The administration of programs for infants and toddlers

In this article, models for providing training in infant and toddler mental health are described. The goal has been to outline programs in enough detail that they may serve as models for persons who wish to develop infant psychiatry training and services within their academic division or their clinical program. From an administrative and fiscal perspective, developing training experiences in infant mental health has many advantages. Consultation experience and clinical experience with infants and young children are training requirements of the psychiatry Residency Review Committee. There is also a workforce shortage of child and adolescent psychiatrists and clinicians who can work with children, and there is an even greater shortage of child psychiatrists and psychologists who can work with very young children. This shortage allows a division chief or program director a particular opportunity to earmark core training funding for this underserved area and to partner with affiliated institutions and programs that can help fund these training efforts. The author's program was helped immensely by a private foundation grant, but for the first 20 years it was able to be self-sufficient through a commitment to training and reimbursement for clinical services. Currently, there seems to be an awareness on the part of community and public sector programs that they not only need to pay for trainee time but also must include administrative and faculty time. Finally, experience has defined major important principles of this work with infants, toddlers, and their families. First, training and clinical service must be provided within a context of knowledge and experience in child development. Second, the principles and knowledge of infant mental health must be used. Third, an understanding of relationship-based interventions provided within the context of reflective supervision and mentorship must be provided.