Tutorial 8 · Developing a Vision and Strategic Planning
for Early Childhood Mental Health Consultation Services

Structuring & Supporting the Consultant-Staff Relationship

In a national study of mental health consultation in Head Start programs, researchers found that the single most important factor that was related to positive consultation outcomes was the quality of relationships between and among mental health consultants (MHC), staff, and parents (Green, Everhart, Gordon, & Garcia-Gettman, 2006). These relationships were even more important than how much consultation was being provided, or the frequency of consultation services! As program director, you can build the foundation for these relationships by hiring a consultant with the characteristics, competencies, and approach to service delivery that best fit the needs of your program, and by making sure that the formal contracting or hiring arrangements include a clear statement of key activities and lines of communication that support positive, collaborative relationships.

Some programs hire MHCs through subcontracts (either with individuals or with other organizations). Other programs hire MHCs directly as program staff. Whatever approach you use, you will want to make sure that there is a detailed contract or job description that includes a detailed description of the types of services and activities that you expect the mental health consultant to provide (and the amount of time expected). By specifying different kinds of activities, you set the stage for how staff and families will interact with the consultant (and vice-versa). It is important to include these in the job description or contract, but once the consultant is hired, you will want to create opportunities to discuss these collaboratively with the consultant.

Consider the following activities that can support collaborative relationships and facilitate positive staff-consultant relationships:

• Have the MHC provide regular formal training to staff
• Build in regular (ideally, at least monthly) time in each classroom
• Build in time for the MHC to attend staffing/family review meetings
• Allow staff to have email or other access so that they can contact the MHC directly with questions or concerns
• Emphasize in the contract that the majority of the consultant's time should be spent doing staff and program level consultation — rather than pull-out activities or direct therapy
• Consider having the MHC lead staff wellness activities, such as a staff support group
• Involve your consultant in the development and maintenance of the mental health strategic plan (see Module 2).

Consider these activities that can facilitate parent-consultant relationships:

• Have your consultant schedule time in the classrooms during drop off/pick up
• Have your consultant provide at least one presentation at Policy Council or at a parent event
• Have your consultant facilitate group-based parent services related to early childhood mental health (e.g., parent-infant attachment groups; parent education groups, etc.)
• Have your consultant write articles for your program newsletter about supporting positive mental health and well-being — make sure they sign their name to these contributions
• Have your consultant available to go on home visits with staff to facilitate consistency in how parents and staff are working with children

Equally important is that staff and families understand who the consultant is and how they should work with the consultant. For families, ask the MHC to write a generic letter of introduction describing the individual and his/her role in the program. Make sure the letter is informal and consistent with the program's vision for mental health services. You may want to co-sign this letter with the MHC.

Work with your program supervisors and managers to make sure that staff understand the role of the consultant and the expectations for partnership that are part of the consultative process. Staff should also understand and be comfortable with the activities that the consultant will be engaging in, and know what the parameters are for direct access to the consultant with questions or concerns.

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