Abstract
Infant mental health develops through relationships with primary caregivers. With the increasing number and proportion of children in child care, these salient relationships are occurring more regularly with child care providers. The principles of infant-parent psychotherapy have been expanded to include consultation to child care providers to meet this growing need. Consultation focuses on the relationships between caregiver and child and between caregivers (teacher-teacher and teacher-parent) as they impact a child's development. Consultation services to early childhood programs requires knowledge of child development, therapy, and child care, understanding of a system's functioning and influence on development, organizational psychology and case management, and a willingness and ability to recognize countertransference and to acknowledge one's role in the system. Neither traditional clinical or social work training nor preschool experience fully prepares consultants to approach these many facets, requiring additional training. Training and supervision focus on developing a stance of collaboration and wondering with child care providers and on recognizing the many levels of influence on child care providers. The pitfalls of early consultation are also addressed: assuming an expert stance, expecting knowledge to immediately remedy problems, difficulties balancing consultation with therapy, and a lack of knowledge of child care and the demands of group care.