Wraparound Blog

Increasing Youth Engagement in Wraparound: Findings from a Randomized Study of the Achieve My Plan Enhancement

March 23, 2018 | Janet Walker

This recent article by NWI/NWIC staff and colleagues describes findings from a randomized study in which half the participants got Wraparound “as usual,” and the others got Wraparound together with an enhancement that successfully increased youths’ engagement and active participation in Wraparound, as well as their alliance with the team. We’re pleased to be able to offer the full text of this article on the NWI website!

Here’s a summary of the article, as well as updates on where the AMP project has been up to since the randomized study was completed.

Achieve My Plan (AMP) is an enhancement for existing interventions and programs that is designed to strengthen providers’ skills in key areas that are typically needed for working successfully with youth and young adults. Specifically, AMP focuses on increasing providers’ capacity for working with young people in ways that promote their acquisition of self-determination skills, ensure that care/treatment is based on their perspectives and priorities, and highlight and build on strengths in meaningful ways.

AMP was originally developed and tested as an enhancement to Wraparound, which is a team-based planning and intensive care coordination process. Wraparound is intended to improve outcomes for children, youth and young adults with the highest levels of mental health and related needs, .and their families. Wraparound’s first principle stresses that the process should be built around the priorities and perspectives of the young person and their family; however, in practice, the young people’s “voice” is often not present to a meaningful extent. The AMP enhancement for Wraparound aims to increase young people’s satisfaction, active engagement and self-determined participation in Wraparound, as well as their alliance with their treatment planning team. Findings from a randomized study of AMP showed that, relative to youth who received “as usual” Wraparound, young people who received Wraparound with the AMP enhancement participated more – and in a more active and self-determined manner – with their teams. They also rated their alliance with their Wraparound teams significantly higher. Furthermore, adult team members in the intervention condition rated team meetings as being more productive, and they were more likely to say that the AMP meetings were “much better than usual” team meetings.

Since its initial development, AMP has been used to enhance providers’ practice within other interventions that include a focus on youth/young adult voice, strengths and self-determination. Current research on AMP is focused on documenting the extent to which training impacts providers’ competencies in these areas. Current AMP training is completely delivered via “remote” training and coaching (i.e., via a series of web conferences across several months, and via a secure internet video-based coaching platform) in a way that conforms to best practices. Specifically, to ensure that AMP training will be applied in practice, each group web conference is followed up with individualized coaching that incorporates observation of a provider’s work with young people and the provision of objective practice-focused feedback over time. This approach also allows trainees to learn and practice more basic skills (with coaching and feedback) before moving on to progressively more advanced skills.

Data was gathered from 67 trainees who have taken part in online training and coaching for AMP to date. Findings show significant improvements in trainee competencies for working with youth/young adults as assessed by their practice in video recordings, and as assessed subjectively by the trainees themselves. Trainees were also highly satisfied with the training/coaching experience. What is more, practice fidelity monitoring is organically integrated into the coaching process, so that no additional investment is required to track it.