The consultation relationship-From transactional to transformative: Hypothesizing about the nature of change.

Increasing numbers of young children with significant social and emotional difficulties are being identified in childcare settings. Early Childhood Mental Health (ECMH) Consultation has been identified as a promising practice in stemming the tide of this troublesome trajectory. While ECMH Consultation is credited with promoting children's positive development, diminishing difficult behaviors, and reducing expulsion rates, the mechanisms of this transformative process are only beginning to be investigated. Recent research cites the salience of the relationship between a consultant and consultee as the central contributor to positive change in childcare-center climate and child outcomes. This article delineates characteristics of a beneficial consultative relationship and postulates the clinical process by which change in childcare providers' behavior occurs as a result of having experienced such a relationship. Paralleling the traits of contingent caregiving, the consultative stance, a posture of mutuality, reciprocity, and positive regard creates an intersubjective space for reflection, repair, and, when necessary, adaptation. Based on perceptual shifts or expansions, the providers' attitude and approach toward children in their care is amended, in turn promoting positive change in the child and classroom atmosphere.