How services are delivered is a critical determinant of whether the consultant will be effective or not. A consultant’s approach to service delivery can have a significant impact on whether or not he/she will be able to form positive relationships with consultees, put successful strategies into place, and ultimately achieve effective ECMHC. There are a number of elements that contribute to an effective approach to service delivery, each of which will be described in this section.

Implement a strong service initiation process: When a consultant first starts working with a HS/EHS program, provider or family member, it is important to take steps to get things off to a good start. Part of this entails clearly communicating each stakeholder’s roles and responsibilities to avoid potential confusion and frustration. If the consultant is brand new to a HS/EHS program, he/she should consider establishing a Memorandum of Understanding (MOU) with the program to clarify expectations. In addition, the consultant should communicate widely with all staff and families about the availability of ECMHC services (and what that means) by disseminating materials, such as introductory letters, and participating in program activities, such as “Back to School” nights and staff meetings. Another important element is setting the right tone at the onset of services. Recommendations for doing this include:

• Convey an attitude of “I’m here to help” as opposed to “I’m the expert”
• Establish that you are working towards the same goal (e.g., helping a child or enhancing mental health services program-wide)
• Demonstrate a commitment to collaboration
• Offer concrete suggests and effective strategies to address challenges and remedy concerns (Duran et al., 2009)

Embrace values that support relationship-building and high-quality service provision.

• Collaborative: Collaboration between and among consultants and consultees (e.g., families, providers and HS/EHS programs) is a foundational component of high-quality services and is particularly critical to service plan development, implementation and modification over time. Through collaboration and open channels of communication, consultants gain a better understanding of which strategies to recommend and what the child, family, provider and program needs are over time. Further, collaboration with HS/EHS staff is essential to ensure coordination of services and avoid duplication of effort.
• Family-centered. Engaging families is essential if consultation — particularly child/family-centered consultation — is to be effective. Families know their children best and can provide valuable insight into a child’s behavior as well as the situations or circumstances that might be affecting that behavior. Furthermore, without family involvement to guide service planning and support implementation of strategies at home, the impact of consultation will likely fall short of desired outcomes.
• Culturally and linguistically competent. Cultural and linguistic competence is an important factor in establishing positive relationships and delivering services that suitable for diverse children, families, staff and programs. When exploring cultural issues, consultants should think broadly and consider ethnic, racial, linguistic, socioeconomic, education and religious aspects. Further, consultants must reflect on how their own culture impacts their approach to service delivery and reconcile this individual perspective with the collective culture of all of those involved in the consultation.
• Strengths-based. By developing strategies that build upon the abilities and positive qualities of the children, families and ECE providers involved in consultation, consultants not only set a positive tone but also increase the likelihood that recommended strategies will be implemented.

Individualize services/strategies. Services and strategies must evolve from and reflect an understanding of the unique needs, strengths and values of the staff, child and family. Individualizing service referrals is also important and consultants should be mindful of how consultees’ might react to a certain referral (e.g., therapy) and how feasible the referral will be given restrictions on time, money, etc.

Promote consistency across home and classroom settings. To maximize the impact of consultation — particularly child/family-centered consultation – service plans should support families and staff in implementing the same or similar strategies and addressing issues consistently across settings to reinforce concepts and/or appropriate behaviors. This need for consistency underscores the importance of collaboration on and individualization of service plans to ensure both parties are willing and able to follow through with the chosen strategies.

Utilize hands-on, practical materials. Another service delivery approach that is particularly effective is having materials that are ready-to-use and easy to successfully incorporate into daily routines (e.g., visual charts and cue cards, scripted social stories, “stomping pads” to help children appropriately vent their frustrations). This approach not only eases implementation for the consultees, but also bolsters relationship-building efforts by providing more immediate help to staff and parents and engendering trust in the consultant’s abilities.

Support HS/EHS program requirements and goals. To provide optimal service delivery to HS/EHS programs, consultants should find creative ways to provide ECMHC in a manner that helps programs meet their requirements and goals while constantly enhancing the scope and quality of mental health services. Approaching service delivery in this way alleviates burden for the program and helps to strengthen the program overall.