Infant mental health and family support: Contributions of Early Head Start to an integrated model for community‐based early childhood programs

Abstract

This paper analyzes the experiences of an Early Head Start (EHS) program in adopting and implementing an infant mental health (IMH) approach in its work with community families. Through qualitative methods (participant observation, qualitative interviews, and case studies), we examined the strategies used, and the challenges encountered, by program staff as they applied IMH principles in their home-visiting interventions with families whose lives involve significant economic, social, and psychological stressors. Our study identified four elements crucial to an effective IMH initiative: (1) teamwork, especially the use of transdisciplinary teams to review family cases, (2) reflective supervision, (3) development of an integrated and empathic understanding of the child's needs and the parent's challenges in meeting those needs, and (4) a dynamic ecological understanding of children, families, and communities in which psychosocial and socioeconomic factors are viewed as mutually important and interactive. We argue that each of these elements both builds on and enhances long-standing dimensions of this EHS program's family support approach, creating an innovative and integrated model of IMH and family support that could prove of value in many community-based programs serving children and families whose emotional health is affected by everyday experiences of economic and social inequality.

Strengthening and recognizing knowledge, skills, and reflective practice: The Michigan Association for Infant Mental Health competency guidelines and endorsement process

“…Criteria for endorsement encourage professionals to integrate new knowledge about infancy and early childhood mental health with strategies that are culturally sensitive and skillful. The emphasis on reflective supervision encourages a framework for best infant and early childhood practice that is consistent with the literature and promotes professional growth (Eggbeer, Mann, & Siebel, 2007;Gilkerson, 2004;Gilliam, 2008;Heffron, 2005;Kaplan-Estrin & Weatherston, 2005;McAllister & Thomas, 2007;Pawl, 1995;Schafer, 2007;Shahmoon Shanock, Gilkerson, Eggbeer, & Fenichel, 1995;Weigand, 2007). Note that in 2006, the Annapolis Coalition for the Behavioral Health Workforce, a national, collaborative group based in New Haven, Connecticut, recognized the MI-AIMH Endorsement with an award for innovation in workforce development.…”

Serving Highly Vulnerable Families in Home‐Visitation Programs

“…It is apparent that no single discipline fully equips professionals to address the complex and diverse range of challenges faced by highly vulnerable families with young children. The use of multidisciplinary teams could better equip home‐visitation programs to address many of the challenges that highly vulnerable families encounter while recognizing the differences in families’ needs and strengths (McAllister & Thomas, ). This approach would enable programs to tailor interventions based on each individual family's needs and strengths, providing the healthcare expertise of a nurse to families with medically fragile, young children, and the expertise of social workers or mental health counselors to families who are struggling with parental addiction, depression, or both (Azzi‐Lessing, ).…”

“…Particularly in the infant mental health field, reflective supervision is well recognized as necessary to support high-quality work with vulnerable, young children and their families (Gilkerson, 2004;Perry & Kaufmann, 2009;Solchany & Barnard, 2004). The application of reflective supervision to home-visitation programs has shown promise (Chazan-Cohen, Stark et al, 2007;McAllister & Thomas, 2007) and should be further explored and evaluated.…”

Maternal depression and parental distress among families in the Early Head Start Research and Evaluation Project: Risk factors within the family setting

“…Some programs, for example, incorporate reflective supervision (Norman-Murch, 1996) into their programs, whereby staff are provided with regularly scheduled opportunities to collaborate with their colleagues and supervisors to more effectively support the families with whom they are working. Reflective supervision, however, has been shown to be extremely difficult to implement in community settings (McAllister & Thomas, 2007), and making "system-level" changes was particularly challenging for programs that aimed to incorporate a reflective supervision process within their programs .…”