Wraparound
Brief Description
The information in this program outline is provided by the program representative and edited by the CEBC staff. The Wraparound program has been rated by the CEBC in the area of: Placement Stabilization.
- Types of Maltreatment: Does not target any specific kind of maltreatment
- Target Population: Designed for children and youth with severe emotional, behavioral, or mental health difficulties and their families. Most often these are young people who are in, or at risk for, out of home, institutional, or restrictive placements, and who are involved in multiple child and family-serving systems (e.g., child welfare, mental health, juvenile justice, special education, etc.) Wraparound is widely implemented in each of these various settings; however, because the youth have multi-system involvement, wraparound participants have many similarities across settings.
Wraparound is a team-based planning process intended to provide individualized and coordinated family-driven care. Wraparound is designed to meet the complex needs of children who are involved with several child and family-serving systems (e.g., mental health, child welfare, juvenile justice, special education, etc.), who are at risk of placement in institutional settings, and who experience emotional, behavioral, or mental health difficulties. The Wraparound process requires that families, providers, and key members of the family’s social support network collaborate to build a creative plan that responds to the particular needs of the child and family. Team members then implement the plan and continue to meet regularly to monitor progress and make adjustments to the plan as necessary. The team continues its work until members reach a consensus that a formal Wraparound process is no longer needed.
The values associated with Wraparound require that the planning process itself, as well as the services and supports provided, should be individualized, family driven, culturally competent and community-based. Additionally, the Wraparound process should increase the “natural support” available to a family by strengthening interpersonal relationships and utilizing other resources that are available in the family’s network of social and community relationships. Finally, Wraparound should be “strengths-based", helping the child and family recognize, utilize, and build talents, assets, and positive capacities.
Essential Components
In order to provide Wraparound with high fidelity — as measured by the Wraparound Fidelity Index, below — the following elements are required:
- Practice that confirms to the "Ten Principles of the Wraparound Process"—citation below—which specify that care should be family-driven and youth guided, community- and strengths-based, individualized, outcome oriented, culturally competent, collaborative, and so on. The document provides information about what these principles “look like” when applied to the Wraparound process.
- Practice must also include the activities outlined in the “Phases and Activities of the Wraparound Process” document—citation below. The phases and activities are listed below. A more detailed description of each phase and activity is provided in the document.
PHASE 1: Engagement and team preparation
- Orient the family and youth to wraparound and address legal and ethical issues.
- Stabilize crises: Elicit information from family members, agency representatives and potential team members about immediate crises or potential crises, and prepare a response.
- Explore strengths, needs, culture, and vision during conversations with child/youth and family, and prepare summary document.
- Engage and orient other team members.
- Make necessary meeting arrangements.
PHASE 2: Initial plan development
- Develop an initial plan of care: Determine ground rules, describe and document strengths, create team mission, describe and prioritize needs/goals, determine outcomes and indicators for each goal, select strategies, and assign action steps.
- Create a safety/crisis plan to ameliorate risk and respond to potential emergencies.
- Complete necessary documentation and logistics.
PHASE 3: Implementation
- Implement action steps for each strategy of the wraparound plan, track progress on action steps, evaluate success of strategies, and celebrate successes.
- Revisit and update the plan, considering new strategies as necessary.
- Maintain/build team cohesiveness and trust by maintaining awareness of team members’ satisfaction and “buy-in,” and addressing disagreements or conflict.
- Complete necessary documentation and logistics.
PHASE 4: Transition
- Plan for cessation of formal wraparound: Create a transition plan and a post-transition crisis management plan, and modify the wraparound process to reflect transition.
- Create a “commencement” by documenting the team’s work and celebrating success.
- Follow up with the family.
Please refer to these documents:
Walker, J. S., Bruns, E. J., Rast, J., VanDenBerg, J. D., Osher, T. W., Koroloff, N., et al. (2004). Phases and activities of the wraparound process. Portland, OR: National Wraparound Initiative, Research and Training Center on Family Support and Children's Mental Health, Portland State University. Presented as pages 5-16. Retrieved on September 3, 2009, at www.rtc.pdx.edu/PDF/PhaseActivWAProcess.pdf.
Bruns, E. J., Walker, J. S., Adams, J., Miles, P., Osher, T. W., Rast, J., et al. (2004). Ten principles of the wraparound process. Portland, OR: National Wraparound Initiative, Research and Training Center on Family Support and Children's Mental Health, Portland State University. Retrieved on September 4, 2007, at www.rtc.pdx.edu/PDF/TenPrincWAProcess.pdf
Child Component
Wraparound was designed with a child component that addresses the following presenting problems and symptoms:
- Severe emotional, behavioral, or mental health difficulties and their families. Most often these are young people who are in, or at risk for, out of home, institutional, or restrictive placements, and who are involved in multiple child and family-serving systems (e.g., child welfare, mental health, juvenile justice, special education, etc.)
Age range: 0 – 17
Developmental Delays:
This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.
Parent / Caregiver Component
Wraparound was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:
- Child in foster or residential care, child in child welfare system, child in juvenile justice system, child with significant emotional and behavioral problems, child at-risk for out-of-home placement.
Group Format
Wraparound was not designed to be conducted in a group setting, and has not been tested for use in a group setting.
Recommended Parameters
Recommended Intensity:
This can vary. Usually there is an intensive engagement and initial planning process that may require two 60-90 minute sessions with the family and two team sessions during the first three weeks to a month. The team continues to meet thereafter, usually with increased intensity in the early phases (often once per month or even more) and decreasing thereafter. The care coordinator, facilitator, and parent partner could have other contacts with the youth and family as necessary. Services and supports called for in the plan are provided by other team members or by people not included on the team.
Recommended Duration:
Well-established programs provide services for an average of 14 months or so.
Delivery Settings
This program is typically conducted in a(n):
- Adoptive Home
- Birth Family Home
- Community Agency
- Foster Home
- Residential Care Facility
Homework
Wraparound includes a homework component:
Youth and family can have homework if the team determines it will facilitate carrying out their roles in implementing the overall plan.
Languages
Wraparound does not have materials available in a language other than English.
Resources Needed to Run Program
The typical resources for implementing the program are:
Most of the cost is in personnel. Programs typically hire care coordinators with caseloads of 10-15 families. Additionally, most programs hire parent advocates/parent partners to work with teams. Because this program is typically a collaborative effort, implementation usually (but not always) requires some sort of inter-agency oversight or governance body with representation from participating child and family-serving agencies and organizations.
Minimum Provider Qualifications
Most programs require staff to be at least at the Bachelor's level for care coordinator and supervisory positions. Requirements for family partners are flexible. The most important qualification is expertise in multi-agency collaboration and the program itself.
Education and Training Resources
There is not a manual that describes how to implement this program; but there is training available for this program.
Training is obtained:
Private consultants are available as needed; see the listing of consultants provided at www.nwi.pdx.edu. This is not an exhaustive list. Also, many states (e.g., Indiana, Michigan, Arizona) provide training and technical assistance to wraparound programs.
Number of days/hours:
Varies.
Relevant Published, Peer-Reviewed Research
This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.
Child Welfare Outcomes: Permanency and Child/Family Well-Being
References
Contact Information
- Name: Janet S. Walker, PhD
- Title: Director of Research and Dissemination, Research and Training Center on Family Support and Children's Mental Health and Co-Principle Investigator
- Agency/Affiliation: National Wraparound Initiative
- Website: www.nwi.pdx.edu
- Email: janetw@pdx.edu
- Phone: (503) 725-8236
- Fax: (503) 725-4180
Date Reviewed: June 2011 (originally reviewed in August 2007)