center on Infants and Toddlers, 2001

4. IECMH Principles  Babies develop in the context of relationships  Caregiver/child attachment is the foundation for all areas of the child’s development, therefore: IECMH work is dyadic in nature Caregivers often explore issues from their own lives that may be interfering with strong attachment Focus is on building resilience in baby, primary caregiver(s) and their relationship

5. IECMH Informed IECMH principles can be applied to any work with young children and families that promotes positive social emotional development of child Mental health, case work, home visiting, child care, nursing, early intervention and more! How might this relate to your field?

6. Infant and Early Childhood Mental Health in Washington  No agreed-upon set of competencies that crosses disciplines  All IECMH practitioners need specialized knowledge and experience to provide consistent, high-quality services  Dearth of practitioners in certain parts of the state, especially rural areas  Need for more awareness and training in the IECMH field (“Now I know what ACEs are, but what can I do about them?”)  Need for more Reflective Supervision and Consultation

7. Role of Washington Association for Infant Mental Health (WA-AIMH)  In 2013, WA-AIMH’s Board voted to adopt a nationally-recognized Endorsement ® System to help address these needs  An Executive Director was hired and funds were raised to purchase the Endorsement ® System  By the end of 2014, funds were raised and the Endorsement and Training Coordinator was hired  May 2015: Endorsement ® Registration opened

8. The Birth of a Professional System: History of Endorsement ® In the 1970s Selma In the 1970s, Selma Fraiberg developed services in Michigan, coining the phrase, infant mental health In 1983, the Michigan Department of Mental Health funded infant mental health services through community mental health agencies where staff training was integral to program design

9. Professional Competencies By 1986, Michigan Department of Education identified core competency domains for early intervention professionals: Theoretical Foundations Legal/Ethical Foundations Interpersonal/Team skills Direct Service Skills Advocacy Skills

10. MI-AIMH Endorsement Committee By 1997, MI-AIMH committee members completed the areas of core competency for IMH professionals by adding to the identified domains: Systems Expertise Thinking Reflection

11. A Systematic Plan for Endorsement ® By 2000, MI-AIMH called the plan an endorsement:  The MI-AIMH Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health ®

12. Alliance for the Advancement of Infant Mental Health (League of States)

13. League Endorsement ® #’s: 2013 STATE# ENDORSEDIN PROGRESS Michigan545290 Idaho102 Kansas6248 Wisconsin1510 Colorado222 Connecticut1812 Texas87259 Alaska40 Virginia100 Arizona76178 New Mexico7027 Oklahoma2328 Minnesota3350 Rhode Island10 West Virginia00 New Jersey30 Indiana270 LEAGUE TOTALS1006906 2012 TOTALS8781092 2011 TOTALS589958

14. The Endorsement - IMH-E® A 4-level, interdisciplinary, professional development system to expand and recognize competency in the infant mental health field : Infant Family Associate - Level I Infant Family Specialist - Level II Infant Mental Health Specialist – Level III Infant Mental Health Mentor (later expanded to specify clinical, policy or faculty/research) – Level IV

15. Endorsement ® : A 4-Level Plan Infant Family Associate Infant Family Specialist IMH SpecialistIMH Mentor: Clinical, Faculty, or Policy EducationCDA/AssociateBachelors or Masters Masters or Post- Graduate Masters, Post- Graduate Work Experience2 yrs. in infant/family field 2 yrs. post- masters IMH practice 3 years as IMH practice leader In-Service Training Minimum 30 hrs. Minimum 30 hrs. Minimum 30 hrs. Minimum 30 hrs. References3333 Reflective Supervision Not requiredMinimum: 24 hours Minimum: 50 hours Clinical: Minimum 50 hours Code of Ethics & Agreement Signed Written ExamNo Yes MembershipYes

16. Structure of Competency Guidelines  Each of the eight domains list subcategories of knowledge and/or skill areas: Theoretical Foundations; Law, Regulation & Agency Policy; Systems Expertise; Direct Service Skills; Working with Others; Communicating; Thinking; and Reflection  At each level, those knowledge/skill areas may be more specific to the Endorsement ® category. For example:  Attachment, separation, trauma, grief, & loss is required at all levels  Disorders of infancy/early childhood is not required at Level I but is required at all others  Parent-infant/very young child relationship-based therapies & practices is required at Level III and IV-C, but not at I or II

17. Overview of Competencies Theoretical FoundationsDirect Service SkillsSelect others Pregnancy & early parenthoodObservation & listeningEthical practice Infant development/behaviorScreening & assessmentAgency policy Infant/family-centered practiceResponding with empathyService delivery systems Relationship-focused therapeutic practice Intervention/treatment planningCommunity resources Family relationships & dynamicsDevelopmental guidanceBuilding & maintaining relationships Attachment, separation, trauma, grief, & loss Supportive counselingSupporting others Psychotherapeutic & behavioral theories of change Parent/Infant relationship- based therapies & practices Collaborating Disorders of infancy/early childhoodAdvocacyAnalyzing information Mental/behavioral disorders in adultsLife skillsExercising sound judgment Cultural competenceSafetyParallel process

18. Individual Benefits Implementation of the Competency Guidelines ® and Endorsement ® can lead to:  A “map” to guide professional development (for both individuals and programs)  Access to specialized, competency-based training  Access to reflective supervision/consultation  A method for demonstrating a specialization in infant mental health

19. What it means to professionals When asked how Endorsement ® has changed view/perception of infant mental health:  “I have a better understanding of the importance of this work.”  “[I am] well-prepared for work with families.”  “I obtained more relevant training and supervision than I would have otherwise.”  “The time spent preparing my application helped increase my understanding of IMH work.”  “The material for the exam deepened my understanding.”  “Increased my credibility.”

20. What professionals say about benefits of Endorsement ® to families  “I think it maximizes my capacity to be fully present with them.”  “I’m a more ‘well-rounded’ clinician due to requirements for reflective supervision and continuing education.  “My knowledge/studies make me a better therapist.”  “I am a better advocate in court.”  “Increased breadth of knowledge and treatment approaches.”

21. System-wide Benefits  Facilitates cross-systems collaboration to provide training and RSC in order to meet the standards laid out in the Competency Guidelines ®  Provides strategies to recognize the importance of workforce development for infant and family professionals  University (pre-service) programs have been designed to align with the Competency Guidelines ®  Endorsement ® is linked to professional development requirements and higher reimbursement rates for services in other states

22. Pursuing Endorsement ® : Next Steps  WA-AIMH website: www.wa- aimh.org/endorsement/www.wa- aimh.org/endorsement/  Review Requirements and Competency Guidelines to best determine which Level you qualify for  Submit Registration through the Endorsement Application System (EASy)  Complete Portfolio Application through EASy, with assistance from a WA-AIMH Advisor  Levels III and IV take written exam after Application is accepted

23. Additional Information  Contact Stacey Frymier WA-AIMH Endorsement and Training Coordinator at: stacey@wa-aimh.org  Contact Nina Auerbach WA-AIMH Executive Director at: nina@wa-aimh.org  Michigan Association for Infant Mental Health: www.mi-aimh.org