Endorsement FAQ

Q.How Long Does The Endorsement® Process Take?

The average time to complete the process is about a year.  However, each person differs depending on their formal education, specific training and experience, and the amount of reflective supervision/consultation received.

Q. What Are The Benefits Of Earning Endorsement®?

  • You’ll grow and strengthen as a professional in the rapidly expanding infant, early childhood, and family services field
  • You’ll be recognized by employers and peers as a competent and skilled professional in a system dedicated to culturally-sensitive, relationship-focused practice, and quality care for all infants, toddlers, and families
  • You’ll better support the infants, toddlers, families, students, agencies, and institutions in the promotion of infant and early childhood mental health
  • As of December 2018, there are 2,623 professionals who have earned IMH-E® across the world and you will be a part of this cross disciplinary group of professionals!

Q. Why Is Endorsement® Important?

  • Endorsement® is meant to honor professionals who apply infant and early childhood mental health principles to their practice. It is not a license but an endorsement of a specific skill set that complements a license or credential.
  • Endorsement® recognizes professionals across disciplines, building a common language around the important factors in serving infants, toddlers, and families: healthy relationships to aid children in processing emotions, social emotional foundations in learning, and providers who recognize the value of caregivers in serving infants and toddlers.

Q. What Types Of Disciplines Can Be Endorsed®?

  • All disciplines who engage with infants/toddlers and their families are eligible for Endorsement® within different categories. Some examples include: Head Start and Early Intervention staff, home visitors, child care workers, pediatricians, social workers, clinical therapists, NICU nurses, etc.

Q. Why Should I Apply For Endorsement®?

  • Endorsement® communicates to families, professionals, and employers that an individual has exceptional experience and training in working with infants, toddlers and families
  • There are some employers and positions that strongly encourage employees to hold Endorsement®
  • An endorsed workforce ultimately means better services and thus better outcomes for babies!

Q. How much does Endorsement® cost?

The costs for IMH Specialist and IMH Mentor are in line with credentialing fees that have been established by other professional organizations. The credentialing fees support the overhead costs of the MassAIMH Endorsement® and allow us to have applications and tests carefully reviewed.

Category Registration Processing Fee
I: Infant/Early Childhood Family Associate (IFS/ECFS) $15.00 $25.00
II: Infant/Early Childhood Family Specialist (IFS/ECFS) $20.00 $100.00
III: Infant/Early Childhood Mental Health Specialist (IMHS/ECMHS) $25.00 $300.00
IV: Infant/Early Childhood Mental Health Mentor-Clinical
$25.00 $400.00
IV: Infant/Early Childhood Mental Health Mentor-Policy
$25.00 $400.00
IV: Infant/Early Childhood Mental Health Mentor-Research/Faculty
$25.00 $400.00

Q. Do Places Outside Of Massachusetts Recognize Endorsement®?

  • Infant Mental Health (IMH) and Early Childhood Mental Health (ECMH) Endorsement® for Culturally Sensitive, Relationship-Focused Practice are internationally recognized credentials.
  • Endorsement® is recognized in 30 states and 2 countries.  This body of states and countries is known as the Alliance for the Advancement of Infant Mental Health and it is growing as additional states adopt the credential.
  • State associations with an Endorsement® license honor reciprocity between other states that have adopted this system.

Q. Why Is Endorsement® Important To Families?

  • Endorsement® recognizes professionals and the organizations they work for as having deepened their understanding of infant and toddler development, healthy social-emotional development, and the importance of relationships in the long-term outcomes of infants and toddlers.
  • Parents should look for providers who hold Endorsement® as a way of verifying that a provider has specialized training in working with infants/toddlers and their families.

Q. If I’m The Parent Of An Infant Or Toddler How Would I Know A Provider Has The Endorsement®?

  • Just ask! Achieving Endorsement® is a great source of pride and recognition for those that work to receive it. Everyone who receives the Endorsement® receives a certificate and their name is maintained in a registry by MassAIMH at MassAIMH.org/endorsementregistry


Q. What is required for the application?

  1. Requirements depend on the endorsement category for which you are applying. The following documents are required for all categories:
  • Official transcripts from educational institutions in a sealed envelope,
  • Lists of specialized in-service trainings related to culturally sensitive, relationship-based practice promoting infant mental health that reflect competencies, paid work experiences with or related to infants, toddlers, and their families, and (for Levels II, III & IV) reflective supervision/consultation experiences while working with infants, toddlers and their families
  • Three reference ratings
  • Signed Code of Ethics
  • Signed Endorsement Agreement
  • Proof of membership in MassAIMH
  • Endorsement Fee
  • Graduates from a college or university program must submit documentation of completion of the program, such as a copy of diploma or certificate.

Q. When Is My Completed Endorsement® Application/Portfolio Due?

  • Please see the Events calendar for Endorsement® Application timelines

If you have a question that is not addressed on this list, email massaimh.endorsement@gmail.com

Q. How do I get started?

Some applicants find it useful to use the Getting Started Form to compile all of their relevant Infant and Early Childhood Mental Health trainings, work experience, and education so they can more easily cross reference them to a particular competency. It can make inputting the information easier.

Applicants can also refer to the webinars or contact the Endorsement® Coordinator, Aditi Subramaniam, for more information.

Q. What happens after I submit my professional application?

All applications are carefully reviewed by two volunteer members who have earned endorsement and/or are members of the Endorsement Team.   After examining your official transcripts, the reference rating forms, and your lists of specialized work, in-service training, and reflective supervision/consultation experiences, each reviewer will make recommendations about whether to endorse (Categories I and II) or to approve you to sit for the exam (Categories III and IV) or may suggest that you pursue further training and/or reflective supervision and then be re-reviewed after a period of time.

Reflective Supervision/Consultation

Q. What are the requirements for reflective supervision/consultation at Category II, Category III and Category IV (Clinical)?

In regards to reflective supervision/consultation, candidates applying at Category II must receive a minimum of 24 clock hours in no less than one year and no more than a two-year time frame.  Candidates at Category III must have received a minimum of 50 clock hours of reflective supervision/consultation within the same time 1-2 year time frame.  Reflective supervision/consultation that meets criteria for endorsement must come from someone who is either endorsed at Category III or Category IV or meets criteria for endorsement at Category III or IV. The only exception is for candidates who are pursuing Category II and are Bachelor’s prepared; they can receive qualified reflective supervision/consultation from someone who has earned Category II endorsement AND is Master’s prepared and receiving reflective supervision.

Q. When we are listing reflective supervision received, are we only able to list supervisors who were formally trained in reflective supervision?  The reason I ask is that I had former supervisors in other work positions whose styles of supervision were very reflective, but I do not know for sure if they were formally trained in that model of supervision?

Reflective supervision/consultation that meets criteria for MassAIMH endorsement should come from an individual who has earned endorsement at Category III or IV (or would meet training and reflective supervision criteria for Category III or IV) or is vetted as a Reflective Supervisor.  So, as you said, lots of clinical supervision is reflective, but perhaps not all is from a specialist in infant mental health. For your application, please only include those hours that were provided by an individual who specializes in infant mental health and that was focused on the practice or the promotion of infant mental health.

Q.My direct supervisor is not an infant mental health specialist and would not meet criteria for endorsement.  Our team does present cases to a clinical consultant hired from outside the agency once a month at a two-hour meeting, and the consultant is endorsed as an Infant Mental Health Specialist, Category III.  However, there are six on our team, so I only present cases twice a year.  Do any of the hours spent in these case presentations count toward endorsement?

Yes, if you meet and participate in the case consultations once a month for two hours, you will have 24 hours of reflective consultation that meets criteria for endorsement.

Q. I have received my reflective supervision and consultation from multiple sources, i.e., former supervisor, current supervisor, program consultant, and reflective practice group.  Should I include all of these sources?

If all of those sources meet criteria for endorsement (see previous question), you may include them all as long as the majority of the required clock hours were provided by just one or two supervisors/consultants.

Specialized In-Service Training

Q.I have attended well over 30 hours of in-service training but I’m not sure if all of it will be accepted.  Should I submit a list of every in-service training I’ve ever attended?

All in-service training hours that meet criteria toward endorsement must be related to the MASSAIMH Competency Guidelines. Be sure to list which specific knowledge or skill area is covered at each training, e.g., attachment, separation and loss; cultural competence; etc. For a training to count toward endorsement at least one competency must have been covered.  It is important to remember that endorsement reflects training specialization in the promotion of culturally sensitive, relationship-based practice promoting social and emotional well-being in the first years of life or infant mental health.

Although the minimum requirement is 30 hours, we expect endorsement candidates to document that they have achieved competency in all (or almost all) of the categories (as identified at your desired category) via college course work, on-the-job training, in-service opportunities and reflective supervision/consultation.  So, if there are still gaps in your competencies with only 30 hours, include as many others as you can to fill those gaps.

Q. How far back can I go when including trainings that meet criteria for endorsement?

There is no limit on how long ago the training was attended to be counted toward requirements.  Some candidates may have been in the field for many years and are encouraged to include all the trainings that have shaped their practice in infant-family work. However, it is not necessary to submit a comprehensive list of every training ever attended. The list should reflect a balance of breadth and depth across the competencies and the promotion of infant mental health.

Q. Are only MASSAIMH sponsored trainings eligible for endorsement?

The training does not need to be sponsored by MASSAIMH to be eligible to count toward your minimum for endorsement.  In fact, many trainings that you attend for professional licensing or agency requirements may also qualify for endorsement (for example an ethics training for social workers, Birth to Three training about family-centered planning, or doula training, to name only a few).

A specialized training that is eligible for endorsement should meet the following criteria:

  1. Is culturally sensitive, relationship-focused and promotes infant mental health
  2. Relates to one or more of the competencies in the MASSAIMH Competency Guidelines
  3. Is specific to the category of endorsement at which you are applying

Q. I was reading the endorsement requirements for trainings at Category II and it states I need “30 clock hours of relationship-based education training pertaining to the social and emotional development of infants, toddlers and families” and then under Continuing Endorsement Requirements it states:  “15 hours per year of relationship-based education training, approved by the organization, specific to the social and emotional well-being of infants, toddlers, and families.”  Are these two separate requirements or do they overlap?

The minimum of 30 clock hours that is required with your application can have been earned over the course of your career, even if they were attended many years ago.

In order to renew endorsement, a minimum of 15 additional hours of specialized in-service training is required annually.  Endorsement and MASSAIMH membership renewal will due by January 31 of each year in order to remain active on the MASSAIMH Endorsement Registry.

Q. Are there any in-service trainings, conferences or courses that are mandatory while working toward endorsement?

No.  But we do strongly recommend that you carefully review the MassAIMH Competency Guidelines to identify the skill and knowledge areas for the category at which you are applying. We expect candidates to document competency in these areas either through course work, work experience, reflective supervision/consultation, and/or in-service training. It is important to seek out in-service training/conference offerings that will fill in any competency gaps you might have.  Some skill areas (such as empathy and compassion, self-awareness) will be documented in the three reference ratings that you will include with your application.

Trainings that might not meet criteria would be focused primarily on school-aged children or adolescents or the elderly.

Q. I heard from a colleague that I could count only one conference in my application.  Is that true?

On the application, candidates must list a minimum of 30 hours of relevant in-service training.  Candidates are encouraged to include all relevant conferences that they have attended, but only one conference (with many workshops) may be counted toward the 30-hour minimum.  MASSAIMH recognizes that conferences are an important way to be exposed to new material, but believes a balance with lengthier, more intense in-services of six hours or more helps to build skills.

Specialized Work Experience

Q.Is there a difference between the specialized work experiences that meet criteria for Infant Family Specialist (Category II) versus Infant Mental Health Specialist (Category III)?

Yes, in general Category II work experience is more broad and encompasses many of the ways that candidates might work with the families of infants and toddlers including case management, Part C service coordination, parent-child play groups, parent education, and family support.  Category III work experiences are often (but not always) home-based and include the following interventions:  advocacy, developmental guidance, emotional support, concrete assistance, and parent-infant psychotherapy.

Competence as an Infant Mental Health Specialist builds with supervised work experience over time with services delivered to the families of infants and toddlers that are relationship-focused and culturally sensitive with an emphasis on examining the role of relationships in reflective supervision.  If you have worked with fewer than 10 families of infants/toddlers for less than six months, you may be advised to begin at Category II.

Q. I have my Master’s degree, so shouldn’t I start at Category III?

Overall, Endorsement is seen as a professional development lattice.  It is most common for people to start at Category I or II.  Over time, once practitioners have had an opportunity to serve many infant mental health cases while receiving reflective supervision/consultation from someone who is endorsed and after participating in many specialized in-service training opportunities, they may have developed a degree of expertise that qualifies them for Category III.  It is important to be sure that a candidate has achieved that expertise so that there is greater assurance of successfully completing the written exam.  Also, once a practitioner has earned Category III, they are qualified to provide reflective supervision to other candidates who are seeking endorsement.


The Endorsement Exam

Q. What is the format of the exam?

There are two parts to the test: Part I consists of multiple choice questions.  Part II consists of three vignettes or scenarios; you are asked to answer two of the three.  You will have three hours to complete the examination (i.e., 1 ½ hours to complete Part I and 1 ½ hours to complete Part II).  The material covered requires knowledge about pregnancy, early development and clinical practice experiences. Both parts draw on cumulative learning experiences in college or university settings and specialized in-service trainings, as well as self-study (e.g. books and journal articles about infancy, early parenthood and infant mental health). Your supervised work experiences with infants, toddlers and families, and experiences within reflective supervision or consultation groups related to your work with infants and families will also contribute to learning that is reflected in the examination questions.

Q. What primary topics are covered in the multiple-choice portion of the test?

  1. The multiple choice questions are related to the competencies as indicated in the MASSAIMH Competency Guidelines booklet such as:
  • Attachment separation, and loss
  • Pregnancy, infant and young child development and behavior
  • Relationship-based therapeutic practice
  • Infant mental health screening and assessment
  • Disorders of infancy/early childhood
  • Cultural competence
  • Reflective practice

Q. How should I study for the exam?

Studying for the test will vary from person to person. If you are currently engaged in relationship-based practice with infants and their families, receive reflective supervision and have consistently updated your knowledge and skills through specialized in-service training or enrollment in university or college course work specific to infancy, early parenthood and infant mental health, you will most likely be very well prepared. If you have not engaged in clinical practice or attended in-service trainings or university-based coursework specific to the promotion of infant mental health, you will find the test challenging.  There is a suggested resourceMassAIMH Exam Prep Resource List