IMH Endorsement ®

IMPORTANT: Beginning January 1, 2018, all new Endorsement applicants are required to receive all RC/S hours from an Endorsed provider in order to meet the requirements for Endorsement. Additional details, frequently asked questions, and other supporting documents can be found here. Please direct all questions to Jean Cimino, CoAIMH’s Director of Endorsement & Special Projects.

Overview of the Infant Mental Health Endorsement®

The Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health (IMH-E ®) is not a license or certification, but rather an overlay onto a person’s professional credentials that recognizes achievement of knowledge and training in the area of infant and early childhood mental health. The Endorsement is one of the first and most comprehensive efforts in the country to identify best practice competencies at multiple levels and across disciplines and to offer a pathway for professional development in the infant, early childhood and family field. For more information, contact Jean Cimino at

Why earn the Infant Mental Health Endorsement®?

The Endorsement materials provide potential candidates with a process for developing a professional development plan, and suggests a ladder of steps for required and supplementary training and experiences to adequately prepare one for work in the infant and family field. Targeted and ongoing training for the professionals from the multiple disciplines that work with infants and young children and their families is essential to ensure that professionals understand infant and early childhood mental health and are equipped to promote positive practices to support these children, prevent problems when risk is identified, and intervene when necessary.

Who can Apply for Infant Mental Health Endorsement®?

Professionals eligible for endorsement range from those who have worked in the early childhood field for at least two years to those who have received a doctorate in their field. Each level of Endorsement has a set of educational, work, training and reflective supervision/consultation requirements. For all levels, specialized work experience with infants, toddlers and their families is required.

COAIMH is an active member of The Alliance for the Advancement of Infant Mental Health(formerly known as League of States). COAIMH has licensed the use of the Competency Guidelines® and Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health® from the Michigan Association for Infant Mental Health with the propose of supporting infant mental health professionals across Colorado.

Frequently Asked Questions

  1. Why did Colorado decide to adopt the Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health® (IMH Endorsement®)?

In 2010, Colorado infant and early childhood stakeholders began engaging in consistent conversations about how best to support our state’s multidisciplinary early childhood workforce. Because the IMH Endorsement® has a cross-disciplinary relevance and structure, these stakeholders believed it would ensure that Colorado’s early childhood workforce was working from the same foundation of best practice competencies. Additionally, the IMH Endorsement® fits under the workforce development component of our state’s Early Childhood Mental Health Strategic Plan. CoAIMH ultimately purchased the license for the IMH Endorsement® in 2011.

  1. Is Colorado the only state that offers the IMH Endorsement®?

No. As of January 2019, Colorado is one of 30 state infant mental health associations and two international associations who have licensed the use of the Competency Guidelines® and/or the Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health®.

These state and international members make up the Alliance for the Advancement of Infant Mental Health® (The Alliance). The members of the Alliance honor reciprocity of the IMH Endorsement® across states, i.e., if a professional earns IMH Endorsement® as an IMH Specialist in Arizona and then later moves to Colorado, the IMH Endorsement® as an IMH Specialist will be honored by the professional’s new state.

  1. What is the benefit for obtaining my IMH Endorsement®?

Obtaining your IMH Endorsement® from CoAIMH verifies that an applicant has attained a level of education as specified, participated in specialized in-service trainings, worked with guidance from mentors or supervisors, and acquired knowledge to promote the delivery of high quality, culturally sensitive, relationship-focused services to infants, toddlers, young children, parents, other caregivers and families.

Endorsed professionals are building the capacity of the infant and early childhood workforce by gaining shared competencies across disciplines. Achieving the IMH Endorsement® sends a message to centers/agencies, peers and colleagues, families, and the community at large that the professional encompasses the set of skills and knowledge necessary to implement best practices for supporting infants, toddlers, and their families.

In a survey of newly Endorsed professionals (across all categories), the following benefits were shared:

  • More knowledgeable about infant mental health
  • Strengthened confidence in providing services
  • Better equipped to identify the supports that a family might need
  • Developed an appreciation for reflective supervision
  • Helped remove judgment when providing services
  • Re-inspired the work
  • Increased credibility when collaborating with other agencies

Other benefits have begun to surface across Alliance members. For example, some Colorado agencies prefer hiring applicants who have or are working toward the IMH Endorsement®. Some states have implemented pay increases for Endorsed professionals, while others are advocating for Endorsed professionals to be able to bill Medicaid for their services. As these developments are constantly evolving, please feel free to check in with CoAIMH for status updates and news.

  1. What if I work with children older than the age of 3?

Providing services to a larger age range of children is common in the early childhood field. The majority of IMH Endorsement® applicants work with children ages 0-5 or 0-8. For the purposes of the IMH Endorsement®, applicants will focus their descriptions of their education, work role, trainings, and reflective consultation (if required) on the services they provide to infants and toddlers (ages 0-3) only.

The Alliance is currently piloting the Early Childhood Mental Health Endorsement®, specific to children ages 3-6 and their families. This is a separate process that CoAIMH is not currently licensed to provide to our state’s early childhood workforce. However, we are exploring the ability to purchase this license in the future.

  1. What if I don’t have a mental health background?

That’s okay! The framework of the IMH Endorsement® is to support the infant and early childhood workforce, which is a multidisciplinary field. CoAIMH has supported a variety of professionals through the IMH Endorsement® application process, including but not limited to home visitors, early care and education teachers/caregivers, early childhood mental health consultants, Early Intervention providers, psychologists, licensed social workers, research faculty, and policymakers/administrators. Even though all of these professionals were not necessarily trained in mental health, their role is critical to supporting the mental health of infants and toddlers.

Infant Mental Health is:

The developing capacity from birth to 3 to:

  • Experience, regulate, and express emotions
  • Form close relationships
  • Explore the environment and learn

…all in the context of family, community, and cultural expectations for young children.

(Zero to Three Infant Mental Health Task Force, 2011)

  1. How long will it take me to complete the Endorsement application?

Applying for the IMH Endorsement® is an individual professional and personal journey. On average, it takes an applicant 12-18 months from application registration to submission of their final application.

  1. Do I need to have met all of the requirements for Endorsement before I begin my application?

No! In fact, the IMH Endorsement® is designed to support the professional development of the infant and early childhood workforce. Moving through the application process supports an applicant in developing a professional development plan, and in turn the experiences an applicant gathers from their training, work role, and reflective consultation (if required) supports their application process.

  1. Who do I contact if I need help during the application process?

Supporting applicants is the primary role of CoAIMH’s Director of Endorsement. Applicants can contact the Director via email ( or phone (303-325-5215) anytime throughout the application process.

  1. Who reviews my IMH Endorsement® application?

Each IMH Endorsement® application receives two reviews from Endorsed professionals from Colorado. (In some cases, reviewers from an Alliance member state are needed.) CoAIMH could not offer the IMH Endorsement without the support of our Endorsement Registry.

  1. Who reviews my written IMH Endorsement® exam?

CoAIMH has a cohort of 10 Endorsed professionals who have been trained by The Alliance to review IMH Endorsement® exams. The identity of exam reviewers and applicants is kept confidential from each other to avoid any conflicts of interest.

More details about the exam can be found here.

Prerequisite Requirements

  1. Membership in CoAIMH or another IMH association*
  2. Training/Education as specified and related to infants, toddlers, parents, other caregivers and families
  3. Experience working with infants, toddlers, parents, other caregivers and families as specified at the desired level

*If you are not already a member of CoAIMH (or another infant mental health association), you must join CoAIMH at the time you submit your preliminary application. To join CoAIMH by credit card, go to: Membership. Please email your Membership Confirmation to the Endorsement Coordinator, at

CoAIMH encourages continuing professional growth and development for all members. The Association requires professionals who have successfully completed the CoAIMH Endorsement (IMH-E®)  to continue membership in CoAIMH or another infant mental health association and to participate annually in 15 hours of culturally sensitive, relationship-based training experiences that promote infant mental health. Documentation of annual training is submitted via the Annual Renewal Form and submitted by Jan 31 of each year.

Requirements of the Infant Mental Health Endorsement®

Click here for a table with requirements by Endorsement category.

For additional detail:
Infant Family Associate
Infant Family Specialist
Infant Mental Health Specialist
Infant Mental Health Mentor – Clinical, Policy, and Research/Faculty

Flowchart: Which Endorsement® is right for me?

Reflective Consultation/Supervision

Reflective Consultation/Supervision is a cornerstone in working with infants, toddlers and their families. As you build your application and are considering your experiences with Reflective Supervision, which is a requirement for the Infant Family Specialist, Infant Mental Health Specialist, and Infant Mental Health Mentor – Clinical Endorsements, you may find the resources listed below helpful.

PLEASE NOTE: Beginning January 1, 2018, all new Endorsement applicants are required to receive all RC/S hours from an Endorsed provider in order to meet the requirements for Endorsement. Additional details, frequently asked questions, and other supporting documents can be found below. Please direct all questions to Jean Cimino, CoAIMH’s Endorsement Coordinator.

  1. RS/C Requirements for the Infant Mental Health Endorsement. This provides more details about the change in RS/C requirements beginning 1/1/2018.
  2. Best Practice Guidelines for Reflective Supervision (RS/C).This gives an overview of RS/C in the context of Infant Mental Health; describes the knowledge, skills, and practices that are critical to reflective supervision/consultation; and distinguishes between administrative supervision, clinical  supervision/consultation and reflective supervision/consultation.
  3. Developing Reflective Practice Supervision/Consultation Skills. This document details the different models for developing reflective practice supervision/consultation skills.
  4. Questions About Applicants’ Reflective Supervision Experience. These questions are useful as you consider how to describe your reflective supervision in your application for Infant Mental Health Endorsement®.

To obtain the Reflective Supervision, CoAIMH has provided a list of supervisors available for contract. Please click here to view the list.

Cost of the Infant Mental Health Endorsement®

When beginning the Endorsement process, an applicant must be a member of CoAIMH. The Registration Fee and Processing Fee for each category is:

Endorsement Fee Schedule

Infant Family Associate

Infant Family Specialist

Infant Mental Health Specialist    Infant Mental Health Mentor
Registration Fee $15 $20 $25 $25
Processing Fee $25 $100 $300 $400
Total $40 $120 $325 $425

These fees have remain unchanged since 2010 and cover the following:

  • The use of an online application system (EASy).
  • Individualized support from CoAIMH’s Endorsement Coordinator throughout the application process.
  • Access to an Advisor to support you with finalizing your application for submittal.
  • Two-three peer reviewers after you submit your final application.
  • A resource study guide to prepare for the exam (required for Infant Mental Health Specialist and Infant Mental Health Mentor applicants only).
  • A proctored exam (there is no separate exam fee).
  • Two-three exam reviewers upon completion of the exam.
  • Recognition on the Colorado Endorsement Registry (upon achieving Endorsement).

PLEASE NOTE: CoAIMH is unable to issue refunds (full or partial) at any stage in the Endorsement process.

Preparing Your Application

The following documents will help you begin to prepare your a professional portfolio. We recommend you begin by reading the Getting Started pdf. This document will help you begin to look at how your education, work experience, and training align with the Infant Mental Health Endorsement® Competency Guidelines. Applicants are allowed one downloaded copy of the Competency Guidelines at no cost. Please do not copy or distribute the Competency Guidelines. Individuals are encouraged to send other interested applicants to the website for the Competency Guidelines.

How Do I Apply?
We have an Electronic Application System (EASy). You can begin to align your education, work experience, training, and supervision with use of the EformClick here for important application deadlines.

1. Registration

To begin your endorsement application, you must register on EASy. Please follow these easy steps to complete your registration.

Completing a preliminary application requires you to provide brief information about your specialized education, work, and reflective supervision/consultation experiences. You will be asked to pay a registration fee via Paypal using a credit card. Fees can be found under the “Fee Schedule” button on the lefthand side of this page.

At the time of registration, applicants must have a current membership with CoAIMH or another infant mental health association. For those who need to join or renew CoAIMH membership, you can do so here.

It is strongly recommended that you register using a personal email address (e.g., gmail, yahoo, hotmail, etc). Employer email servers often block messages sent by the EASy system. We also strongly recommend that you use a desktop or laptop computer; EASy is not supported for use on iPads or other mobile devices. If you do not have access to a computer or the internet, or if you have an application that was started on paper, please contact the Endorsement Coordinator,

2. Preparing Your Professional Portfolio

Once the registration information and fee have been received and your CoAIMH membership has been confirmed, EASy will email a username and password. You may then log in, as often as necessary and from any computer with an internet connection, to build your portfolio on-line. The professional portfolio reflects the applicant’s capabilities within the infant and family field as identified for each level of endorsement.

EASy will ask you to electronically “sign” the CoAIMH Code of Ethics and Endorsement Agreement. You will list your specialized education, in-service training*, and reflective supervision/consultation experiences**. Sealed transcripts are required from ALL Institutions and need to be emailed to or mailed to:

Attn: Infant Mental Health Endorsement
P.O. Box 260134
Lakewood, CO 80226

You will be asked to list the names and email addresses for the 3 individuals who will complete reference rating form on your behalf. EASy sends an email to each reference rater; the whole process is done electronically. Please ask your reference raters for a personal email address so they will receive the secure link to complete the form on EASy.

If questions come up while using EASy, there is a Help button on the top right. Applicants can indicate whether the issue is technical or related to the endorsement process. There are also comment sections on most pages where applicants can ask questions or leave remarks.

EASy replaces the E-form for MI-AIMH Endorsement® and all other paper documents that were formally used to create a portfolio.

*30 hours of specialized in-service training are requited at all levels. Eligible specialized in-service training meets the following criteria:

  • Is culturally sensitive, relationship-focused and promotes infant mental health
  • Relates to 1 or more of the knowledge/skill areas in the CoAIMH Competency Guidelines
  • Is specific to the level of endorsement for which the candidate is applying

**Applicants for the Infant Family Specialist, Infant Family Associate and Infant Mental Health Mentor-Clinical include information about the provider and the nature of reflective supervision/consultation experiences. Please refer to the Best Practice Guidelines for Reflective Supervision/Consultation for additional information about which experiences qualify toward Endorsement. Please note that beginning January 1, 2018, all new Endorsement applicants are required to receive all RS/C hours from an Endorsed provider in order to meet the requirements for Endorsement. Additional details and frequently asked questions can be found here. Please direct all questions to Jean Cimino, CoAIMH’s Endorsement Coordinator.

3. Finalizing Your Application and Submission

PLEASE NOTE: Our current submission timeline here.

The full application needs to be submitted by the application deadline. Shortly after the application deadline, you will be matched with an Advisor. Your Advisor will review your portfolio and be available for a minimum of two appointments by phone prior to the beginning for the Portfolio/Application Review. The Advisor provides support, answers questions, and may make revision suggestions in regards to your portfolio.

Once the applicant has been through the Advisor process and all sections are complete, including reference ratings and transcripts uploaded by CoAIMH, the applicant may hit the “Submit” button that appears on his/her EASy dashboard and pay the Endorsement Processing Fee relative to the sought Endorsement level. The Endorsement Processing Fee will be paid via Paypal.

Endorsement Processing Fees:

Infant Family Associate – $25

Infant Family Specialist – $100

Infant Mental Health Specialist – $300

Infant Mental Health Mentor – $400

4. Portfolio/Application Review

CoAIMH reviews portfolios two-three times a year, depending on Endorsement category. Infant Family Associate & Infant Family Specialist applicants receive an endorsement decision after at least two portfolio review committee members examine and approve the portfolio. Infant Mental Health Specialist & Infant Mental Health Mentor applicants move on to a written exam after at least two portfolio review committee members examine and approve. CoAIMH offers the written exam three times a year. Please visit the timeline for upcoming application schedules and exam dates.

5. Endorsement Examination

Infant Mental Health Specialist and Infant Mental Health Mentor applicants are required to pass a written examination following portfolio approval.  The exam is offered three times a year. Currently, the exam is only offered in the Denver Metro area. Part One of the exam consists of 60 multiple-choice questions. Part Two consists of responses to two vignettes, which are based upon either Infant Mental Health Specialist or Infant Mental Health Mentor (Clinical, Policy or Research/Faculty). It is recommended that in preparation for the exam, you download the Recommended and Suggested Resources List and review this page for more detailed information.

How long does the Endorsement process take?

Achieving your Endorsement is a journey, not a race.

Each person will take a different amount of time depending on their formal education, specific training, and the amount of Reflective Supervision/Consultation received. However, the average time to complete the process is 6-12 months. Please contact the Endorsement Coordinator at with specific questions.
CoAIMH is committed to recognizing the expertise of professionals working with infants, toddlers and their families as well as promoting their professional development. To this aim, we have provided a number of resources to support applicants throughout the process of achieving Infant Mental Health Endorsement®.

Colorado Endorsement Registry
Please click here to view a list of all professionals with the Infant Mental Health Endorsement in Colorado. 

Annual Endorsement Renewal

All Endorsed professionals are required to complete a minimum of 15-clock hours* of relationship-based education and training, pertaining to the promotion of social-emotional development and/or the practice of infant mental health (e.g. regional training, related course work at colleges or universities, infant mental health conference attendance) each year** and maintain a current CoAIMH membership in order to remain on CoAIMH’s Endorsement Registry. Documentation of training hours are submitted with membership renewal each January.

*Up to 7 hours spent in the role of IMH-E® Application Advisor/Reviewer and/or IMH-E® Exam Reviewer counts toward the 15 hours each year.

**The documentation of 15-clock hours of training is not required for the year immediately following the year Endorsement was achieved. For example, if an applicant earned Endorsement in 2017, he/she does not need to provide documentation of 15-clock training hours to renew Endorsement in 2018. However, 2018 CoAIMH membership is required to renew Endorsement for that year.


2020 IMH-E® Renewals will be due January 31st, 2020IMH-E® Renewal Fees will be included in your
2020 CoAIMH Membership Fee if IMH-E® renewals are SUBMITTED BY THE DEADLINE.

For renewals submitted Feb 1, 2020 or later
IMH-E® renewal fees will be as follows:
February 1, 2020 – March 15, 2020: $25 Renewal Fee***

March 16 – April 30, 2020: $50 Renewal Fee***

***in addition to annual CoAIMH Membership

Renewals submitted May 1, 2020 or later will incur fees and additional updating requirements
in alignment with Alliance for the Advancement of Infant Mental Health Policy as follows:
Step 1:  Renew your CoAIMH membership on-line.
Sept 2:  Update your endorsement credentials in EASy:
  • Register or log into existing application on EASy;
  • Add education, work, in-service training and reflective supervision/consultation experiences that have been accrued since removal from the registry;
  • Get three updated reference ratings (via EASy); and
  • Pay Endorsement Processing Fee (varies dependent upon category).

Infant Mental HeakthA Little History

For the past 9 years, MI-AIMH has provided direction and support to leaders from each infant mental health association through an informal structure, the “League of States, ” providing technical assistance to promote social and emotional or relational health by working with a shared set of Competency Guidelines® and Endorsement®.  In 2014, in response to the need for a more formal governing structure, the MI-AIMH Board of Directors and the policy leaders of the “League of States” set in motion plans for a formal governing structure, named the Alliance for the Advancement of Infant Mental Health (The Alliance).

What Is The Alliance?

The Alliance is a newly forming, formal, global organization that includes those states and countries whose infant mental health (IMH) associations have licensed the use of the Competency Guidelines® and Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health® from the Michigan Association for Infant Mental Health (MI-AIMH).  Each IMH association that purchases a license becomes a member of the Alliance, with representation in the governance of the organization.  To date, 23 US IMH associations and 1 international association participate.

Of additional importance, and because of its national and international reach, the Alliance includes the Infant Mental Health Journal (IMHJ) (owned by the Michigan Association for Infant Mental Health) with approximately 3,000 subscribers worldwide.  Equally important is Early Attachments: IMH Home Visiting®, also developed in Michigan, and unique in its use of infant-parent psychotherapy (IPP) when working with very high-risk infants and their families.  Both are important components of the Alliance, contributing to the promotion of IMH nationally and internationally.

Why An Alliance?
In line with MI-AIMH’s strategic plan, the Alliance is currently incorporating as a non-profit organization with 501C3 status.  The intent is to build a strong infrastructure for the Alliance by December 31, 2016.  A Founding Board of Directors, made up of 6 MI-AIMH leaders and 5 leaders from out-of-state, has met for the past year, to establish the legal structure for The Alliance.    With bylaws approved, a Board of Directors elected, and staff appointed, the Alliance will be a stronger national and international entity.    The overarching goals of the Alliance are to:

  • Respond to interest from new IMH associations in both the Competency Guidelines® and Endorsement®
  • Provide technical assistance to those who have newly licensed the workforce development system
  • Assure fidelity in the use of the Endorsement® process to guide work force development

Increase access to the Infant Mental Health Journal as well as evaluation and expansion of the IMH Home Visiting model.

Benefits Of The Alliance
Under the leadership of MI-AIMH, members of the Alliance benefit from having access to technical assistance related to the use of the Competency Guidelines® and Endorsement® process to guide work force development, assuring fidelity to the system. Alliance members, including MI-AIMH, have access to IMH faculty, training materials and learning tools across states, e.g. observational assessments to chart change in reflective practice skills; reflective consultation groups; evaluation data and grants received for the benefit of the whole.  The Alliance encourages regional alignments of IMH associations to market and promote the Competency Guidelines® as a basis for work force development, e.g. Northeast Regional. Of additional interest, the Alliance provides opportunities to link closely with other state and national organizations or initiatives that have shared goals, e.g. the Ounce of Prevention Fund and its on-line training initiative or the newly funded Center for Infant and Early Childhood Mental Health Consultation at Georgetown.  Perhaps most importantly, the Alliance formally continues what has been so vital to the informal network of the League of States – the expansion of working relationships across states to promote IMH research, training, practice, and policy development.

News from The Alliance

  • To date, 1,640 people across the country have earned Endorsement®
  • The Alliance Founding Board and the MI-AIMH Executive Board, under the guidance of non-profit specialists, Plunkett Cooney, Inc., approved the ByLaws for the newly forming Alliance, setting the state for formal organization
  • MI-AIMH, under Nichole Paradis’s direction, has managed technical assistance reviews with all states new to the Alliance
  • MI-AIMH and Alliance leaders, under Ashley McCormick’s direction, have developed 3 new webinars to assist all applicants, reviewers and advisors in using and supporting others in the application process
  • MI-AIMH and Alliance leaders, under Faith Eidson’s direction, have engaged in regional quality review sessions to assure consistency in exam scoring across states
  • MI-AIMH and Alliance leaders, under Nichole Paradis and Faith Eidson’s direction, are moving forward with a MI-AIMH and Alliance priority: to expand the Endorsement® criteria to include Early Childhood Mental Health
  • MI-AIMH, under the direction of Kate Rosenblum and Maria Muzik at the University of Michigan, and in partnership with Mary Ludtke of the Michigan Department of Human Services, Betty Tableman, the research team MITRE, and community IMH home visiting program staff, have successfully secured funding for expansion of the evaluation of the IMH Home Visiting model, now a promising practice, in Michigan
  • MI-AIMH, under the direction of Sheryl Goldberg, and in partnership with Alliance members, is organizing and sponsoring the 1st Annual Alliance Reflective Supervision/Consultation Symposium for MI-AIMH members and Alliance members to be held in August in Ann Arbor, Michigan (more information to come)

In summary, there is much to celebrate and a great deal of hard work ahead to firmly establish the Alliance for the Advancement of Infant Mental Health.

For additional information, please go to the the Alliance section of the MI-AIMH website:

Deborah J. Weatherston, PhD, IMH-E®, Infant Mental Health Mentor – Clinical
Nichole Paradis, LMSW, IMH-E®, Infant Mental Health Mentor – Clinical