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Endorsement® Policies

Annual Renewal of Endorsement® Requirements

To renew Endorsement® annually, the following is required:

2024 Reminder
Infant Family Specialists and Infant Mental Health Specialists who are RSC providers must be endorsed with the ERS Add-On by December 2024 to continue to provide RSC for the purpose of Endorsement going into 2025.

Reinstatement of Endorsement Lapses

If a practitioner fails to update membership in ITMHCA and/or annual Endorsement® renewal hours by February 1st of any year, they will be removed from the Endorsement® Registry.

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

Reinstatement also requires a current membership with ITMHCA.

Applying for Endorsement® if Out of State Applicant

ITMHCA cannot accept Endorsement® applications from those who reside outside of Arizona. Even if the Applicant works in Arizona, 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. ITMHCA 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 or IMHM 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
The EASy registration fee is waived for applicants who are changing 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. Please contact the Endorsement Coordinator at to find out your Endorsement Processing Fee. It is the responsibility of the applicant to notify ITMHCA about changing Endorsement® categories. If the applicant pays the full Endorsement Processing Fee without informing ITMHCA about changing categories, there will be no refund.

Changing Endorsement® Category: Time-frame guidelines for application

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®

Inactive Endorsement® Status

ITMHCA 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. Complete the Application 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® credential after their name or promote themselves as actively endorsed or as a provider of reflective supervision/consultation.

For IFS, IMHS and IMHM 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 Endorsement® (through a new IFA 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 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 ITMHCA.

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 ITMHCA, PO Box 2234, Phoenix, AZ 85002-2234.

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 one to two times each year, please see the Announcements located on the login page of EASy to learn when the next exam is scheduled. 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. ITMHCA 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 or IMHM 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.

ITMHCA is committed to meeting the needs of all of its members but may not be able to grant every accommodation request. ITMHCA 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 ITMHCA is unsure of the appropriate accommodation for a special circumstance, ITMHCA may contact the Alliance for the Advancement of Infant Mental Health Quality Assurance Director.

If an IMHS or IMHM 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 ITMHCA 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 ITMHCA 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 and IMHM applicants are expected to submit a completed application at least 4 weeks before exam date. You can find Exam dates and application submission deadlines in the Announcements section on the login page of EASy.

Applications must be submitted via EASy in their entirety*, by 11:59pm on the day of the deadline. IMHS and IMHM 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. ITMHCA 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 or IMHS. 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
ITMHCA does not refund EASy Registration Fees.

Endorsement Processing Fee
The Endorsement Processing Fee only partially covers the ITMHCA 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 and IMHM 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, ITMHCA 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.

For questions about Endorsement® please email