KAIMH

Registration


This is the Kansas version of EASy. If you are applying in another state, please be sure to select that state from the drop-down below.


Please fill out the form below. Fields marked with an asterisk* are required.

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  • Step 3

Endorsement*

This field is required.

Please note:

The primary work focus of individuals in this category is to promote optimal social-emotional and relational development for infants aged 0-36 months, and their families.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

The primary work focus of individuals in this category is to promote optimal social-emotional and relational development for children aged 3-6, and their families.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

The primary work focus of individuals in this category is to prevent barriers that will impede the optimal social-emotional and relational development of infant 0-36 months old via providing direct prevention/early intervention services to the infant/toddler and their caregiver together.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

The primary work focus of individuals in this category is to prevent barriers that will impede the optimal social-emotional and relational development of the 3-6 year old via providing direct prevention/early intervention services to the infant/toddler and their caregiver together.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

The primary work focus of individuals in this category is to intervene where identified disorders of infancy exist by providing mental health relationship-based therapeutic interventions to 0-36 month olds and their families.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

The primary work focus of individuals in this category is to intervene where identified disorders of infancy exist by providing mental health relationship-based therapeutic interventions to 3-6 year olds and their families.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Infant Mental Health Mentor – Clinical Endorsed Professional’s primary scope of practice is/was providing mental health relationship-based therapeutic services to 0-36 month olds and their families. Then also received training on providing reflective supervision and consultation (RSC) to others and provide RSC for at least 3 years.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Early Childhood Mental Health Mentor – Clinical Endorsed Professional’s primary scope of practice is/was providing mental health relationship-based therapeutic services to 3 up to 6 year olds and their families. Then also received training on providing reflective supervision and consultation (RSC) to others and provide RSC for at least 3 years.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Infant Mental Health Mentor – Policy Endorsed Professional’s primary scope of practice is working post masters in policy/program administration related to the infant, young child-family field.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Early Childhood Mental Health Mentor – Policy Endorsed Professional’s primary scope of practice is working post-maters in policy/program administration related to the toddler/ young child-family field.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Infant Mental Health Mentor – Research/Faculty Endorsed Professional’s primary scope of practice is working in a university and/or published research related to infant mental health principles and practices.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

An Early Childhood Mental Health Mentor – Research/Faculty Endorsed Professional’s primary scope of practice is working in a university and/or published research related to infant early childhood mental health principles and practices.

For detailed information about the requirements for this category, please consult the competency guidelines or reach out to your Endorsement Coordinator

Personal Information*

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Please use a personal email address (yahoo, gmail, etc.) as many agency email servers block emails from EASy.

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Education (check one or more)


Work Experience(s) with/related to infants, toddlers and their families*

Please provide a brief description of your work experience with pregnant women, infants, young children and their families:


Reflective supervision/consultation:

Additional:


Documentation

You may attach a résumé or curriculum vitae. This is recommended if you have more than 3 relevant paid work experiences.

File should be in .PDF, .DOC, .DOCX or .RTF format


Membership

You must join or renew membership to KAIMH (or another infant mental health association) when submitting this preliminary application.

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Please review and verify all data before submitting!