The purpose of this study was to clearly articulate the essential elements and activities of IECMHC across settings, and – consistent with the theory of change – to explicitly center the importance of the relationships formed and the promotion of racial equity in those activities. Prior efforts to articulate the activities of IECMHC have advanced shared understanding of IECMHC to a point, yet lacked sufficient detail to lay the foundation for a fidelity measure, were not based upon expert consensus, and did not address relationship-formation or equity (Duran et al., 2009). By seeking to understand the “black box” of consultation, the processes by which IECMHC directly affects the adults who work with young children could become clearer. These adults decide whether to expel a child, and their wellbeing, implicit biases, and overall skillfulness in fostering social-emotional health in the classroom have significant impacts on young children. (author abstract)