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Q. Why should I apply for Endorsement?


Consider the following:

  • To enhance your professional profile as a specialist in the infant and family field.
  • To affirm the specialized knowledge and skills you have acquired through formal education experience and in-service training.
  • To validate the work that you have done under the guidance and supervision of experienced mentors in the infant and family field.
  • To link your professional growth and development to competency standards that reflect best practice.
  • To be identified as a competent professional in a system that reflects commitment to best practice and quality care for all infants, toddlers and families.

Q. How much does Endorsement cost?

Endorsement Fees

Level 1 • Application Fee $15.00 • Endorsement Fee $25.00

Level 2 • Application Fee $15.00 • Endorsement Fee $50.00

Level 3 • Application Fee $25.00 • Endorsement Fee $200.00

Level 4 • Application Fee $25.00 • Endorsement Fee $300.00



Q. What is required for the Professional Portfolio?

Requirements depend on the Endorsement level for which you are applying. The following documents are required for all levels:

  1. Official transcripts in a sealed envelope from all colleges/universities attended.
  2. A list 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.
  3. Three reference ratings in sealed envelopes with rater signature across the seal.
  4. Signed Code of Ethics.
  5. Signed Endorsement Agreement.
  6. Proof of membership in MACMH-IEC or other infant mental health association.
  7. Endorsement Processing Fee


Q. What is the difference between the specialized work experiences that meet criteria for Infant Family Specialist (Level II) versus Infant Mental Health Specialist (Level III)?

In general, Level II work experiences are 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. Work experiences at L II demonstrates work in the area of prevention

Level III work experiences are often (but not always) home-based or clinical in nature and include the following interventions: advocacy, developmental guidance, emotional support, concrete assistance, and parent-infant/child psychotherapy. Work experience at Level III demonstrates Intervention and Theraputic work with a dyadic focus. 

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.


Q. How many infants or toddlers do I need to work with to meet the specialized work criteria?

MACMH-IEC believes that Endorsement applicants should have enough experience with infants/toddlers so that the persons who complete the reference rating forms can confidently answers questions about the applicant’s knowledge and skills related to the promotion/practice of infant mental health. The requirements state, “Minimum two years paid, post Bachelor’s, professional work experience providing services that promote infant mental health. Work experience meets this criterion as long as the applicant has:

  1. Served a minimum of 10 families of infants/toddlers (birth to 36 months) and,
  2. A primary focus of the services provided is the social-emotional needs of infant/toddler and,
  3. Services include attention to the relationships surrounding the infant/toddler.”

Q. How do I apply for Endorsement?

MACMH-IEC is now using the EASy (Endorsement Application System) online system for endorsement applicants.  This was developed by the Michigan Association for Infant Mental Health (MI-AIMH).   To begin the endorsement process, follow these steps:

1.  Go to the MACMH-IEC EASy site

2.  Register as an Applicant.

3. You will be asked to pay an Endorsement Application fee.

4.  Your new Application will be either be approved or you will be contacted by the Endorsement Coordinator for a follow up conversation. Once approved, you will be sent a password, the Competencies and other information to get you started in the Application process.

5. You will also be assigned an advisor (usually the Endorsement Coordiantor) who will help you with any questions or concerns. E mail with any questions that may arise during the process. 

6.  The EASy system will guide you through the development of your professional portfolio, matching it to the infant mental health competencies.

7.  Once your portfolio is completed and your references and transcripts are received and your application is submitted, they will be reviewed by two assigned reviewers to see that it demonstrates the competencies or to advise you about what areas in which you might need to receive additional training or experience before completion. 

8.  If you are applying for Levels III or IV, you will also need to take a three-hour written exam.   The exam includes multiple choice questions and clinical, policy or faculty/research vignettes to assess knowledge, skills and competencies.

9.  Endorsement, including an Endorsement Certificate, is earned when you have met all of the program requirements.

If you have any questions about the process, contact Kristin Armbruster Irrer at 651-644-7333 or e mail

Annual Renewal of Endorsement requires continued membership in MACMH-IEC or another infant mental health association and annual documentation of 15 hours (minimum) of training experiences which promote infant mental health practice; reflective supervision/consultation recommended for endorsed members at Levels II, II & IV (Clinical).

Membership runs January 1st – December 31st of each year. 

Click here to become a member of MACMH-IEC using our online form

Q. What happens after I submit my professional portfolio?

All portfolios are carefully reviewed by two volunteer members who have earned Endorsement and/or are members of the Endorsement Committee. Reviews are conducted online through the EASy system reviewing all the knowledge and skill areas, including reflective supervision or consultation experiences, under the broader competency categories. 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 (Level I and II) or to approve you to sit for the exam (Level 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.


Q. What is the format of the exam?

There are two parts to the test:

Part 1 consists of multiple choice questions.

Part 2 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., 90 minutes to complete Part 1 and 90 minutes to complete Part 2).

The material covered requires knowledge about each Competency area including Theoretical Foundations, Direct service skills, Law, Regulation, & Policy, Systems, Thinking, Working with others, Communicating, and Reflection.

Both parts draw on cumulative learning experiences in college or university settings and specialized inservice 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?

The multiple choice questions are related to the knowledge and skill areas of the Competencies as indicated in the MACMH-IEC Competency Guidelines booklet such as:

  • Attachment separation, trauma, grief, and loss
  • Pregnancy, infant and young child development and behavior
  • Relationship-based therapeutic practice
  • Psychotherapeutic & behavioral theories of change
  • Adult mental health
  • Infant mental health screening and assessment
  • Disorders of infancy/early childhood
  • Cultural competence
  • Reflective practice 
  • Parallel process


Q. What happens if I do not pass the exam?

A passing score on Part 1 (multiple choice) of the exam is 80%. Candidates who receive a score of less than 80% will be invited to take the exam again in one year. In order to carefully protect the exam materials, candidates will not receive specific feedback related to the questions missed on Part 1.

Candidates who do not receive a passing score on Part 2 (response to vignettes/scenarios) will be provided specific feedback based on exam reviewers’ remarks. Those candidates will be invited to take the exam again in one year. There is no charge to retake Part 1 or Part 2 of the exam.


Q. How do I indicate that I have earned the MACMH-IEC Endorsement?

The IMH-E® mark indicates that a person has earned endorsement. Use of the registered trademark is important (whenever possible) to distinguish from other systems of “endorsement.” The level of endorsement is indicated after the IMH-E® in parentheses and the title can be written under, such as:

Jane Doe, MSW, LCSW, IMH-E® (III)
Infant Mental Health Specialist


Q. What is the value of a Competency-Based System of endorsement?

A competency-based endorsement system is valuable in the following ways:

1) Training and professional development

  • Competencies provide foundational guidelines for higher education institutions’ or other organizations’ and pre-service training programs
  • IECMH candidates across disciplines have a better understanding of what they are expected to know in their roles working with very young children and their families
  • Provides incentives and opportunities for ongoing multidisciplinary professional development
  • Guides portfolio development and helps identify gaps in knowledge for front line providers, supervisors, and administrators across disciplines
  • Using a “level” system, trainings can be targeted efficiently to frontline providers, e.g. mental health providers, care providers, allied disciplines, etc.

2) Enhancement of professional credibility

  • Provides a visible standard for what knowledge and skills are needed to provide mental health services to very young children and families, thus enhancing accountability  (e.g. Michigan has begun to use endorsement for hiring preferences and qualifications)

3) Using the competencies as a ‘gatekeeper’ for practitioners

  • Provides a way to establish ‘quality control’ to ensure that providers across disciplines have the qualifications necessary to work with young children and their families.
  • Assures families, agencies and the public that “the person who is providing services to infants, very young children, and their families meets standards of knowledge and skill that have been approved by a professional organization devoted to promoting infant mental health” (22)

4)  Financial reimbursement considerations

  • Some precedent in Michigan and New Mexico for establishing new rules that tie Medicaid reimbursement for certain IECMH activities to provider endorsement

From Jon Korfmacher & Aimee Hilado (2008). Creating a workforce in early childhood mental health:   Defining the competent specialist. Research Report.2008, No.1. Herr Research Center for Children and Social Policy at the Erikson Institute

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