Building reflective capacity and improving well‐being of early childhood professionals through an embedded cross‐system model of infant early childhood mental health consultation

Abstract

Infant and Early Childhood Mental Health Consultation (IECMHC) aims to improve early childhood professionals' abilities to promote children's mental health through relationship building and collaboration. Using a longitudinal, matched-comparison group design, a 3-year pilot study of a cross-system, embedded model of IECMHC assessed teachers and home visitors in intervention and comparison programs in reflective capacity, burnout, and perceptions of children's behavior. A sample of 136 staff (n = 72 intervention group; n = 64 comparison group; 21% Black; 51% White; 28% Latina/Hispanic) participated in surveys over a 21-month implementation period. A subsample of staff (n = 26) participated in interviews that included a narrative measure of reflective capacity; and a smaller subsample of teachers only (n = 21) completed assessments of children. Staff in the intervention group significantly increased reflective capacity after 21 months. For the staff interview subsample, receiving the intervention predicted lower levels of burnout at 12-15 months post-baseline. Among teachers completing child assessments, those with higher reflective capacity rated children's behaviors more positively than teachers with lower reflective capacity.We conclude that this IECMHC model successfully improved reflective capacity in staff. Future research should investigate reflective capacity as a potential mechanism of change for IECMHC.

Reflective supervision and reflective practice in infant mental health: A scoping review of a diverse body of literature

“…Parallel process (what the practitioner's emotional experience in the relationship tells them about the emotional experiences of the infant/child and the family members in their relationships) appears to be a difficult concept and affectivecognitive skill to learn and to discuss (e.g., Meuwissen & Watson, 2022;Veloni, 2017). Spielberger et al (2022) found no effect on teacher reports of child wellbeing or expulsion risk (on the Preschool Expulsion Rissk Measure) as a result of teacher engagement in an IECMH program. Shivers et al (2022) also measured expulsion risk and found that it decreased more strongly for Black boys than white boys over the course of a 12-month IECMHC program.…”

“…However, this is not corroborated by Spielberger et al (2022), who found no effect on burnout from participation in an IECMH program, nor by Hazen et al (2020), who found that RS/C quality did not impact post-intervention burnout ratings. The latter study found some evidence of RS/C quality having a mediator effect on burnout (Hazen et al, 2020) but this has not been corroborated by other studies (Spielberger et al, 2022).…”

“…Shea et al. (2020) found self‐rated reflective self‐efficacy negatively associated with endorsement of the statement “I feel burnt out at my job,” in their survey study of 56 IMH clinicians, and positively associated with the statement “I find my job satisfying.” In Spielberger et al.’s (2022) longitudinal evaluation of the effects of early childhood workers’ participation in an IECMH program, average participant ratings of burnout were low or low‐to‐moderate on all subscales of Maslach's Burnout Inventory (MBI), across timepoints; participation did not significantly affect self‐rated burnout. 15 supervisors and 55 home visitors engaged in a RS/C program evaluated by Watson et al.…”

“…There is some evidence (from Eaves et al, 2022) that practitioners who experienced consistent provision of a quality reflective supervisory relationship had lower self-rated burnout than practitioners who had less experience of a quality supervisory relationship, and an association between level of reflective practice self-efficacy and job satisfaction and not feeling burnout (Shea et al, 2020). However, this is not corroborated by Spielberger et al (2022), who found no effect on burnout from participation in an IECMH program, nor by Hazen et al (2020), who found that RS/C quality did not impact post-intervention burnout ratings. The latter study found some evidence of RS/C quality having a mediator effect on burnout (Hazen et al, 2020) but this has not been corroborated by other studies (Spielberger et al, 2022).…”

“…In the Shea et al (2016) survey-based study piloting the authors' RSSESS measure for supervisors and supervisees, 16 of 17 items on the supervisor measure showed an increase from before to after a reflective supervision training. Spielberger et al (2022) longitudinally assessed practitioner reflective capacity (using the Reflective Functioning Questionnaire) and found a statistically significant increase in reflective capacity after 21 months, as measured by the "Uncertainty" scale of the RFQ, although the absolute change in score was minimal. Shea et al (2022) conducted another study with IECMH consultants, grant specialists, supervisors, program managers and their group reflective consultants.…”