Being a mental health consultant and taking a consultative stance are a fundamentally different approach than the traditional one-on-one, therapy services for which mental health practitioners are typically trained. In fact, mental health practitioners prepared to be early childhood mental health providers AND consultants can be few and far between.

Even when early childhood mental health providers are present in the community and available to a Head Start and Early Head Start program, early childhood mental health consultation that is relationship-based, capacity building, yet indirect in its approach requires a unique set of skills. Specific training in being a consultant and practices associated with the consultative stance requires special focus to fully prepare for early childhood mental health consultation.

Although there are a number of models for training early childhood mental health consultants and increasing the availability of a prepared workforce (Korfmacher & Hilado, 2008), there are few formal training programs that emphasize the consultative stance as an important skill in effective mental health consultation.

San Francisco Daycare Consultants Program, within the University of California, San Francisco Infant-Parent Program has offered consultation services to over 125 child care settings and currently serves 40 child care programs, early education, and other settings.

Daycare Consultants is a unique practice-based training program for mental health clinicians who wish to become consultants. The training integrates infant and early childhood mental health principles and knowledge of early childhood education and development, and is comprised of four key elements: a didactic training seminar; a clinical conference; clinical supervision; and direct consultation experience (Johnson & Brinamen, 2005). A particular strength of the Daycare Consultants Program is the focus on relationship-based consultation and the practices associated with the consultative stance. As a training approach, The Daycare Consultants Program’s preparation for becoming a consultant uses seminars, case conferences, supervision, and consultation experience to build a knowledge base that includes:

• Focusing on self-reflection
• The consultative stance — elements of mutually respectful, reciprocal relationships
• Early childhood development from a transactional perspective
• Group care —culture and implications for consultation
• Relationship focused adult group work and organizational functioning
• Adapting clinical interventions to serve consultative role
• Observation — several programs with a seasoned staff consultant, proceeded and followed by discussion
• Initiating Consultation —initial request and considerations, getting to know the program
• Beginning Case Consultation — gaining entry and setting the tone
• Gathering Information — creating a picture of the child
• Co-creating Meaning — interpreting behavior and developing hypotheses
• Translating Meaning into Action
• Termination or consultation

(Johnston, 2010)

In Georgetown’s study of six effective consultation programs, all sites had in-service workforce development plans and as well as structures for supervision. While there was a good deal of variability across study sites with regard to the length of training and who facilitates the training, there was much commonality in the topic areas addressed. Four sites specifically focused on relationship-based intervention, reflective practices, and supervision. Within these four, two sites provided orientation to as well as training and support for practices associated specifically with the “consultative stance” (Duran et al, 2009).

Incorporating formal preparation in the skills and practices associated with the consultative stance in training programs focused on early childhood mental health consultation remains an important area of growth.