>> MARY MACKRAIN: Hello and welcome, everybody.
This is Mary Mackrain with the Center of Excellence.
You are attending the Key Considerations for Building a
Quality Infant and Early Childhood Mental Health
Consultation Model Part 1.
Today we're going to be talking about designing an Infant and
Early Childhood Mental Health Consultation approach or model.
So today's Infant and Early Childhood Mental Health
Consultation webinar is made possible through the federal
leadership of the Substance Abuse and Mental Health Services
Administration in partnership with the Administration for
Children and Families and the Health Resources and
Services Administration.
So today we are going to explore the critical ingredients to
consider when developing or enhancing a model for Infant and
Early Childhood Mental Health Consultation.
So when we talk about a model, we're really referring to an
approach to delivering these kinds of services.
So although we will not be providing an overview today of
what Infant and Early Childhood Mental Health Consultation is,
you can access our past three webinar recordings to get that
information following today's webinar.
So if you want to dive a little bit deeper into the definition,
what it looks like in home visiting or early care and
education, we have this series of webinars that have already
been recorded and are available for you to listen to.
So we have three objectives today.
It may seem that's not a lot to cover, but we indeed do have a
lot to cover with you today.
So, first we want to share the components or key ingredients of
successful models known to work.
So while the Center of Excellence does not use or
advocate for a specific model currently, we do provide
guidance from research and successful national models to
really assist all of you on the line today in navigating your
own planning and development.
I know that I was part of developing a model in Michigan
and we started over a decade ago.
And at that point there weren't a lot of models to pull from but
we really did wonder what are other people doing that
really works.
And now, a decade later, there are lots of really
successful models.
So what we try to do is really pull those key ingredients from
evidence-based or research-informed models and put
them into an interactive that would really help you consider
those same kinds of ingredients for the work that you are doing.
So the guidance and resources to support your work can be found
in the Center of Excellence Models interactive planning
guide which we will navigate today with the help of several
additional speakers.
Lastly, we hope, as in all of our webinars, you can take away
several next steps for you and your team to enhance or grow
your own model for implementing mental health consultations.
So whether you're seasoned and you've been doing this for 10 or
15 years, maybe you're just getting started, you've been at
it for a couple of years, or you're just on the edge of
thinking about it as something that you want to pursue, I think
everybody will get a little something out of
today's webinar.
So I would like to turn it over for a few minutes to Jennifer
Oppenheim, the Senior Advisor on Early Childhood for SAMHSA's
Center for Mental Health Services.
Jennifer is going to share our long-term vision for Infant and
Early Childhood Mental Health Consultation models.
Jennifer, I will turn it over to you.
>> JENNIFER OPPENHEIM: Okay. Thank you so much, Mary.
As Mary mentioned, I am the Senior Advisor on Early
Childhood at SAMHSA and I have the great privilege of getting
to lead the work on the Center of Excellence.
SAMHSA is the agency within the Department of Health and Human
Services that is charged with advancing the behavioral health
of the nation.
Personally, I can think of no better way to promote the
nation's behavioral health than beginning with young kids and
ensuring that they have experiences and opportunities
that lead to healthy development, in particular
healthy social/emotional/ behavioral development.
As many of you know, Infant and Early Childhood Mental Health
Consultation is a strategy for making sure that adults who
teach kids, interact with children, nurture their
development are equipped to promote their
healthy development.
And consultation really builds adults' capacities to recognize
developmental and behavioral issues and address
them effectively.
So that's why we're all here.
One problem is that not everyone has access to this approach.
The opportunity, on the other hand, is that more and more
people are learning about it and wanting to use it.
And the mission of the Center of Excellence is to help more
states, tribes, and communities adopt Infant and Early Childhood
Mental Health Consultation and build systems that support its
widespread use.
Mary mentioned the Toolbox on the SAMHSA website is one key to
moving this work forward.
And you all are going to get to delve into part of the
Toolbox today.
The Toolbox itself contains seven modules that comprise the
major areas of activity for building an Infant and Early
Childhood Mental Health Consultation system.
Each module of the Toolbox has an aspirational vision statement
like the one that you see on this slide which is for
the Model.
As the slide depicts, the Model's vision statement has
two components.
First, that every community will adopt a high quality model of
Infant and Early Childhood Mental Health Consultation, one
that is evidence-based, culturally responsive, and
sustainable, and second, that communities that are interested
will be able to choose from national proven models that can
be implemented easily and effectively.
Unfortunately, the field is not yet at the point where national
evidence-based models are ready for widespread adoption.
On the other hand, the Toolbox offers you two next best things.
First, an interactive tool and lots of guidance to help you
walk through building your own high-quality model, as Mary
mentioned, and that is based on what's currently known about key
steps and essential ingredients in high quality models, and then
second, examples of existing models and model components from
around the country that will also give you more information
and ideas to build from.
So, without a doubt, the backbone of establishing an
Infant and Early Childhood Mental Health Consultation
system is creating a strong model for service delivery;
hence, today's webinar.
And I commend all of you for joining the webinar to
learn more.
The Center really is committed to supporting you in doing this
important work.
And we will be providing even more guidance and examples and
tools related to model development in the year ahead.
In the meantime, though, I'm going to turn things back over
to Mary and the other presenters so they can explore the Models
module with you and hopefully get you energized to do or
continue doing this important work where you are.
So, thank you.
And, Mary, I'll turn it back to you.
>> MARY MACKRAIN: Great. Thanks. Okay, everybody.
I want to give you a very brief history of the development of
the Models work and then we'll dive into the actual components
so you can get your hands on some of the tips and tools
and resources.
The Center of Excellence team began planning the development
of this Toolbox by first investigating categories that
were generated from a national convening of Infant and Early
Childhood Mental Health Consultation experts and federal
partners in September of 2014.
After this convening, you'll see the categories on this screen
that popped up as really important components or
ingredients for mental health consultation.
In addition to a thorough gap analysis across each one of
these categories, our team also administered a survey to, again,
national experts and practitioners across the United
States to really rank and organize the greatest gaps and
needs across categories because a lot of really good information
has already been created and developed.
So, as you can see, 100% of the respondents strongly agreed that
Models was an area where we really needed to focus on
building a national vision and where we needed to
increase resources.
The developers you can see on the screen.
These are folks that have had a hand in this kind of work for a
long time.
So we did organize a group of professionals who have worked in
this field for many years.
And the work we're going to present next from the Models
interactive planning really reflects these
collective experiences.
We did want to give a special thank you to Liz Neptune with
Neptune Advantage for reviewing and refining this resource with
an important lens for tribal communities.
Additionally, we are really grateful to Faith Lamb-Parker,
the Director of the Center for Culturally Responsive Practice
at Bank Street College, who did an intentional review and
refinement of what you are going to see ahead of you and the
accompanying resources to strengthen cultural sensitivity.
We know that we have a lot of work to do in this area and
we're learning together, but we do want to make sure that
culture is at the forefront and that we're really putting out
resources that are equitable and really help move us forward.
So we wanted to give a thank you to those participants.
Today you have several presenters: Jordana Ash who
works with the Colorado Office of Early Childhood, Linda
Delimata, a TA specialist with the Center of Excellence, and
Deborah Perry, one of our senior experts who advises us along the
way from the Center of Excellence through our partner
at Georgetown University.
If you get onto the SAMHSA website and you go to the
Toolbox, you'll notice to the far left the arrow is pointing
to Models.
This is just demonstrating the webpage where you find the
Models section.
And again, although we're not offering you models for you to
choose from and use, we are offering you tips and tools from
research and successful national models to really assist you in
navigating your own planning and development.
So you make sure that what you develop meets those criteria but
also meets the unique needs of your community, children,
and families.
Once you click on the Models interactive, this is the cover
page that you'll see.
And you can choose to go through the entire interactive or go
step-by-step.
And at the conclusion you get a summary with accompanying tips
and tools unique to your needs for your state, tribe,
or community.
You might have wondered why do we have a Part 1 and a Part 2.
The interactive planning guide is organized sequentially with
each step building on the one before.
So this is going to allow everybody that accesses this
resource to really reflect and address each step that research
and practice-based experience really deemed important for
developing a comprehensive model.
So you can choose to move quickly through some content
areas that you're well established and you can spend
more time in areas that you need further development
or refinement.
You can print this planning guide out as a PDF and really
use it to guide your work together.
So it might be tempting to go into Part 2 and begin creating
your service delivery methods, but just remember that the
initial six steps in Part 1 really set a good foundation for
a well-designed, strongly supported, and clearly
articulated model.
Part 1 is going to help us to determine what is needed to
begin the process and Part 2 identifies how you want to do
your mental health consultation work.
Although there are six steps in this first section, our speakers
Jordana, Linda, and Deborah will do a deep-dive into three
components and share tools and experiences.
And anyone listening today can dive in and peruse the
additional steps at any time.
We'll talk about developing a core team, and overarching
vision, and developing your theory of change.
With that, I'm going to turn it over to Jordana who is our
first speaker.
>> JORDANA ASH: Thank you, Mary.
And good afternoon, everyone.
I'm excited to talk to you about the development of your core
team as part of your Infant and Early Childhood Mental Health
Consultation system.
Whether you're just getting started with building the
consultation work in your state or region or if you already have
an existing system of consultation that you're
enhancing or bringing to a bigger scale, a core team is
essential to your success.
Before we go into what to think about when developing your core
team, let's take a moment to ground ourselves in why a core
team is even necessary.
You may have momentum growing in your agency or organization
around Infant and Early Childhood Mental Health
Consultation, you may have some funding on board, you may feel
like you're ready to go.
Is slowing down really necessary at this stage?
I would say in a word yes.
The core team brings together individuals with a range of
knowledge and experiences essential to the development of
a sustainable system of Early Childhood Mental
Health Consultation.
The nature of that consultation work at its most basic level is
really cross-sector.
We're bringing together a mental health professional into an
early childhood system.
Right away differences emerge.
What defines a client?
What do outcomes look like in different spheres?
Who regulates the work?
And how quality is assured looks different from
different disciplines.
Programs are financed through a range of state, federal, and
private sources each with different assumptions and
approaches to doing business.
These constraints and opportunities for alignment are
operating and influencing the work and the core team becomes
your mechanism of understanding and incorporating all voices
into the development, support, and growth of your program.
Champions may be present at the onset but equally likely they
may emerge by having an interested participant deepen
their understanding of the mission and of the impact of
the work.
That often sparks a passion and a commitment to move the
work forward.
You don't always know who in the room is going to become
that champion.
I once went to a leadership camp way back when I was about 14
years old.
Actually, it was here in Colorado before I lived here.
I've never forgotten one of the sayings that we learned when we
were there.
People tend to support what they themselves create.
The core team for Infant and Early Childhood Mental Health
Consultation is like that.
When people are brought to the table to participate in the
thinking together and feel like they have contributed to the
building of something, they are often then invested in its
growth and longevity.
The interactive helps us think about how to go about this.
I know from experience that taking time right here in the
process is key, no matter what stage you're in.
I have been in the world of Infant and Early Childhood
Mental Health Consultation for about 16 years now and I admit
that sometimes I want to take shortcuts when it comes to
methodically working through the initial steps in considering the
system of consultation, but slowing down and taking the time
to candidly review where we were in Colorado with our core team
has been extremely beneficial to our progress here.
These two questions that you see up here on the slides are really
prompts to just get you thinking.
There are great resources available to you by clicking on
the links and taking a deeper look.
Here is an example of what you see when you access the action
planning document on the interactive.
That was one of the links on the page right before this.
So this screenshot right here is not exhaustive.
It's one of multiple pages on the Action Plan document, but it
gives you a sample of the types of entities that you're going to
want to consider as you initiate or grow your core team.
The Center of Excellence has done some really good thinking
about who might contribute, but you will have your own local or
regional unique partners to think about and to include in
this process.
I would suggest from my own experience that this become a
living document.
You may consider going beyond just checking off or assigning a
numerical representation there about how it's going to actually
identifying the individual name of who is going to participate,
and even more so than that, coming up with another contact
at that particular agency or organization to be in touch with
for the long term.
We want to institutionalize support for this work so that
when and if there are changes in members or participants on your
core team, the commitment to the work lives on.
Some of us needed to identify a core team for funding or to
build legislative support for efforts around Infant and Early
Childhood Mental Health Consultation in your own
individual state, and that's a really good place to start.
But again, I would suggest that you plan to revisit this at
least once a year to ensure that you continue to have the right
people at your table as the work and your system of
consultation evolves.
So now I'm going to share Colorado's story, specifically
related to developing our core team.
This isn't about our whole system of consultation, but it
will give you a sense of what it takes when you begin to focus on
the members of the core team, the participation, the kinds of
activities that can get done, and the real foundational
support it provides your system.
You may find that there already exists a group of people who are
gathered together around early childhood issues in your
community, state, region, tribe, or territory.
Maybe it's your Infant Mental Health Association that's
spearheading the consultation work in your state.
I imagine that some of you are Project LAUNCH grantees and that
you have a Young Child Wellness Council that may be designated
to serve as your core team.
And, of course, some of you are just setting out on
this journey.
So this is a condensed history of how our core team has
operated here in Colorado.
Early on in 2004 we had representatives from a wide
variety of community and provider groups, mental health
providers, state agencies, and others.
This group met around a shared interest, how could we leverage
our collective knowledge, skills, and experience to ensure
that all children reach their socio-emotional potential?
This was a new and exciting territory for all of us.
It was inspiring and motivating to be in the same room, to be
feeding off each other's insights, and collaborating
on initiatives.
We worked together for a number of years developing and
eventually even publishing Colorado's first strategic plan
for early childhood mental health in 2008.
It was at that time that we sort of moved from the red bubble, if
you will, to this sort of yellowish bubble.
Following that effort in 2008, a smaller group continued to meet
with a more targeted focus on Early Childhood Mental Health
Consultation. The rationale for that was multi-faceted.
We had and still continue to have to this day state-funded
mental health consultation programs.
There was some push from the broader early childhood system
to put in place some structure around the consultation work
in Colorado.
There were opportunities recognized that were on the
horizon in our state to influence and impact our
childcare regulatory system to be more inclusive of early
childhood mental health practices.
And there were champions within our group that kept the
enthusiasm high for all of us to see what we could accomplish in
this arena.
So an outgrowth of that work was our Mental Health Consultation
Infrastructure Brief which laid the groundwork for a more
fully-financed system of competent mental health
consultation in Colorado.
That's the publication in 2012 that you see there in the
green bubble.
Another accomplishment was made initially in 2013 to the
licensing regulations in Colorado for home childcare
providers regarding training on socio-emotional development and
the need to demonstrate how providers would contact a mental
health consultant if needed to support the needs of young
children in their care.
This took effort from our core team and enlisting outside
advocacy organizations to be successful in getting those
changes through the state plan process.
What I would say - and I wanted to share this piece with you
guys in particular - was that following this, while some core
members remained engaged, in truth, over time attendance
waxed and waned, especially when the core team did not have a
task or a goal that galvanized us.
We slowed down to some degree while there were other state
initiatives taking place, including investments in early
childhood mental health through the creation of my position in
the Office of Early Childhood.
We needed to sort out what resources people had, including
what energy there was around continued focus on consultation,
whether there was duplication of efforts, how to align and
organize the activities and participation so that people
weren't attending multiple groups for the same purpose.
The reinvigoration of our team happened for us around the
state-funded positions doubling to 34 FTE.
We had some funds around that time that we were able to devote
to building up our resources for the practice of consultation
in Colorado.
We paused and took a look at who was around our table.
We asked ourselves, similarly to the prompts on the Center of
Excellence Core Team Assessments, do we have the
diversity of voices that we need?
Who is missing from this conversation?
What haven't we thought about yet in this work?
And no surprise, some key a-has emerged.
We realized that we intentionally needed to include
the voices of consultants which actually had not emerged prior
to this.
They had certainly informed our work in the past and
periodically we had their representation at
our convenings.
That said, it took us getting into the weeds, into the
nitty-gritty of day-to-day practices to propel us to
develop a strategy for reaching out and including them.
Their contributions have provided a richness, a present
day reality that we had been missing.
Adding to that outreach, we committed to more effectively
using technology to bring in voices from the rural and remote
areas of our state.
Their experiences are shaped by the needs, barriers, and even
geography - like the mountain ranges in Colorado - that they
have to navigate in their service delivery system.
Our Denver-centric recommendations don't always
work for them and so we really need them at our table.
Lastly, we are fortunate in Colorado to have a robust Early
Childhood Mental Health Funders Network.
They are our authentic thought partners.
They fund important initiatives and they bring a
unique perspective to our system.
So currently our recharged core team is made up of people
involved touching policy, practice, workforce, and
research for the Colorado System of Consultation.
I just want to ask another one of our presenters, Linda, if any
of the pilot sites that you have been providing TA to bring
diverse voices to their core team.
>> LINDA DELIMATA: Thank you, Jordana.
That's a great question.
And the answer is yes.
But I think what we find is it's not enough.
Sometimes we are attempting to find a team that represents the
state that we serve and we have difficulty finding those people.
The answer is not just to say, okay, we don't have them or
let's give up.
The answer is to figure out, okay, what do we do about that?
If we don't have, say, consultants who represent the
population they serve, how do we go about making sure that
training happens?
How do we go about making sure there are resources to support
them as they get their continued education or whatever supports
they need to do that?
So you don't just stop.
You try to go deeper into some of the work.
I think of one state in particular that is looking at
how do we support a group of parents because it's a bit
awkward to bring one parent onto a team of state leaders.
How do we have several?
How do we make sure they represent the population?
So a lot of work is going into the planning of that.
>> JORDANA ASH: Yes. Thank you, Linda.
That makes a lot of sense.
I am going to turn this over to Linda who is going to share with
you her thoughts about creating a vision.
Thank you all.
>> LINDA DELIMATA: Thank you, Jordana.
One of the things we know is that we need to figure out what
does our success look like.
Where are we headed?
What do we want to do?
We need a vision statement that clearly talks about what will
success look like and major long-term impacts when
it's achieved.
So the vision statement in my mind looks like a signpost that
says headed in this direction and so we have to take a look at
how we put together that vision statement.
It sets the stage for consistent and shared understanding and it
gives us priorities so we know where to work and what to do.
Our Toolbox has several things that we can show that help us
with that.
One of the questions in our interactive planning guide is
about the vision statement and it asks these questions.
Does your team have a well-defined vision that
supports your success in Early Childhood Mental
Health Consultation?
Are your staff, families, and key partners a part of
creating that?
And are staff, families, and key partners able and willing to
articulate this vision?
You will see many people are saying, nope, we don't
have that.
If that's the case, then we have some things that we can offer
you to help with that.
One of them is a tip sheet.
In our tip sheet there is a guidance that talks about when
you create an overarching vision for your model and things that
you need to consider.
So you may have been thinking about we have to get really
complicated and pull in dictionaries and thesauruses,
when in reality what you want is something that is fairly simple
and includes our quality indicators and it's brief enough
that people can remember it and they can use it.
We need them to be easy to remember and we need a reminder
of what we're trying to get when we get stuck in the middle of
this work.
Here are things from the tip sheet that's in the Toolbox and
each of these are samples of websites that have some really
clear and well-defined vision statements that are a part of
the work that we do.
I wanted to point out the Administration for Children
and Families.
Their website says "Children, youth, families, individuals,
and communities who are resilient, safe, healthy, and
economically secure".
So it's pretty easy to understand what it is that
they're looking for.
They want to make sure their families are safe and they are
economically secure.
So I want to talk about one of the states I work with.
I work with three amazing states.
We've all been a part of the core team assessment, we've been
a part of a couple of other things, and several of the
states have been able to do some work on their visions.
West Virginia is one of them.
During a site visit, we pull together all the stakeholders
that we could think of in their state that were involved in
early childhood mental health, understood consultation, or even
if they didn't, understood what impacts young children, and we
did some problem-solving and we did some popping out of ideas
and we used our vision guide to go through that.
We got lots and lots of information.
It was just very impactful.
Because we may not know what all is going on in our states and
this gave us the opportunity to do that.
Then we pulled together the core team that is a part of our
support through the Center of Excellence.
That core team consisted of state leaders and we added some
people based on our core team assessments.
One of the things we thought about was where do families and
children go when they need socio-emotional support?
One of the things they added was, gosh, they go to their
physician, and the other one was many times they go to
faith-based agencies.
So having thought through this and looked at their core team
and talked about their vision, they made a change to what it
was that they were doing.
After we got some thoughts about the previous day, walked through
some things, we started working on what might this look like.
If we had a vision, what might this look like?
And several members - there were maybe about 16 or 17 at this
point - wrote down some things and then we pulled everybody
together and started rewording and saying, no, we want to make
sure we have that, and, no, we want to make sure we have that.
So, together, this entire team had input from the larger group,
thought through how it was going to affect them, and then put
together their vision statements.
So here it is.
This is West Virginia's vision that will move them forward as
they do this work: Supporting children, empowering families,
strengthening West Virginia communities through Infant Early
Childhood Mental Health Consultation.
What is so lovely about this vision statement is that they
named it.
They made it clear.
They aren't saying all kids will be healthy.
They're saying through Infant Early Childhood Mental
Health Consultation we're going to support the kids and empower
the families and strengthen West Virginia communities.
It was an amazing experience.
But we had a very amazing experience in Iowa as well.
In Iowa, we brought together a group of stakeholders.
We talked about everything going on in the state because many
people didn't understand and weren't sure where we were.
And then the core team started looking at that discussion and
talking about, well, what did we learn from that discussion?
Then we talked about a vision but it became clear that they
already had a vision.
They said in our early childhood world, we have a vision that
leads our state, and every person in the room could name
that vision, which was amazing.
So we decided we don't need a new vision.
This vision works.
Let's talk about a mission that relates to that vision.
That's what this group did.
They spent some time coming up with things for the mission.
They reworded them, they made sure they had all of the ideas
they want, and, of course, we'll go back and review and
revise it.
But right now, this is our vision statement.
So the vision statement is already there.
Every child, beginning at birth, will be healthy and successful.
But the mission statement says: To design and implement a
statewide, equitable and integrated Early Childhood
Mental Health Consultation system that addresses promotion,
prevention, and intervention so that every child reaches an
optimal level of socio-emotional development and wellbeing.
After we go back next time to our team, we'll ask everybody
about this.
There are some things in here that might be questionable.
How do we do this?
Do we do intervention?
So we will take that back to the team and we will walk
through that.
Okay. Deb, I think it's you.
>> DEBORAH PERRY: I just want to thank Mary and Jen and Jordana
and Linda for setting up my little section of this so well.
I think it's going to be very clear when you hear kind of this
last part how all these pieces really come together so well.
So what I'm going to do is really kind of talk a little bit
more about our theory of change, what a theory of change is, why
do we need one, and who should be involved in developing a
theory of change, and then maybe just for a second talk about
what's different between a theory of change and a logic
model because I think many of us have the experience of
developing logic models but not everybody may be familiar with
the concept of a theory of change.
A theory of change is really either a graphic or a narrative
articulation of the pathways or mechanisms through which we
believe an intervention or approach leads to changes in
short term or longer term outcomes of
collective interests.
Let's unpack that a little bit.
This idea of pathways or mechanisms through which we
believe an intervention leads to changes, that's the
secret sauce.
That's how do we think what we're doing is making
a difference.
And then this idea of both shorter term and longer
term outcomes.
That's where I think a lot of people may get confused between
a logic model and a theory of change.
Sometimes when people ask me what's the difference, for me,
if you have a very well done logic model, the theory of
change is actually the arrows in your logic model.
It's those pathways through which one thing is leading to
the next thing.
We're doing a specific set of activities, they lead to changes
in a specific set of short-term outcomes, which leads to some of
those bigger picture things that Linda was talking about in terms
of the vision statement.
I think one of the things I just want to emphasize is it's really
important to clearly specify the elements of the interventions
that are essential and sort of nonnegotiable.
And these are some of the very things in this Models
interactive that Mary described earlier that can help your core
team get greater clarity on.
You see how all these pieces are coming together.
Because, in fact, both Jordana and Linda highlighted the
importance of gathering the right mix of folks together to
help you walk through this process.
Theories of change are not just academic activities.
They're really, really useful in a number of different ways.
For example, it can make sure that how your training is being
delivered for the people who are doing Infant and Early Childhood
Mental Health Consultation, that those people are getting trained
in those essential nonnegotiable elements of the interventions.
So you can use that for training, you can use that for
fidelity monitoring.
You also can use it to engage partners in this work both at
the state level, so when you're building that core team, but
also when you're out in the community really engaging folks
with you in consultation so that you can be really clear about
what consultation is and what it isn't.
Also funders.
Funders are interested in having a very clear idea of why you
think what you're doing is going to make a difference.
Of course, my favorite reason for having a theory of change -
because my role in mental health consultation has always been
around evaluation and research - is that having a very clear
theory of change can help your evaluator tell the story of
successful implementation and help them make sure that they
pick tools and approaches that are unique for your context
and approach.
So those are some of the reasons why we think it's so important
to do that.
In the Models interactive, these are a couple of the questions
that we have you reflect on together.
You can see that immediately it's tied back to the vision.
So, in your vision, have you actually articulated some
long-term goals and outcomes?
And then how carefully aligned is your theory of change with
your program's vision?
So it's really a deepening and extension of some of the work
that Linda was talking about that she's done with her teams.
I have this picture up here for a couple of reasons.
There is a group of folks that represent about eight or nine
state systems of Infant and Early Childhood Mental Health
Consultation that have been around for a while.
Primarily, but not exclusively, the mental health consultation
work has been going on in early caring education settings, and
we collectively sat down and tried to see if we could come up
with a collective theory of change that would reflect all of
the different models and approaches that were being
implemented across these different states.
You can see that it happened on flip chart paper and there were
several drafts of it that were much messier and harder to read,
but a couple of things to take away from this.
One of the most important things is that there always needs to be
an acknowledgement of the context in which this work is
being done.
That is so important.
And Jordana mentioned rural and frontier.
The work in rural and frontier areas, it must look different
than it does in Denver and really representing the context
in which the work is getting done is crucial.
The other thing is that there are some of these sort of
digging a little deeper pieces that I want to explore in the
next slide.
So we took that sort of informal thing and we put it together
into something that looks a little bit more refined.
But I would tell you that this is still really very much an
evolving process.
Here we've got a few more double-headed arrows.
But, in general, if we're thinking about our theory of
change of mental health consultation, again sort of
thinking about childcare as a particular application of that,
we want to make sure that we take into account sort of the
characteristics or attributes or the experience or training that
the consultant brings into the work.
We also want to look at the characteristics and attributes,
experience and training that the consultee brings to this work.
And when we talk about mental health consultation as a true
partnership between a consultant and a consultee, those
characteristics and those attributes and what they bring
into the relationship is going to be crucial and we need to
articulate that as part of the approach or the model.
So, for example, the consultant will have experience with mental
health; will have at least a master's in mental health.
What does that mean about the way the work gets done?
This next box here is where we really are trying to go a little
deeper about what are the essential features of mental
health consultation that, for example, might distinguish it
from quality coaching.
There's a lot of activity going on in states right now.
People are working hard with their early care and education
folks to improve the quality of what's going on in the
classrooms and what's the unique part of mental
health consultation.
And so you can see here that we articulated a few pieces of what
Kadija Johnston calls the consultative stance which is a
way of being in the work that is sort of unique to a mental
health stance.
So that has things like creating a holding environment for the
teacher so that they feel safe to talk about things like
anxieties or worries they have about implementing different
kinds of interventions or reflective questioning or the
parallel process.
You'll also see here that we articulated reflective
supervision as an essential element of a mental health
consultation model and sort of called that out specifically.
That's one of those nonnegotiables.
And then here in terms of mental health consultation, sort of the
activity itself, we went a little deeper and talked about
what kind of content strategies and delivery strategies might be
part of those models.
When you unpack all of that, our theory of change then says that
doing these things in this particular way leads to changes
in the way the consultee thinks about their work, feels about
individual children or their co-teachers or their peers, what
they believe about what's developmentally appropriate, and
what they know about young children, what's important for
young children's development.
Those things in turn manifest in behavioral changes, changes in
relationships with children, changes in relationships with
their co-teachers.
And then through those changes we see changes in child and
family level outcomes or changes in the classroom climate.
This articulation, this sort of slowing down and thinking
through is what a theory of change really looks like.
I want to just give Linda a chance to kind of talk through
their experience in Illinois when they developed their theory
of change. Linda.
>> LINDA DELIMATA: Thank you.
I think that you really said a lot.
So one of the things that we thought about was how do we go
about designing this theory of change.
So we pulled in some people to help us write this and go
through the process and think through it and then think
through it again and refine and develop it so that it meets what
we would like to do as we move forward with our national model.
It's an open document.
It changes.
It guides us.
But it's open to having some thoughts or suggestions as we
move forward.
And I can't emphasize how helpful it was to have someone
come in and walk us through that.
Thank you, Deb.
>> DEBORAH PERRY: I really like the fact that, Linda, you
mentioned that sometimes it can be helpful to have an external
person who is kind of capturing this and asking those sort of
probing questions to go a little deeper about what these
pieces are.
What I like about the Illinois theory of change is that it
looks at systems level strategies, too.
I think that's a real addition to the example that I had
provided earlier.
I think I'm going to turn it back to Mary now.
>> MARY MACKRAIN: Great. Thank you so much, Deb.
We surely hope that you got some good tips and tools today on
developing your core team, creating an overarching vision,
and really diving into the development of a theory
of change.
Hopefully you see now that there are lots of resources that you
can pull from within the Models interactive.
At this point, though, I did want to remind folks that our
Part 2 of the Models webinar is coming up, so please do join us.
It was wonderful having all of you online learning with us.
Thank you, everybody.
Have a wonderful day.
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