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What Does it Mean to Be a Leader in the Infant and Early Childhood Mental Health Field?: Research on Training and Supervision Needs

Jun 1, 2022

Emily C. Brown, Wayne State University; Christie Spudowski, PCS Counseling, Northville, Michigan, and Live Light Birth & Family, Detroit, Michigan; and Carla C. Barron, Merrill Palmer Skillman Institute, Wayne State University


This mixed methods study aimed to better understand the training and supervision needs of those in infant and early childhood mental health (IECMH) leadership positions. The study used individual interviews and online surveys to explore the question “What does it mean to be a leader in IECMH and what unique challenges do they face?” 10 IECMH leaders completed individual interviews and 64 completed the online survey. Using qualitative thematic analysis, interview data suggest that while IECMH leaders have extensive clinical training and education, they described challenges related to race, training/development, and feeling prepared and competent in their leadership roles. Data suggest that IECMH leaders use reflective supervision as one way of managing these challenges. This research provides considerations for organizations in regard to educating, training, promoting, and developing IECMH leaders.

The role of a leader in the infant and early childhood mental health (IECMH) field is complex. IECMH leaders hold in mind layers of relationships and influences that can impact the health and well-being of very young children and their families. This relationship-based perspective within the IECMH field requires an understanding of the many ways relationships can impact other relationships—including those between a young child and their caregivers, caregivers and IECMH practitioners, and practitioners and supervisors (Pawl, 1994; Weatherson et al., 2010). Thus, IECMH leaders must maintain a broad view of these important relationships. IECMH leaders often provide direct guidance to practitioners to address the emotional aspects of the work through the provision of reflective supervision (RS) and consultation and through advocacy for ongoing training and emotional support for their staff.

In addition, IECMH leaders must also hold in mind programmatic needs, such as productivity, billing, budgets, and agency goals (Schafer, 2007). Maintaining this balance is challenging to accomplish in a way that can offer both a reflective space for staff to explore their emotional responses to this work and opportunities to discuss administrative aspects of this work. IECMH leaders may also be in positions that require grant writing, networking, and advocating skills. In these ways, they offer indirect support of staff and families by effectively managing programs and advocating for policies that support IECMH work and the well-being of the families they serve (Weatherston et al., 2020).

Given these complex aspects of their work, it is important to gain a better understanding of the experiences of IECMH leaders. Identifying and examining the challenges that leaders face in this field and the resources that support them can strengthen service delivery. While there is vast clinical literature and growing empirical research related to the provision of RS (Heffron & Murch, 2010; Heller & Gilkerson, 2009), there is minimal research aimed at understanding the experience of IECMH leaders and supervisors. This study fills a gap in understanding ways to best support and mentor IECMH leaders in their role.

Photo: shutterstock/SteelStock

Infant and early childhood mental health leaders hold in mind layers of relationships and influences that can impact the health and well-being of very young children and their families.

For the purposes of this study, we defined leadership within IECMH primarily by specific roles/positions such as reflective supervisors, middle/upper program management, and policymakers. While there is clinical and empirical literature aimed at the provision of services for young children and families, there is a lack of understanding about how to recruit, support, mentor, and train IECMH professionals to take on a leadership role.

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