Annual Renewal of Endorsement® Requirements


In order to renew Endorsement® annually, the following is required:

  • On-going membership in F5A

  • 15 clock hours of training related to culturally sensitive, relationship-focused practice promoting infant and early childhood mental health.  If you are a provider of RSC, at least 3 hours of the 15 hours required need to be about the provision of RSC

  • 12 clock hours of qualifying reflective supervision on an annual basis for all Infant/Early Childhood Family Specialist, Infant/Early Childhood Mental Health Specialist, and Infant/Early Childhood Mental Health Mentor-Clinical endorsees.


Reinstatement of Endorsement Lapses


If a practitioner fails to update membership in F5A and/or annual Endorsement® renewal hours by January 31st of any year, they will be removed from the Endorsement® Registry.


If removed from the Endorsement® Registry, a professional must:

  • Register on EASy

  • Add education, work, in-service training and RSC experiences that have been accrued since removal from the registry

  • Get three updated reference ratings (via EASy)

  • Pay Endorsement® Processing Fee


Reinstatement also requires a current membership with F5A.  



Applying for Endorsement® if Out of State Applicant


F5A cannot accept Endorsement® applications from those who reside outside of Alabama.  Even if the Applicant works in Alabama, if the Applicant resides in another state, 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.



Changing Endorsement® Categories


Applicants may not earn two categories or designations of Endorsement® at the same time.  An applicant will earn one category of Endorsement® and then add an additional category of Endorsement® at a later date.


To assure fulfillment of the Endorsement® requirements as specified, an endorsed professional will “add a new Endorsement® application” within their EASy application.  F5A requires that this is done a minimum of 4-weeks before the review deadline to assure that all of the requirements are understood, that there is adequate time for preparation for the IMHS/ECMHS or IMHM/ECMHM Endorsement® exam, and that the applicant’s application is updated with new information pertinent to the applicant’s current status (including contact information).


Changing Endorsement® Category: Application and payment

*include the AIMH’s policy here.  See the Policy Manual for guidance, specifically, see section “Changing Endorsement® Categories”


Changing Endorsement® Category: Time-frame guidelines for application


IMH-E® to IMH-E®:

IFA to IFS: Minimum of one year from the date of Infant Family Associate Endorsement®

IFS to IMHS: Minimum of one year from the date of Infant Family Specialist Endorsement®

IMHS to IMHM: Minimum of three years from the date of Infant Mental Health Specialist Endorsement®

Additional IMHM designation: Minimum six months from date of first Infant Mental Health Mentor Endorsement®


IMH-E® to ECMH-E®:

IFA to ECFS: Minimum of one year from the date of Infant Family Associate Endorsement®

IFS to ECMHS: Minimum of one year from the date of Infant Family Specialist Endorsement®

IMHS to ECMHM: Minimum of three years from the date of Infant Mental Health Specialist Endorsement®

IMHM to ECMHM: Minimum one year from the date of Infant Mental Health Mentor Endorsement®



ECFA to ECFS: Minimum of one year from the date of Early Childhood Family Associate Endorsement®

ECFS to ECMHS: Minimum of one year from the date of Early Childhood Family Specialist Endorsement®

ECMHS to ECMHM: Minimum of three years from the date of Early Childhood Mental Health Specialist Endorsement®

Additional ECMHM designation: Minimum six months from date of first Early Childhood Mental Health Mentor Endorsement®


ECMH-E® to IMH-E®:

ECFA to IFS: Minimum of one year from the date of Early Childhood Family Associate Endorsement®

ECFS to IMHS: Minimum of one year from the date of Early Childhood Family Specialist Endorsement®

ECMHS to IMHM: Minimum of three years from the date of Early Childhood Mental Health Specialist Endorsement®

ECMHM to IMHM: Minimum one year from the date of Early Childhood Mental Health Mentor Endorsement®



Inactive Endorsement® Status


F5A maintains an Inactive Endorsement® Registry for those who have earned Endorsement® but have extenuating circumstances and are unable to meet annual renewal requirements.  There is one type of Inactive Endorsement®.


Inactive Status: Endorsed professional continues with on-going requirements for membership and 5 hours of specialized in-service training annually but is unable to fulfill the full training requirement of 15 hours.  All categories of Endorsement® are eligible for Inactive Status. 


Endorsed professionals who move to Inactive Status will be removed from the Endorsement® Registry and are no longer able to use the IMH-E® or ECMH-E® credential after their name or promote themselves as actively endorsed or as a provider of reflective supervision/consultation. 


For IFS/ECFS, IMHS/ECMHS and IMHM/ECMHM endorsed professionals who are no longer working in the IECMH field and no longer receiving RSC, but who wish to continue to remain on the Endorsement® Registry, they will be offered the option to apply for IFA/ECFA Endorsement® (through a new IFA/ECFA Application in EASy).  These professionals will not need to complete the entire application, as they previously demonstrated fulfillment of the competencies and requirements through their previous application for Endorsement®.  Upon applying for and receiving IFA/ECFA Endorsement®, these endorsed professionals will be required to follow the ongoing annual Endorsement® renewal requirements of 15-hours of in-service training and maintenance of membership in F5A.



Inactive Endorsement Status: Returning to Active Endorsement Status


When the endorsed professional is ready to return to active status, they will complete and submit an Application for Reactivation to Active Endorsement® Registry and a check for $25 for the Reactivation Fee to F5A, Address of AIMH.  Contact the Endorsement Coordinator for the application,


Once reviewed and approved, the endorsed professional’s name will be moved from the Inactive Endorsement Registry to the Endorsement Registry. The number of training hours expected for annual Endorsement® renewal will be prorated depending on the date that the application to reactivate is received.  The Endorsement Coordinator will email you with the number of hours you will be expected to submit.



Endorsement Exam Special Accommodations


Dates and Location

The Endorsement® examination is generally offered two times each year, once in March and once in September. The exam will be proctored in one primary location.  Permission can be sought to have the exam proctored in an additional location.  Requests to determine an alternate exam site need to be made at least 10-weeks prior to the exam date.  Requests are submitted in writing to the Endorsement Coordinator.  F5A will offer the exam at the primary location and at no more than two alternate locations at any given exam administration.  Exams administered at an alternate location must occur on the same date as the primary exam administration.  $50 shipping and handling fee be added for each applicant whose request to take the exam in any location other than the primary site has been approved.


Accommodations for the Exam

If an IMHS/ECMHS or IMHM/ECMHM Endorsement® applicant would like an accommodation for either part of the examination, they must submit a written request to the Endorsement Coordinator at least eight weeks before the exam date. The request must detail the kind of accommodation being requested, as well as documentation of the need for an accommodation (i.e. assessment from a professional). The Endorsement Coordinator will respond to the request at least 10 days before the examination date


F5A is committed to meeting the needs of all of its members but may not be able to grant every accommodation request.  F5A will work closely with the applicant to develop a plan that offers a reasonable accommodation without compromising the integrity of the exam, the identity of the applicant, or the identity of the exam reviewers.  In these instances, it may be necessary and appropriate to offer the exam on a different date in order to accommodate the applicant.  If F5A is unsure of the appropriate accommodation for a special circumstance, F5A may contact the Alliance for the Advancement of Infant Mental Health Quality Assurance Director.


If an IMHS/ECMHS or IMHM/ECMHM Endorsement® applicant’s primary language is something other than English, and the Applicant requests an accommodation, they can have up to an additional 60 minutes for each section of the exam, i.e., a total of 2 ½ hours for Part One and a total of 2 ½ hours for Part Two.  In addition, they may take a dictionary into the examination to assist in translation (e.g., a Spanish to English dictionary).  ESL accommodations do not require documentation except for a written request for the standard extension of time outlined above.  If more time than the standard extension is requested, further documentation may be required. 



Endorsement Exam Scores, Feedback, Retakes and Decision Reviews


Applicants must receive passing scores on both Part One and Part Two of the exam to earn F5A Endorsement®. A passing score on Part One (the multiple-choice section) of the exam is 80%.  In order to carefully protect the exam materials, applicants will not receive specific feedback related to the questions missed on Part One.  Applicants who do not receive a passing score on Part Two of the exam (response to vignettes/scenarios) will be provided with feedback based on the exam reviewers’ remarks.


Regardless of outcome, all who take the exam will be provided with feedback based on the exam reviewers’ remarks.  The feedback is offered in the spirit of promoting professional development and can help guide selection of specialized in-service training opportunities and continuing reflective supervision or consultation experiences.



Applicants must submit a written request to retake the exam at least eight weeks before the examination date. The request must be sent to the Endorsement Coordinator.  Whether retaking Part One, Part Two, or both, applicants must wait at least one year before retaking the exam. There is no charge to retake either part of the exam the second time.  However, if any applicant does not successfully pass the exam after two attempts, the applicant must: wait at least one year before taking the exam again, update their EASy application with three new reference ratings, new training/work/supervision experiences and submit their application for another review.  If the applicant is approved to sit for the exam again, the applicant must pay the retake fee of $100.


Review of an Exam Decision

A minimum of two trained exam reviewers must agree on whether or not an exam response (qualitative section) passes or not. There is no appeal process if the applicant does not agree with this decision. As stated in the Endorsement® Agreement, signed by every Endorsement® applicant: “The decision of F5A concerning whether or not endorsement will be granted is final and binding.”


Applicants are invited to consider the feedback offered by exam reviewers and sit for the exam again in one year’s time (see policy above, “Retakes”)


Endorsement® Application Submission, Review and Approval to sit for the Exam

IMHS/ECMHS and IMHM/ECMHM applicants are expected to submit a completed application at least four weeks before exam date. Exam dates and application submission deadlines are posted within our Events Calendar.
 Applications must be submitted via EASy in their entirety*, by 11:59pm on the day of the deadline. IMHS/ECMHS and IMHM/ECMHM applications are reviewed by at least one professional who has earned Endorsement® and has been trained to review applications. 


If the application reviewer(s) believes the applicant is not yet ready to sit for the exam, the applicant will be given specific feedback related to the decision. F5A will provide an email to the applicant identifying strengths and gaps, as they relate to the competencies. The applicant will be invited to update their EASy application, including new reference rating forms, one year later and will be reconsidered to take the exam at that time.



Reflective Supervision/Consultation (RSC)


RSC is supervision or consultation that distinctly utilizes the shared exploration of the parallel process. In addition, RSC relates to professional and personal development within one’s discipline by attending to the emotional content of the work and how reactions to the content affect the work. Finally, there is often a greater emphasis on the supervisor/consultant’s ability to listen and wait, allowing the supervisee to discover solutions, concepts and perceptions on their own without interruption from the supervisor/consultant.


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® at IMHM-C/ECMHM-C or IMHS/ECMHS. 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.



Refund Policies Associated with Endorsement Fees


EASy Registration Fee

F5A does not refund EASy Registration Fees.


Endorsement Processing Fee

The Endorsement Processing Fee only partially covers the F5A expenses related to supporting applicants through the process, facilitating application reviews, compiling feedback letters to each applicant, creating and mailing the Endorsement® certificate, and maintaining the Endorsement® Registry.  In addition, for IMHS/ECMHS and IMHM/ECMHM there are the additional expenses related to the creation and field testing of a new exam each year, administering the exam, and reviewing the exam.  Therefore, F5A is unable to refund Endorsement Processing 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.

First 5 Alabama is a Member Organization of
The Alliance is a global organization that includes multiple states and international associations whose infant mental health associations have licensed the use of the Competency Guidelines® and Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health® under their associations’ names.
The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of Substance Abuse and Mental Health Services Administration (SAMHSA) or U.S. Department of Health and Human Services (HHS). 
©2020 by First 5 Alabama.