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Assessing fidelity for early childhood mental health consultation: Lessons from the field and next steps.

Early childhood mental health consultation (ECMHC) has become a common approach to delivering mental health services and supports for young children, their families, and the early care and education community. While many states and communities are implementing some form of ECMHC, the evidence base is still developing. One obstacle to building a rigorous evidence base has been a lack of focus on fidelity measurement, and one barrier to fidelity assessment has been a lack of a common framework for the essential components of effective ECMHC. This article briefly summarizes the development of a conceptual model for effective ECMHC based on a qualitative study of six ECMHC programs with positive outcomes (F. Duran et al., 2009). The common components and processes derived from those six programs are then used to articulate an approach for operationalizing fidelity. Specific examples of strategies used to support fidelity by three of the six programs are highlighted. We close with a discussion of the implications of these approaches and suggestions for next steps in defining a consensus-based model for measuring fidelity to ECMHC services. Abstracts translated in Spanish, French, German, and Japanese can be found on the abstract page of each article on Wiley Online Library at http://wileyonlinelibrary.com/journal/imhj.