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Reflective Consultation With Groups via Virtual Technology: What Is Best Practice?

Ashley McCormick, Faith Eidson, and Mary E. Harrison


As the field of infant and early childhood mental health (IECMH) continues to grow and professionals realize the value of reflective supervision/consultation (RS/C), the need for equitable access to quality RS/C expands. One way that providers of RS/C have increased access to RS/C is through virtual technology. The growth of virtual RS/C requires professionals to define best practice for this new medium. Through the use of the Best Practice Guidelines for Reflective Supervision/Consultation (Guidelines; Michigan Association for Infant Mental Health, 2004), we offer three case studies in which the Guidelines serve as the foundation for providing virtual RS/C to distinctly different groups.

The use and understanding of reflective supervision/consultation (RS/C) is critical to strengthening infant and early childhood mental health–informed (IECMH-informed) practice. IECMH-informed professionals include those who work in behavioral health, child welfare, early care and education, early intervention, health, home visiting, and mental health consultation. In 2004, the Michigan Association for Infant Mental Health (MI-AIMH) created the first edition of the Best Practice Guidelines for Reflective Supervision/Consultation (Guidelines). Infant mental health (IMH) professionals from Michigan, across multiple service sectors, created these guidelines to familiarize professionals with RS/C, to emphasize the importance of RS/C for best practice, and to better ensure that those providing RS/C were appropriately trained. MI-AIMH’s long commitment to the use of a multidisciplinary approach made it increasingly important to be able to refer to a clear set of guidelines describing the organization’s collective understanding of RS/C across disciplines and service sectors. In 2005, MI-AIMH expanded the Guidelines with input from the Texas Association for Infant Mental Health, now known as First3Years. Both groups offered this document as an open source to all their members.

RS/C is a key component of Endorsement® for Culturally Sensitive, Relationship-Focused Practice Promoting Infant and Early Childhood Mental Health (Endorsement®). Beginning in 2002, MI-AIMH started a national effort to raise the professional standards for the IECMH field by licensing the Competency Guidelines® and Endorsement to associations for infant mental health (AIMHs; Funk et al., 2017; Weatherston, Kaplan-Estrin, & Goldberg, 2009; Weatherston, Dowler Moss, & Harris, 2006). As the effort grew, the Alliance for the Advancement of Infant Mental Health (The Alliance) was created to provide the leadership and support needed for a growing organization (Funk et al., 2017). To date, 30 AIMHs and 2 international AIMHs participate.

The Guidelines have evolved over time to reflect changes in the IECMH field and to include new voices and new knowledge of RS/C practice. In this sense, it is a “living document” with each version representing a collective set of recommendations at the time. The most recent revision in 2018 was led by The Alliance to provide clarity around the following:

  • best practice for IECMH policy leaders, faculty, and researchers
  • best practice for consultants and consultees
  • reference to the Diversity-Informed Tenets for Work With Infants, Children and Families (Irving Harris Foundation, 2018)
  • differentiation between types of RS/C, including program supervisor as provider, group, and individual
  • exploration of the provision of virtual RS/C
  • more thorough definitions of the RS/C that is required for Endorsement

The Guidelines capture best practice at this moment in time. Members of The Alliance will respond as the IECMH field grows and changes, and while the core Guidelines provide a framework, this living document will continue to be revisited to reflect evolving knowledge from the field. The Guidelines remain an open source document for the field.

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