Core Program Components

Although mental health consultation has been a part of mental health services in Head Start/Early Head Start (HS/EHS) programs for years, it has only recently begun to generate more widespread national attention. More and more states and communities are investing in early childhood mental health consultation (ECMHC) to support young children’s social/emotional development and address challenging behaviors in early care and education (ECE) settings. As interest in ECMHC has grown, so has the need for data-driven information about the central features of effective consultation. To address this need, the Georgetown University Center for Child and Human Development (GUCCHD) conducted a study of programs that were specifically designed to provide ECMHC services in their states and/or communities (i.e., consultation programs) and that had demonstrated their effectiveness through positive child, family, provider and/or ECE program outcomes (Duran et al., 2009). Six diverse consultation programs from across the country – ranging in size from 2 to 20 mental health consultants — were selected to participate in in-depth site visits. As part of these site visits, the study team conducted interviews with multiple stakeholders, including consultants, family members and early care and education providers, and gathered materials to learn about consultation practices and assess commonalities.

Findings from this study resulted in the following framework for effective early childhood mental health consultation:

Framework for Effective Early Childhood Mental Health Consultation

Although this framework emerged from examination of consultation programs and includes some guidance that is geared toward this audience, for the most part, it speaks to the provision of effective ECMHC overall – regardless of whether it is provided through a structured consultation program, an independent mental health professional, or another arrangement.

As illustrated above, five key features of effective ECMHC surfaced across the consultation program study sites. These same features are relevant to Head Start and Early Head Start programs in the design and implementation of strong consultation services within their program.

• Solid program infrastructure. Effective consultation services in Head Start and Early Head Start are supported by strong program leadership, community outreach and engagement, and a clear organizational structure. Some specific organizational features include having clear values and a vision for mental health services, a thorough and thoughtful consultant hiring/selection process, providing or requiring strong support and supervision for consultants, and evaluating the impact of consultation services.
• Highly-qualified consultants. Highly-qualified consultants possess core areas of knowledge as a foundation for working effectively with young children, caregivers and early care and education programs like Head Start and Early Head Start. A consultant’s skills help them to build the capacity of caregivers and programs to support the social emotional of children in their care. The consultant’s attributes or characteristics influence the relationship-based and collaborative aspects of effective mental health consultation
• High-quality services. High-quality services include an array of services provided through an approach that relies on relationships, collaboration, and clear communication. The array of services spans those that focus on promotion, prevention, and intervention; build the capacity of caregivers and programs; include evidence based practices whenever possible; and are responsive to the unique needs and goals of the Head Start and Early Head Start program and the children and families that they serve.
• Positive relationships. The nature of the relationships between and among the consultant and consultees is key to effective consultation. The consultant’s capacity to “make a connection” with providers, family members, and children; build trust and develop strong positive relationships; as well as work collaboratively all contribute to the success of consultation.
• Readiness for ECMHC. The readiness of families and Head Start and Early Head Start programs to take part in consultation services, as demonstrated by an openness to gaining new skills at the individual level and the creation of opportunities to support consultant/consultee collaboration at the program level, also contribute to the success of consultation.

While each component is important and will be addressed in depth in this or another tutorial, relationships and readiness — which are labeled “catalysts for success” — are particularly important. These components act as the yeast in this recipe for effective ECMHC and deserve special attention. As such, the Center for Early Childhood Mental Health Consultation (CECMHC) has developed some specific resources to provide guidance on how to build strong relationships (see Mastering the Consultative Stance) and raise awareness of how Head Start/Early Head Start programs can enhance readiness at the program, staff and family levels (see Administrators Toolkit).

The remainder of this tutorial will focus on the defining characteristics of a highly-qualified consultant and high-quality services, as well as how to put those elements into place. Other tutorials will explore in depth how HS/EHS programs can nurture and support consultants to help them be as effective as possible, and hone in on enhancing key consultant skills such as cultural and linguistic competence and working in group settings.