There is ever growing research on the critical importance of early relationships and social emotional health in young children which sets the stage for all development. However, there is a distinct lack of trained professionals to address the social-emotional and mental health needs of young children. NYCIT’s sister agency, New York Center for Child Development ( NYCCD), was selected by the NYC Department of Health and Mental Hygiene to become the NYC Citywide Training and Technical Assistance Center where they partnered with NYU’s McSilver Institute for Policy, Poverty and Research. Read about TTAC’s exciting efforts to build force capacity through training and technical assistance.
Building Workforce Capacity to Support the Mental Health Needs of Young Children and Their Families
By: Susan Chinitz, Psy.D.
Early Childhood Mental Health Training and Technical Assistance Center (TTAC)
New York City is supporting its youngest children’s early development and their families through an innovative training partnership and network, funded by the New York City Department of Health and Mental Hygiene (DOHMH) as part of ThriveNYC.
The Early Childhood Mental Health Network, which launched in 2016, consists of seven Early Childhood Therapeutic Centers (ECTCs), which are embedded within licensed mental health clinics across the city. The ECTCs are responsible for providing psychotherapeutic services for children birth to five years of age and their families, as well as Early Childhood Mental Health Consultation within publically funded early care and education programs serving children under five. A further innovation of the NYC model was the simultaneous development of a Training and Technical Assistance Center (TTAC) as an integral part of the Network, which provides workforce development and ongoing professional support for the staff of the Therapeutic Centers and others who work with young children and their families.
The specialized skill set required to provide psychotherapy to children under 5, and mental health consultation in preschools, as well as the paucity of clinicians who are trained in infant and early childhood mental health, made it critical to develop and provide training support as new clinical services were developed. The target audience for training is the staff of the ECTCs as well as staff in other child serving systems who have become increasingly cognizant of the importance of healthy social emotional development in early childhood. TTAC is a collaborative effort between the New York Center for Child Development, an early childhood service provider, and the McSilver Institute for Poverty, Policy and Research at the NYU Silver School of Social Work, each of which bring different and highly complementary areas of expertise to this effort.
TTAC offers its most intensive training to the staff of the seven Early Childhood Therapeutic Centers. This primarily includes on-going training in evidence-based therapeutic interventions. Based on an early needs assessment of newly hired staff in the Therapeutic Centers, as well as on knowledge of the high prevalence of trauma in many communities across the city, Child Parent Psychotherapy (CPP) was selected as the first evidence-based intervention in which clinicians and their supervisors were trained. CPP – a relationally focused, dyadic therapeutic intervention for young children along with a parent or caregiver – is indicated when either the child, the parent or both have been victims of traumatic experiences or have otherwise struggled with relationships disorders. This is an 18-month long training that incorporates the use of didactic sessions and the development of a learning collaborative of clinicians who convene monthly on group supervision calls.
In its second year, and in response to the needs expressed by staff of the ECTCs, training in a second evidence-based intervention – Triple P – a parenting intervention, has been provided.
In addition, staff of the ECTCs has been provided with intensive and on-going training and support in the provision of Early Childhood Mental Health Consultation using the Georgetown Framework. This, too, has included didactic training sessions supplemented by the use of monthly group supervision calls.
Throughout its first two years, the TTAC has enhanced its training efforts by inviting experts in trauma and other practice areas to address the clinicians working in the ECTCs as well as the larger community of professionals who work with young children. Drs. Alicia Lieberman and Chandra Ghosh Ippen, international experts in trauma in infancy and early childhood, spoke to a large, interdisciplinary audience about the impact of trauma on very young children as well as best practice principles of therapeutic intervention and community support. Dr. Marie Anzalone, a nationally known occupational therapist and author, provided training in sensory processing disorders, which often underlie children’s behavior problems at home and in school, to a large citywide audience of clinicians, preschool teachers and developmental therapists.
Clinicians from the ECTCs, as well as many clinicians working in other licensed mental health centers, attended a two-day training provided by ZERO TO THREE on the Diagnostic Classification for Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-5). This newly revised edition includes the latest conceptualizations on early onset mental health, developmental, and relational disorders, and also informs a developmentally, contextually and culturally attuned approach to clinical assessment and diagnosis of young children.
Given the pressures on clinics to be financially solvent, several half-day workshops have been offered by the McSilver Institute staff on the topic of business sustainability.
A significant feature, and asset, of the TTAC is its capacity to be flexible in its offerings, which are developed based on feedback from the ECTC staff, specific requests from other professional groups, and in response to emerging issues in the field. For example, in response to the presence in NYC this past summer of migrant children separated from their parents at the southern border, TTAC provided trainings to the staff of the organizations that provided legal and social services to these children on early childhood trauma, vicarious trauma and self-care, which were welcomed and very well received by these professionals.
Since its launch in 2016 through November 2018, TTAC has provided training for 205 staff from the DOHMH-funded Therapeutic Centers, 434 staff from other licensed mental health clinics, and more than 978 staff from various child serving organizations, totaling 1,617 unique individuals. Each training is followed by a detailed evaluation completed by participants, which provides feedback and input for new programming for the Network. To date, all trainings have received positive ratings and have been judged useful and effective for the Network’s practitioners. TTAC was also instrumental in the development of a series of three webinars on social emotional development in infancy and early childhood that has just been released by the NYC Bureau of Early Intervention, and will be available to thousands of early childhood professionals.
In conclusion, though the field has affirmed the efficacy of early childhood mental health services, there is great need to support the development of a work force that has the training and resources to work effectively with this special population. TTAC builds the capacity and competencies of mental health and early childhood professionals to identify and address the social emotional needs of children birth through five and their families through the continual needs assessment of professionals who work with young children, specialized training in evidence-based interventions and best practice approaches to mental health consultation, and via the development of workshops, webinars and other learning forums on topics related to social emotional development and early childhood mental health. Indication from all assessments suggests that these efforts have been effective and can provide a model for other localities seeking to expand mental health services for very young children.