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STOP! If you currently hold an endorsement as a TMHP, MHS, RPFI or RPFII and wish to add an additional endorsement please use a SUPPLEMENTAL application form.

California Infant-Family and Early Childhood
Mental Health Endorsement Application

I. Reflective Practice Facilitator I (must be able to check each criterion to qualify for RPF I)
Materials needed for the Transdisciplinary Mental Health Practitioner (TMHP) or Mental Health Specialist (MHS) and the Reflective Practice Facilitator (RPF I - II - Mentor) endorsements include:

1.     Brief Personal Statement regarding professional background and endorsement interest.
View personal statement document checklist.
2.     Current resume or CV. 
View resume checklist that illustrates information that you must include.

3.    Signed letter of recommendation on official letterhead from a past or current supervisor stating the endorsement title and age category (0-3 or 3-5 or 0-5) they are recommending you for.
View letter of recommendation for TMHP/ATMP/MHS checklist.    

4.    Brief narrative of your knowledge organized according to the eight knowledge areas (Domain 1) and summary of your work experience supported by reflective practice (Domain 2).
View TMHP/ATMHP/MHS learning narrative checklist.
Direct Service Hours and RPF Support accumulatedprior to January 1, 2017 may still be used to meet the Domain 2 criteria total. Hours accumulated after that date must be supported by an endorsed RP Facilitators
Please save all documents into .doc or .pdf format prior to uploading.
Mental Health Training program certificates may not be substituted for the learning narrative document but hours can be referenced and the transcript certificate submitted in the document field.
*You may not count the same training hours in more than one training knowledge area. *Indicate the number of hours in the college course work that applied to the 0-5 age group.

5.    Materials that document training in knowledge areas will vary according to where you have received your training. For example, they might include a certificate from a specialized infant mental health training program, certificates of attendance from conferences, workshops and community training courses, or transcripts that show college coursework that covers knowledge domains.

Reflective Practice Facilitator I or II Applicants need the following in addition to the TMHP or MHS items listed above.
You cannot apply for Reflective Practice without a TMHP/ATMHP or MHS endorsement.

1.    The letter of recommendation signed and on official letterhead stating the endorsement category (Reflective Practice Facilitator).  This needs to be a different person from the one for MHS/TMHP and usually the person who provided training and mentorship to become a RPF.  
View RPF letter of recommendation guidelines.
It is suggested that you provide this information to the letter writer.

2.    Reflective practice facilitators will need the names and email contact information for three people to whom you provided reflective practice facilitation. California Center staff will send a request for verification via email.
View the email verification that will be sent to the 3 names you provide.
Reflective Practice Mentor requires completiona of all of the RPF criteria along with additional RPMentor criteria as listed in the CA Compendium (2016). You cannot apply for RPMentor without the TMHP/MHS and RPF endorsements or completing those applications.

1.   Letter of recommendation from your mentor documenting the reflective practice facilitation mentorship you received that is related to the work you have done to help others become reflective practice facilitators. Your mentor must state that she is recommending you as a mentor to trainees for the purpose of providing RPF to others.
View the guidelines for the Mentor letter of recommendation.
It is suggested that you provide this information to your mentor.
If you are applying for Mentor endorsement without previously holding the RPF endorsement, your RPF application recommendation letter cannot be the same letter for both since the endorsements are for different activities.  
2. Reflective Practice Mentor applicants will need the names and email contact information for three people that you mentored to become RP facilitators. California Center staff will send email requests for verification.
These are people that you provided mentorship to become RP Faciliatators, not colleagues who were trained with you to become RPF.
View the email that will be sent to 3 names you provided.
3. A 10-20 minute video and short written reflection of your own RPF mentor session.
View Mentor video guidelines.
I am applying for one: (Upon completion of the TMHP and MHS application page, you may choose to apply for additional reflective practice facilitator endorsement: RPF I, RPF II and RP Mentor) *