1. The UCSF Daycare Consultant’s Approach to Training Kadija Johnston, L.C.S.W. Infant-Parent Program, U.C.S.F.

2. UCSF Daycare Consultants A component of the Infant-Parent Program – began in 1988 Extended the philosophy of treating young children in the context of seminal relationships to childcare Offers a range of mental health services in settings where young children (birth to 5 years) reside or are cared for including: family resource centers, residential substance abuse treatment, homeless and domestic violence shelters and, primarily, childcare centers.

3. Changes in Child Care Increase in number of children Greatest expansion of infant care Increase in hours spent in care

4. Increase of Children with Puzzling Behaviors Due to: Child care envisioned as protective measure As place to repair relationships Group care overtaxing for some children

5. Consultation Approach Based On : Understanding current conditions in child care Predicated on an appreciation of the transactional nature of development Acknowledging the growing sphere of adults

6. Aim of Consultation: Improving the quality of relationships especially the provider-child relationship. The surrounding adult relationships are attended to as well.

7. Intensive Training Program Developed Previous training rarely provides the skills and sensibility needed for consultation. Specifically absent a) an appreciation of early development from a transactional perspective b) appreciation of the importance and effect of interpersonal dynamics on organizational climate and c) appreciation of the implications/culture of group care. Clinicians whose culture and language capacities promote their ability to connect with the range of providers and parents with whom we were working. In addition to content expertise, a stance must be cultivated that allows for mutually respectful, reciprocal relationship.

8. Focus of Intensive Training Cultivate a sensibility and the consultative stance 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

9. Elements of Training Program Mental Health Consultation Seminar weekly year long Early Childhood Development Seminar weekly,year long Clinical Conference - monthly presentations on a rotating basis Clinical supervision – individual, 2-4 hrs, weekly Direct consultation experience – 2 to 5 programs

10. Consultation Seminar Observation – several programs with a seasoned staff consultant, proceeded and followed by discussion History of and current conditions in child care Cultivating the Consultative Stance – elements of a positive consultative relationship Initiating Consultation – initial request and considerations, getting to know the program Addressing Process through Content – considering levels of influence Adult relationships- consultant - consultee, interstaff and parent - provider

11. Consultation Seminar cont. Case Consultation 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

12. Early Childhood Development Seminar A bio-psycho-social model of development is introduced. A focus is maintained on the relational and broader social/cultural contexts that shape development. While typical development is the primary focus of the course, attention is also paid to the range of things that can complicate, threaten, or negatively impact optimal development. Risk and Resiliency Range of approaches to developmental screening and assessment

13. Clinical Conference. On a rotating basis, present an aspect of consultative work All clinical supervisors present Exchange clinical perceptions Share information regarding resources Learn about the other consultant’s experiences Commiserate about frustrations, struggles and disappointments.

14. Individual Clinical Supervision. A place for self reflection Understand ones impact on centers, consultees and families Emphasis on parallel process Explore conflicting emotions and assist consultant in maintaining emotional equilibrium Fosters mutual exploration and problem solving

15. Who is Trained? Initial Cohort Licensed or license eligible mental health professionals Ethnicities and /or language capacities reflected predominant populations served Each member of a 3 agency collaborative hired 2 clinicians All continue to work as ECMH Consultants

16. Who is Trained? Ongoing Newly hired consultants – within Daycare Consultant and mental health agencies in SF and surrounding California counties Graduate level mental health interns– pre or post doctoral or masters level, from the fields of social work or clinical psychology. Occasionally interns from other disciplines All with prior clinical experience with young children, preferably in group settings.

17. In response to requests from professionals not in a position to commit 20 hours a week Responded to requests on an ad hoc basis for several years. Recently developed a second comprehensive training program offering classroom-based training and program development consultation. Training Community Clinicians

18. Who Is Training ? The training staff represent a number of disciplines: Clinical psychologists (Ph.D. & Psy.D.), Licensed Clinical Social Workers (L.C.S.W.), Masters in Education (M.Ed.) w/, specialization in clinical infant studies and Marriage and Family Therapists (M.F.T.). Each has over a decade of mental health consultation experience.

19. Resources Description of Daycare Consultants Intensive Practice Based Training Program Sample syllabus for didactic seminar on consultation Johnston, K. & Brinamen, C. (2006). Mental Health Consultation in Child Care: Transforming relationships among directors, staff and families. Washington, DC : Zero To Three Press.

20. What Works ? Question Review and Response