Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health®
An internationally recognized credential for professionals working with or on behalf of pregnant people, infants, toddlers, and their caregivers.AzAIMH Endorsement®
Endorsement® is Good for Babies
AzAIMH Endorsement® (IMH-E®) supports and recognizes the development and proficiency of infant mental health professionals across Arizona. Endorsement® is based on a set of competencies designed to support and enhance culturally-sensitive, relationship focused practice within the framework of infant mental health. The IMH-E® ensures professionals, who work with or on behalf of our youngest citizens (0-36 months), have attained a certain level of expertise and skill. An IMH-E® applicant demonstrates acquisition of the competencies through education, employment, specialized training/professional development, and reflective supervision experiences. Endorsement® is relevant for professionals across disciplines including early care and education, prevention and early intervention, home visitation, medicine, child welfare, mental health, policy, academia, and others. Growing evidence indicates that endorsed professionals are better prepared to support the foundational early development of babies and young children, in the context of their caregiving relationships. Learn more about the value of Endorsement from Endorsement is Good for Babies.
There is something for everyone! Which category is right for you?
AzAIMH Endorsement® (IMH-E®) is for professionals who specialize in supporting pregnant people and who help foster healthy development of infants and toddlers (0-36 months) within their caregiving relationships.
The IMH-E® is available across four different practice specialties spanning the continuum of care. Individuals apply for the IMH-E® category that best matches their scope of practice and work.
Infant Mental Health Endorsement® Categories:
• Infant Family Associate: Promotion
• Infant Family Specialist: Prevention/Intervention
• Infant Mental Health Specialist: Clinical Intervention/Treatment
• Infant Mental Health Mentor: Leadership
Endorsed Reflective Supervisor Add-On: Available to any professional who wants to provide qualifying RSC
This chart represents only a summary of requirements for each of the IMH-E® categories. Applicants can more fully explore categories with the AzAIMH Endorsement Coordinator (email link) to determine the best fit based on scope of work and experience.
Endorsement® decisions are not made on the basis of race, sex, age, religion, color, national origin, marital status, physical handicap, sexual orientation or any other basis prohibited by state or federal law.
reference ratings
References are critically important as they are the primary source for documenting an applicant’s skills in the domains of Reflection, Working with Others and Thinking. Reference rating forms are filled out electronically via EASy. An Endorsement® applicant enters the name and email address of the rater and then the EASy system emails the rater a secure link for completing the form.
Tips for Applicants:
If the reference is your supervisor (program and/or reflective), consider looking over the questions together in supervision session to mutually assess the applicant’s professional progress and to request feedback.
Ask your reference provider if they would be willing to complete a form (electronically) for you.
Be sure each reference is familiar enough with your work, knowledge, and skills to provide ratings (if rater scores “I do not have enough information to rate/comment” 6 or more times, the reference cannot be counted).
The content of the reference rating response is confidential and will not be viewed by the applicant.
Tips for Raters:
Have you known the applicant for at least a year?
If the applicant is part of a reflective supervision/consultation (RSC) group that you facilitate, have you heard enough from this applicant to feel that you know his/her skills well enough to rate them? (We cannot count ratings with 6 or more “I do not have enough information to rate/comment” scores).
Is the applicant providing direct service to pregnant people or families of infants/toddlers (0-36 months)?
If it is a IMHM-Clinical applicant, are you familiar with his/her skills as a provider of RSC (and not only as a practitioner)?
Consider reviewing the reference rating questions (see above) with the applicant periodically to help track your assessment of his or her progress over time.
If you have reservations, have you shared them directly with the applicant?
The content of the reference rating response is confidential and will not be viewed by the applicant.
If you have reservations, consider either declining the request to provide a reference or indicating that you do not recommend. We occasionally see very low scores, but with an overall recommendation to endorse, which can be confusing for reviewers and applicants.
Endorsed Reflective Supervisor (ERS) Add-On
Would you like to provide reflective supervision/consultation to support the reflective practice for IMH professionals?
Endorsed Reflective Supervisors can provide qualifying RSC hours to all others seeking Endorsement or Endorsement renewal. We encourage RSC providers and recipients to talk about goodness of fit when starting and throughout their time together.
ERS Prerequisites:
- IMH Endorsement in Any Category:To apply for the ERS add-on, you must hold an active Endorsement in any IMH category.
- Supervision Prerequisite:a minimum of 24 hours of reflective supervision/consultation (RSC) from an Endorsed provider while engaged in IMH-related work.
ERS Requirements:
- 1 year of providing RSC whilereceiving 12 hours of RSC about the provision of RSC (Not required for Emerging*)
- 15 of training on provision of RSC (5 hours required for Emerging*)
- 2 references: one from a RSC provider & one from a RSC supervisee (2 references: 1 from RSC provider and 1 other required for Emerging*)
Emerging: *Emerging is a provisional status for professionals growing in RSC. Once established, professionals will have 2 years to meet and document the complete requirements.
Key to Qualifying RSC:
To obtain, and maintain Endorsement, qualifying RSC must come from one of the following:
- An Endorsed provider with the ERS add-on
- An Infant Mental Health Mentor-Clinical provider
Mentor-Clinical Endorsees: Mentor-Clinical endorsees can receive qualifying RSC hours from either another Infant Mental Health Mentor-Clinical provider or an ERS-endorsed provider
Endorsement Coordinator: Heather Bonitz Moore ATR-BC, LPC, IECMH-E®
Endorsement Coordinator: Heather Bonitz Moore ATR-BC, LPC, IECMH-E®
Heather is available to help explain the Endorsement® process, policies, and to answer questions about the Endorsement® categories. Heather can provide support via email, phone or virtual meeting. Please contact Heather at azendorsement@gmail.com.
Alliance for the Advancement of Infant Mental Health
Alliance for the Advancement of Infant Mental Health
The Alliance for the Advancement of Infant Mental Health is a global organization partnering with infant mental health associations and child-serving groups to support, grow, diversify, and advocate for their local mental health workforce. The Arizona Association for Infant Mental Health is a founding member of the Alliance, along with other U.S. and international AIMHs licensed to use the Competency Guidelines and Endorsement for promoting Infant & Early Childhood Mental Health® (MI-AIMH Copyright © 2026).
Competency Guidelines®
Endorsement® for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health is an internationally recognized credential that supports and recognizes the development and proficiency of professionals who work with or on behalf of pregnant people, infants, toddlers (0-36 months), and their caregivers. The IMH-E® is based on a set of Competency Guidelines® designed to support and enhance culturally-sensitive, relationship focused practice within the framework of infant mental health. An Endorsement® applicant demonstrates acquisition of these competencies through education, work, specialized training, and reflective supervision experiences.
Each of the four Endorsement® categories have unique competency requirements within eight core areas, including:
- Theoretical Foundations
- Law, Regulation, & Agency
- Systems Expertise
- Direct Service Skills
- Working with Others
- Communicating
- Thinking
- Reflection
HOW TO APPLY
TEN STEPS TO ENDORSEMENT®
Application Submission and Exams
At this time, new registrations and applications may be submitted in EASy on an ongoing basis.
Submissions that are received during an Endorsement Renewal period may take longer to review.
Applicants for the Infant Mental Health Mentor (IMHM) category should expect at least 4-6 weeks following application submission to taking the exam. Applicants who are approved to sit for the exam will be notified and connected with the Alliance for the Advancement of Infant Mental Health to complete the exam through the virtual platform, Question Mark. Applicants are encouraged to begin preparing for the exam while their application is being reviewed.
Fees Associated with AzAIMH Endorsement®
|
Endorsement® Categories |
AzAIMH Membership |
EASy Registration |
Endorsement® Processing |
|
Infant Family Associate |
$60 |
$15 |
$25 |
|
Infant Family Specialist |
$60 |
$20 |
$100 |
|
Infant Mental Health Specialist |
$60 |
$25 |
$200 |
|
Endorsed Reflective Supervisor Add-On |
N/A |
N/A |
$100 |
|
Infant Mental Health Mentor (Clinical, Policy, & Research/Faculty) |
$60 |
$25 |
$300 |
AzAIMH now offers a discounted membership rate for students. See membership information here.
Endorsement® Exam
Infant Mental Health Mentor applicants must pass an exam prior to earning Endorsement®. The exam has two parts; both are based on the Competency Guidelines®.
Applicants are encouraged to engage their provider of RSC to think together about the applicant’s professional journey, capacity for reflection, and understanding of parallel process all in relation to readiness for the exam. The reference rating form can be used to solicit feedback related to knowledge and skill areas of the competencies. If gaps in knowledge are identified, the indexed list of resources below can be used to identify readings. If the provider of RSC expresses reservations related to the capacity to apply IMH principles into practice, the applicant is encouraged to continue with RSC and the on-going assessment of skills in the areas of Reflection, Thinking, and Working with Others.
Exam Preparation
Click for the 2026 Exam Packet
Exam Administration
All Endorsement exams are administered through the Alliance for the Advancement of Infant Mental Health, which oversees the implementation of Endorsement. All exams are administered through Questionmark, an online exam platform that allows applicants to take the exam from their own computers and the comfort of their own space.
Exam windows are available the last full week of each month (January through November) and will open from Monday 12:00 AM to Sunday 11:59 PM Eastern. Applicants can select any 2 to 4-hour time block within the designated exam window week.
With the purchase of your Exam Support Package the Alliance will ensure your exam is reviewed by trained exam reviewers, maintaining anonymity throughout the reviewing process, and providing you with meaningful feedback regardless of exam outcome. The Alliance Exam Support Package is valid for one year from the date of purchase.
Part One (60 Multiple Choice Questions – 90 minutes)
The multiple-choice, or quantitative, section is primarily focused on infant mental health knowledge specific to work with infants, young children, and their families. Most questions will be related to direct service, but there will be some questions related to reflective supervision/consultation, policy, and research. Knowledge gained through course work, specialized in-service training, and self-study will be most useful in this section of the exam. IMH-E® applicants are expected to have knowledge about pregnancy, infants, young children (through age 3), and work with parents/caregivers/families.
Part Two (Vignettes – 90 minutes)
The qualitative section will ask for responses to vignettes. This section is intended to measure the applicant’s capacity to apply their knowledge of IMH principles into practice and to demonstrate a reflective, relationship-based approach. While all of the competency areas are important, the ones under the Reflection, Thinking, and Working with Others domains are important to the qualitative section for Mentors – Clinical.
The Administration domain is the primary focus of the Policy exam. Policy applicants are asked to demonstrate a capacity to promote IMH principles and practices within and across systems.
The Research & Evaluation domain is the primary focus of the Research/Faculty exam. In the Research/Faculty exam, one scenario is more specific to teaching; the other scenario is more specific to empirical research. Research/Faculty applicants will demonstrate a commitment to IMH principles and practices related to research or course planning and instruction.
Exam Accommodation Policy
The Alliance is dedicated to addressing the needs of all members and will work collaboratively with applicants to create a reasonable accommodation plan. However, not all requests may be granted, as accommodations must align with maintaining the integrity of the exam and the confidentiality of the applicant.
For applicants whose primary language is not English, an accommodation of up to an additional 60 minutes per section is available allowing a total of 2 ½ hours for Part One and 2 ½ hours for Part Two of the exam. Additionally, applicants may bring a translation dictionary (e.g., Spanish-to-English) into the examination. This standard English-as-a-Second-Language (ESL) accommodation requires only a written request.
For additional assistance, please contact the AzAIMH Endorsement Coordinator at azendorsement@gmail.com.
Exam Agreement, Scoring, Feedback, & Retakes
Exam Agreement:
The Alliance Endorsement Exam Agreement is a formal document outlining the expectations and requirements for individuals approved to sit for the Endorsement Exam as a Mental Health Mentor. It ensures that candidates understand and commit to maintaining the integrity of the exam process.
Scoring & Feedback:
Applicants must receive passing scores on both Part One and Part Two of the exam to earn Endorsement®. A passing score on Part One (the multiple-choice section) of the exam is 80%. To carefully protect the exam materials, applicants will not receive specific feedback related to the questions missed in Part One. Applicants who do not receive a passing score on Part Two of the exam (vignettes/scenarios) will be provided with feedback based on the exam reviewers’ remarks.
Regardless of the outcome, feedback is offered in the spirit of promoting professional development and can help guide the selection of specialized in-service training opportunities and continuing reflective supervision/consultation experiences.
Retakes:
- If an applicant does not achieve a passing score on the multiple-choice and/or the written exam, they may retake that section, six months after the original exam date. A new exam support package must be purchased.
- If an applicant does not complete either or both parts of the exam after being scheduled. A new exam support package must be purchased.
For assistance, please contact the AzAIMH Endorsement Coordinator at azendorsement@gmail.com.
Endorsement® RENEWAL
Continued growth and development are essential for all IMH professionals to maintain and enhance skills, knowledge, and ethical practice. AzAIMH captures this ongoing process of professional development through the Endorsement® renewal.
Endorsement Renewal is now on a fixed 3-year cycle, which is completed through an attestation and audit system. This provides greater flexibility for those who are navigating life events such as family leave, medical leave, or job transitions.
The next Endorsement renewal period will be October 1 – December 15, 2027.
Endorsement® Renewal Process
Renewal Timeline:
The next renewal is due by December 15, 2027. Future renewals will follow a three-year cycle (e.g., 2030, 2033).
Attestation and Audits:
Endorsed professionals will attest to meeting renewal requirements. AzAIMH’s Endorsement Coordinator will conduct random audits for compliance.
You can continue to enter your training and RSC information in EASy to keep track of your renewal requirements.
Renewal Requirements: Renewal requirements remain the same (accumulated over three years)
- Training:
- 45 hours of training specific to social-emotional well-being in IMH (equivalent to 15 hours/year)
- 9 of the 45 hours on the provision of reflective supervision/consultation for Endorsed Reflective Supervisors and Mentors-Clinical
- Reflective Supervision/Consultation:
- 36 hours over three years for Family Specialist, Mental Health Specialist, and Mentor-Clinical categories
- Although it is not required, it is strongly recommended that Family Associates and Mentor Policy & Research/Faculty also participate in reflective practice.
- Membership: Maintain your AzAIMH membership for the duration of the renewal cycle.
Frequently Asked Questions
How do I ask for help while completing the Endorsement® process?
How do I know which RSC hours qualify for Endorsement® applications & renewal?
RSC that meets criteria for Endorsement® must come from an individual who has earned the Endorsed Reflective Supervisor Add-On or Infant Mental Health Mentor-Clinical. A lot of clinical supervision is reflective, but perhaps not all is from a specialist in infant and early childhood mental health.
Can I supervise/consult with a colleague or peer?
Peer supervision (defined as colleagues meeting together without an identified supervisor/consultant to guide the reflective process), while valuable for many RSC experienced practitioners, does not meet the criteria for Endorsement®, even if one or more of the peers has earned Endorsement® as an ERS or IMHM-C. The provider of RSC is charged with holding the emotional content of the cases presented. The ability to do so is compromised when the provider is a peer of the presenter. Unnecessary complications can arise when the provider of RSC has concerns about a peer’s ability to serve a particular family due to the peer’s emotional response AND the provider and peer share office space, for example.
Endorsement® resources
- Endorsement® Is Good For Babies
- Helpful Tools for You – Crosswalks for Endorsement®
- The Alliance partners with organizations to promote our mutual commitment to workforce development across the field through competency-informed training, coursework, and experiences. To do this, we develop a crosswalk across the partner organization’s content and the Competency Guidelines. The Competency Guidelines are aligned with many in-service training/curriculum, evidence-based practice models, certificates, and secondary education programs.
- The presence on this list means that the crosswalk has been aligned with the knowledge/skill areas found within the Competency Guidelines® and authored by at least one professional holding the Infant/Early Childhood Mental Health Endorsement® (IMH-E®/ECMH-E®) credential. AzAIMH and the Alliance cannot guarantee Endorsement® will be earned upon completion of any or all the training curricula and/or coursework listed in the crosswalks. Additionally, AzAIMH and the Alliance cannot guarantee the accuracy, reliability or completeness of the crosswalk.
- Perceptions on the Infant, Toddler Mental Health Endorsement (ASU Center for Child Well-Being, May 2016)
Adding Endorsement® Categories
The AzAIMH Endorsement Committee would like to encourage all Endorsees to consider whether they meet the criteria for an additional category of Endorsement®. The categories are not considered hierarchical as each is incredibly important; however, there are benefits to adding an Endorsement® category.
- An opportunity for you to enhance your professional profile in the rapidly growing field of Infant Mental Health.
- Recognition of your professional growth and ongoing development of knowledge and skills.
- Validation of the work you have done under the guidance and supervision of experienced mentors.
- Highlight yourself as a competent professional in a system that reflects the commitment to best practices and quality care for infants, toddlers, and their families.
- Help AzAIMH increase capacity for reflective supervision/consultation in your local community and across Arizona!
Applicants may not earn two categories or designations of Endorsement® at the same time. An applicant will earn one category of Endorsement®, then add an additional category of Endorsement® at a later date. There are no timeframe restrictions for adding new Endorsement® categories. Applicants can apply for another category whenever they meet the requirements to do so.
To assure fulfillment of the Endorsement® requirements as specified, an endorsed professional will “add a new Endorsement® application” within their EASy (link) application and add information pertinent to the “new” category.
Application and Payment
The EASy registration fee is waived for applicants who are adding Endorsement® categories. The Endorsement Processing Fee will be the difference between the fee paid when the applicant initially became endorsed and the current Endorsement® Processing Fee for the “new” category. Please contact the AzAIMH Endorsement Coordinator (link to azendorsement@gmail.com) to determine the Endorsement® Processing Fee. It is the responsibility of the applicant to notify AzAIMH about adding Endorsement® categories. If the applicant pays the full Endorsement® Processing Fee without informing AzAIMH about adding categories, there will be no refund.
Policies
Reinstatement if Endorsement® Lapses
Endorsement® renewals are due by December 15th of the renewal cycle year.
If a practitioner fails to maintain membership with AzAIMH and/or fails to submit Endorsement® renewal by December 31st of the renewal cycle year, they will be removed from the Endorsement® Registry.
To have an Endorsement® reinstated, a practitioner must:
1. Re-register on EASy (link)
2. Document education, work, in-service training and RSC experiences that have been accrued since removal from the Endorsement® registry.
3. Add three updated reference ratings in EASy
4. Pay Endorsement® Processing Fee
5. Renew and maintain membership with AzAIMH (link)
Applying for Endorsement® as an Out-Of-State applicant
AzAIMH cannot accept Endorsement® applications from those who reside outside of Arizona.
If an Applicant resides in another state, but works in Arizona, they must apply for Endorsement® in the state in which they reside.
If an Applicant works in a state that has Endorsement® but resides in a state that does not have Endorsement® AND the Applicant’s employer requires Endorsement®, it may be possible for the Applicant to earn Endorsement® through the Alliance for the Advancement of Infant Mental Health.
To see if Endorsement® is available where you reside, please visit The Alliance for the Advancement of Infant Mental Health.
Refund Policies Associated with Endorsement® Fees
AzAIMH does not refund registration fees or processing fees.
The Endorsement fees only partially cover AzAIMH’s expenses related to supporting applicants through the Endorsement process. Therefore, AzAIMH is unable to refund fees once an application has been submitted for review. This policy applies even if applicant is deferred, submits an incomplete application, does not pass the exam, or accepts Endorsement® at another category with a lower fee.
If you have questions, please contact the Endorsement Coordinator prior to submitting payment: azendorsement@gmail.com
