Publications and Tools Search for Wraparound Stakeholders

(SPANISH VERSION) The Achieve My Plan (AMP!) youth advisory group compiled a list of things that commonly happen in team-based planning meetings that can be frustrating for young people. This guide describes some suggestions and strategies that meeting facilitators and team members can use to address these issues and promote meaningful youth participation in planning meetings.

The Achieve My Plan (AMP!) youth advisory group compiled a list of things that commonly happen in team-based planning meetings that can be frustrating for young people. This guide describes some suggestions and strategies that meeting facilitators and team members can use to address these issues and promote meaningful youth participation in planning meetings.

This best practice model defines Wraparound community mobilization teams known as CMT. It covers community development and mobilization efforts across Ontario, describes purposes of the CMT, expectations, structure and best ways to develop CMTs.

Crosswalk of several team planning models, including Wraparound.

This is a review of 198 pieces of literature published about Wraparound since 1988, including journal articles, books, book chapters and dissertations. Trends pointed to an accelerating growth rate in the publication of literature about Wraparound. However, results of the analysis also indicated a need for additional rigorous studies to be included in Wraparound's growing literature base.

This is an authors' manuscript of a literature review published in the Journal of Child and Family Studies. This article reviews 206 Wraparound-related publications. Among these were 123 empirical studies � 22 of which were controlled studies. The article discusses the findings of these studies and highlights future Wraparound research needs. The link to the article from the publisher is: http://link.springer.com/article/10.1007/s10826-016-0639-7 For an excel file with information about all the literature reviewed in this article, please access http://www.nwi.pdx.edu/pdf/Wraparound-Lit-Review-Manuscript-Sortable-References.xlsx

This resource is a sortable excel file containing information about all of the literture included in: Schurer Coldiron, J., E. J. Bruns and H. Quick (2017). A Comprehensive Review of Wraparound Care Coordination Research, 1986�2014. Journal of Child and Family Studies: 1-21. doi:10.1007/s10826- 016-0639-7 The authors' manuscript is available from NWI at: http://nwi.pdx.edu/pdf/Wraparound-Lit-Review-Manuscript-Self-Archive.pdf

12 mistakes to avoid in using family partners in Wraparound; Making Family Support a Specialty Service, Creating an Assistant Class, Failing to Hire Family Members in this Role, Confusing Agreement and Understanding, Family Partners as Parent Correctors, Family Partner as Ultimate Role Model,Turning family partners into youth workers,Family Partners as the Values Police, Family Partner as Decoration, Confusing Personalities and Skills, Confusing Peer-to-Peer Support and the Wraparound Process and Stopping at One.

The Oregon Health Authority, Addictions and Mental Health Division, conducted a comparative analysis of costs in regions served by the ten Oregon Health Plan (OHP) Mental Health Organizations (MHOs) according to participation in the Statewide Children's Wraparound Initiative (SCWI) demonstration project. This study shows the initial findings of that analysis, demonstrating generally lower costs for children's mental health services in the Wraparound demonstration sites.

This Guide is designed to serve as a road map for governors and their staffs interested in designing their own successful Governor's Children's Cabinets.

A review of Wraparound outcomes and publications aiming towards cataloging outcomes and results from controlled studies.

In this informal letter, a Wraparound provider from New Zealand reflects on his experiences visiting Wraparound programs in the Pacific Northwest.

A core element of the Wraparound process is the planning of services that build not only on family assets, but also on youth strengths and capabilities. This principle is founded in the belief that by capitalizing on the capabilities of children and adolescents, Wraparound providers create a sense of hope for the future and enhance motivation for change (Saleebey, 2002). To facilitate the process of assessing the internal and external resources of youth, a variety of methods and tools have been advanced, ranging from informal "strengths chats" (VanDenBerg & Grealish, 1996) to standardized measures, such as the Behavioral and Emotional Rating Scale (BERS; Epstein & Sharma, 1998). Little work has been done, however, to delineate the process of tapping the strengths identified through these and similar means. In an effort to fill this gap, this chapter provides a roadmap for Wraparound practitioners, intended to guide their efforts in developing plans of care that build on the skills, interests, and capacities of the youth served.

Brochure designed to help youth understand Wraparound.

This article presents a systematic review of the effectiveness of Wraparound, a value-guided, widely used service planning process and philosophy of care originally developed for children with serious emotional disturbance and their families. In contrast to conventional systematic reviews, which concentrate on the empirical literature, this article uses the multidimensional evidence-based practice approach, which adds professional knowledge and consumer perspectives to a value-critical analysis. The findings contextualize the limited empirical support for Wraparound within a social work value frame, suggesting areas of improvement for the implementation of the Wraparound model. A broader ecological frame for Wraparound highlights the need to include more natural supports on teams, to ensure backing from higher level administrators, and to emphasize client self-determination. Youths and families should be afforded leadership roles on teams and be supported by parent advocates. To extend the empowerment idea of Wraparound beyond the individual case level, a clear commitment to social justice by working toward systems changes must be added. Full text not available from the NWI, for more details about this publication please visit - http://www.ncbi.nlm.nih.gov/pubmed/21314073

In this report, the authors describe the results of an effort to better define the Wraparound process for children and adolescents with serious emotional and behavioral problems. Results indicate that using the experience of a wide base of stakeholders to operationalize a complex model such as Wraparound is feasible and holds many potential benefits, including building consensus in the field, improving service quality, and accelerating the incorporation of evaluation results into real-world practice. Full text not available from the NWI, please visit http://www.ncbi.nlm.nih.gov/pubmed/17085605

Wraparound is a team-based service planning and coordination process intended to improve outcomes for children and youth with serious emotional and behavioral disorders and support them in their homes, schools, and communities. Given the substantial resources devoted to implementing Wraparound, a meta-analysis of outcome studies was conducted to better understand current empirical support for this process. A literature search identified seven studies between 1986 and 2008 that documented the effects of youth receiving Wraparound compared to control groups. Mean treatment effects across outcome domains ranged from medium for youth living situation (0.44) to small for mental health outcomes (0.31), overall youth functioning (0.25), school functioning (0.27), and juvenile justice-related outcomes (0.21). The overall mean effect size across studies was 0.33. Interpretation of results was complicated by the lack of consistent documentation of implementation fidelity across studies and conditions, variations in target population and intended outcomes, and methodological concerns. The authors conclude that, though the published Wraparound research base is expanding and findings are largely positive, it continues to be in a preliminary state of development. However, there are insufficient data to support calls for Wraparound's acceptance or dismissal based on the strength of existing studies. Full text not available from the NWI, for more information about this publication please visit - http://www.ncbi.nlm.nih.gov/pubmed/19834802

We used the framework identified by the National Implementation Research Network�s (NIRN) analysis of 35 years of implementation outcomes literature from diverse fields of endeavor to review the current state of Wraparound implementation research. Model definition, model fidelity and intervention outcomes were areas of relatively greater development, while target population, theory base and theory of change, organizational context and readiness, staff selection, training, supervision or coaching, purveyor selection, and program installation were less examined or even overlooked. We conclude with suggestions for building a research agenda on Wraparound implementation. Full text not available from the NWI, for more information about this publication please visit - http://link.springer.com/article/10.1007/s10826-010-9430-3

We describe the structure for implementation of the Wraparound process within a multi-tiered system of school wide positive behavior support (SWPBS) to address the needs of the 1-5% of students with complex emotional/behavioral challenges. The installation of prerequisite system features that, based on a 3 year demonstration process, we consider critical to full operation of the Tier 3 Wraparound intervention within a system of SWPBS is also described. We include examples of system implementation benchmarks that occur concurrently with student outcome data and are logically linked to full operation and sustainability of Wraparound implementation. Challenges surrounding implementation and proposed advancements are also discussed. (Contains 2 figures.) Full text not available from the NWI, for more information about this publication please visit - http://eric.ed.gov/?id=EJ948201

The rate of youth with mental health needs is disproportionately high in juvenile justice. Wraparound planning involves families and providers in coordinating juvenile justice, mental health, and other services and supports. This study compares data from two groups of juvenile offenders with mental health problems: 106 youth in a juvenile justice Wraparound program called Connections and a historical comparison group of 98 youth in traditional mental health services. Cox regression survival analyses revealed that youth in Connections were significantly less likely to recidivate at all, less likely to recidivate with a felony offense, and served less detention time. Full text not available from the NWI, for more information about this publication, please visit - http://cad.sagepub.com/content/52/3/375.short

The Wraparound process has been promoted in the children�s services field as a mechanism to achieve collaborative service planning and delivery for families of young people with complex emotional and behavioral needs that span multiple agencies. We compared results of two surveys of state children�s mental health directors, completed in 1998 and 2008, to derive estimates of the extent of Wraparound implementation in the United States and to better understand trends in how Wraparound has been implemented and supported over time. Results from 2008 found that 88% of states reported having some type of Wraparound program that conformed to the definition and provided an estimate of 100,000 children and families served via Wraparound in that year. Between 1998 and 2008, states reported increased application of Wraparound standards, a greater number of agencies involved in Wraparound initiatives, and more formal evaluations of Wraparound initiatives. Results provide substantiation of the widespread implementation of Wraparound implementation in the United States, and evidence that the model is becoming more consistently supported by formal implementation structures over time. Full text not available from the NWI, for more information about this publication please visit - http://link.springer.com/article/10.1007%2Fs10826-011-9535-3

The Wraparound process has emerged as perhaps the most frequently implemented comprehensive approach for planning and providing individualized, community-based care for children and adolescents with serious mental health conditions. Providing comprehensive care through the Wraparound process necessarily requires a high level of collaboration across organization and agency boundaries. This need for significant inter-agency or 'system-level' collaboration creates a complex implementation environment for Wraparound. It is therefore not surprising that creating and sustaining a hospitable implementation environment has proven to be extremely challenging. For the people who are responsible for managing the inter-organizational collaboration, it is not easy to evaluate the adequacy of local system-level support for Wraparound and to see exactly what kinds of supports are lacking or where system-development efforts should focus. Furthermore, as system-development strategies are put into practice, it can be difficult to assess whether or not meaningful progress is occurring. The Community Supports for Wraparound Inventory (CSWI) was developed to respond to the need for an assessment of the extent to which a community has developed system-level capacity to implement Wraparound. This article reports on a study that evaluated the reliability and validity of the CSWI for use in communities implementing Wraparound. Findings indicate that the CSWI shows promise as a reliable, valid and useful tool. Full text not available from the NWI, for more information about this publication please visit - http://connection.ebscohost.com/c/articles/67480994/community-supports-wraparound-inventory-assessment-implementation-context-wr

This article describes the results of a research project designed to assess the efficacy of a secondary transition model, RENEW (Rehabilitation, Empowerment, Natural supports, Education and Work), on the social and emotional functioning of 20 youth at risk of dropping out of high school using the Child and Adolescent Functional Assessment Scale (CAFAS) supplemented by a case study to illustrate one student's experience. The study indicates that youth who engaged in the RENEW process had significant improvements in functioning in school and at home, and overall positive gains in several behavioral health domains. Full text not available from the NWI, for more information about this publication please visit - http://eric.ed.gov/?id=EJ942876

One of the most significant recent trends in the field of children's mental health has been the shift in the conceptualization of authority and expertise. Increasingly, there are demands to recognize-and to respond to-the perspectives of people who have traditionally been seen more as passive targets of interventions and other change efforts. This has led to a variety of efforts to blend perspectives and/or build partnerships between consumers and providers or between researchers and practitioners. This article explores how a commitment to blending perspectives as a way of providing children's mental health services was a central factor in the emergence of Wraparound, a widely implemented care-planning approach for children with complex needs and their families. The commitment to blending perspectives is also a central organizing principle of the collaborative work of a community of practice called the National Wraparound Initiative (NWI), which has worked to support Wraparound and to generate knowledge about Wraparound practice and implementation. The article goes on to describe some of the benefits, challenges, and tensions that have emerged in the work of the community of practice and to consider what the experience of the NWI may have to offer to others engaged in similar efforts. Full text not available from the NWI, for more information about this publication please visit - http://connection.ebscohost.com/c/articles/60132535/national-wraparound-initiative-community-practice-approach-building-knowledg

Poll question during June 15, 2010 webinar: what type of data does your community or Wraparound project most consistently collect and use?

This chapter explains why being strength based is important, what actions or behaviors characterize a strength based practice, specific metrics for determining whether services are being delivered in a strength-based way.

list of items for identifying risks and strengths across domains

tool for eliciting and recording child's view of strengths, some needs, and important life events

This guide, prepared by Pathways RTC Project AMP+ (https://www.pathwaysrtc.pdx.edu/proj5-amp-plus), lists ten examples of what (and what not) to say when working with young people. The examples demonstrate techniques for involving young people in their treatment plans as active participants.

Tips on informing people in key leadership positions about about Wraparound's underlying philosophy.

Financial mapping and analysis helps identify more effective, efficient and equitable use of funds through the development of coordinated cross-agency financing strategies. This resource describes this process and how to implement it in systems of care.

Sample of a crisis safety plan from the webinar: Functional Behavioral Analysis and Wraparound on August 11, 2011.

Paper describes iterative development process that incorporated user/ stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. Includes methods and results for a series of six small studies that informed system development, how these results informed system design and refinement and present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT.

Systems of care financing model covering target group, funding approach, care management and benefit plan.

2010 presentation from Georgetown Training Institutes on moving from principles to practice and measuring the quality of practice for better fidelity and better outcomes.

Information sheet by the Family Partner Task Force on how agencies have dealt with the hiring of people who are well qualified and have problematic personal histories revealed during background checks.

The Affordable Care Act provides a critical opportunity for family run organizations to expand their scope, achieve sustainable funding, and become established Medicaid providers of family and youth peer support services. This resource provides guidance to family run organizations that are considering whether to become Medicaid providers, and uses examples from three states - Arizona, Maryland, and Rhode Island - to illustrate key aspects of this decision and process. From the Center for Health Care Strategies, Inc. and accessed from: http://www.chcs.org/publications3960/publications_show.htm?doc_id=1261625#.UxpixfldUQF

Comparison of the values underlying Wraparound-like approaches with those underlying child welfare work

This brief offers tips to increase meaningful youth participation in collaborative team planning meetings.

This February 2015 webinar was created at UMFS (United Methodist Family Services) in partnership with the VA Center of Excellence, NAMI VA, and Department of Behavioral Health and Developmental Services. It was centered on the Parent Support Partner program that UMFS developed in central and Northern VA. The full webinar recording is available from http://www.csa.virginia.gov/COE/coe.cfm

This chapter covers recruiting, hiring, training, supervising and transitions stages in building strong family partner capacity.

This chapter describes using MIS software and covers managing and evaluating data and lessons learned.

This is a tool for identifying Wraparound team members and natural supports.

This fact sheet outlines the core characteristics of Care Management Entities, which offer a centralized vehicle for coordinating the full array of needs for children and adolescents with complex behavioral health issues.

This technical assistance tool discusses the application of case rate scans to the financing of Care Management Entities. A case rate scan is defined as a pricing method in which a flat amount covers a designated set of services on a per-diem or per-child basis. (Accessed from: http://www.chcs.org/usr_doc/Case_Rate_Scan_for_CMEs.pdf)

Blank crisis plan template

Blank Wraparound plan template.

This document lists the 23 states that have established Children's Cabinets.

Guide to choosing a Wraparound project consultant

Life areas to cover during intake assessment.

Arranger Clinician job description

Tool for eliciting and recording information about sources of formal/informal support and stress

Marlene Penn shares three stories about engaging family partners in Wraparound efforts - and how it benefited the community.

This document is a 2008 version of the CSWI. It is an assessment of the implementation context for Wraparound. Contact NWI for information about current updates.

Comparison of three techniques for use in developing initial plans: bubble planning, storyboarding, and clock planning

Crosswalk of TCM (Traditional Case Management) and the Wraparound Service Model (WSM) across the following domains: engagement, crisis stabilization, assessment, team, power balance, plan, crisis planning, implementation, and transition.

Esta publicación define el “Wraparound” y describe su proceso. También se presentan los estudios que respaldan el uso de “Wraparound” y los requisitos para la implementación fiel de “Wraparound”.

Several necessary system and organizational support conditions for Wraparound have been identified (Walker et al. 2003). Yet, the relationship between these necessary system level conditions and Wraparound fidelity has only recently begun to be examined. Similarly, few studies have included a measure of Wraparound fidelity when examining the relationship between Wraparound implementation and youth outcomes. The statewide implementation of a Wraparound demonstration grant offers the opportunity to explore these relationships and to identify factors that predict improvement in functioning for youth receiving Wraparound. Findings suggest that significant relationships exist between (1) the stage of development of necessary support conditions for Wraparound and Wraparound fidelity and (2) Wraparound fidelity and improvement in youth outcomes.

Form for summarizing a family's Wraparound and post-wrap needs

Sample ground rules

Questions and blank form for eliciting strengths by life domain.

Spanish language information release form provided by Wraparound Oregon.

The Substance Abuse and Mental Health Services Administration (SAMHSA) through the Bringing Recovery Supports to Scale Technical Assistance Center (BRSS TACS) has developed a draft set of core competencies for Peer Workers in Behavioral Health settings. A draft copy is available through NWI. For the final version, please visit - http://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/core-competencies.pdf

This document lists core foundational, definitional, and critical skills for clinicians. It is listed within the Resource Guide to Wraparound, created by the National Wraparound Initiative. You can access this publication online from: http://nwi.pdx.edu/NWI-book/

This bulletin from SAMHSA and CMS highlights Wraparound as an effective method to meet the needs of children, youth, and young adults with mental health conditions. The bulletin provides guidance to states on creating a benefit package to cover this population.

This article describes the King County Blended Funding Project. The project was created as part of a Robert Wood Johnson grant designed to meet the needs of children who had experienced years of failure in the mental health, child welfare, education and juvenile justice systems.

examples of creative plan strategies using informal/natural supports

tools for developing strategies for crisis plans

tips and example strategies for crisis planning

technique/tips, tool, and blank form for crisis planning

tool for putting together strengths, needs and supports

This report offers practical and financial approaches to health home customization based on intensive care coordination models using high fidelity Wraparound that have emerged from systems of care in children’s behavioral health care.

This study seeks to determine the impact of proximity to resources on the effectiveness of a Wraparound program for stabilizing foster care placements among a sample of youth. The authors present a methodology for deriving proximity scores for individual clients using Geographic Information Systems technology, and incorporate this score into a model for predicting placement disruption among youth in foster care receiving services within a Wraparound model aimed at preventing placement disruptions.

After conducting five recidivism studies since 2009, the overall rates of recidivism for Wraparound enrolled youth appear low and stable. While national norms for recidivism are lacking, local studies such as that done by the Public Policy Forum demonstrate that youth in the Wraparound Milwaukee program are not re-offending at as high a rate as the general delinquency population as a whole.

This guide was produced by the Agency for Healthcare Research and Quality to provide information about developing Care Management Entities (CMEs). Drawing on the experiences of CHIPRA quality demonstration states, the resource provides an introduction to CMEs, guidelines for assessing a state's implementation readiness and an overview of different CME design strategies. Also available on-line at: http://www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/implementation-guides/implementation-guide2/index.html

Tips/techniques, blank form, and sample crisis plan

Children with SED are different from adults with mental health issues. This brief describes those differences and how they can be incorporated in the development of Medicaid health homes for this group. (Accessed from: http://www.chcs.org/usr_doc/Developing_Health_Homes_for_SED_02_24_14.pdf)

Quality indicators for programs integrating parent-delivered family support services for children�s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components.

tips/technique for stimulating creative thinking during strategy development

Parent partners are parents or caregivers such as foster parents who have had success in dealing with a difficult child in a child welfare, mental health, or probation system and who become key players on Wraparound teams for families with youths with emotional or behavioral disabilities who are in out-of-home care. Although many studies have been conducted on the Wraparound model, none of them have described the parent partner�s role and fidelity to the model. The Parent Partner Fidelity Tool (PPFT) was developed to address this gap in Wraparound research; it is the first tool designed to measure parent partner adherence to the Wraparound model and identify parent partner training and support needs. The 28-item PPFT captures parent partner activities related to the four Wraparound phases designated by the National Wraparound Initiative: engagement, planning, implementation, and transition. Similar PPFT versions are completed by Wraparound facilitators, parent partners, and parents/caregivers to provide multiple perspectives on the parent partner�s work. The PPFT pilot testing project was conducted with 14 California Wraparound programs. Analyses of the 585 responses showed good reliability and validity for the PPFT, indicating that it is a psychometrically sound tool.

tips/techniques for identifying natural/informal supports

Direct Support services are the flexible, creative, community-based services that help put an effective Wraparound plan into action.

Human service and educational agencies often convene interdisciplinary teams to work collaboratively with adolescents and their parents or caregivers. However, research on adolescent development suggests that it may be difficult to successfully engage adolescents this kind of team-based planning. This article focuses on Wraparound as an example of a team planning process, and uses data from several sources to reflect on questions about whether�and under what conditions�collaborative teams are successful in engaging young people�and their caregivers�in planning.

This information is intended to assist anyone who is interested in learning more, or who wishes to use the DDCAT to assess the dual diagnosis capability of addiction treatment services, and will also help those who wish to learn about and begin to use the DDCYT. Those that may benefit from these tools include state or regional authorities (such as single state agencies), treatment program administrators, clinicians, consumers, various treatment services and researchers.

Tips/techniques for crisis planning

In this study, we compared service experiences and outcomes for youths with serious emotional disorder (SED) randomly assigned to care coordination via a defined Wraparound process (n = 47) versus more traditional intensive case management (ICM; n = 46) The Wraparound group received more mean hours of care management and services; however, there ultimately were no group differences in restrictiveness of residential placement, emotional and behavioral symptoms, or functioning. Wraparound implementation fidelity was found to be poor. Organizational culture and climate, and worker morale, were poorer for the Wraparound providers than the ICM group. Results suggest that, for less-impaired youths with SED, less intensive options such as ICM may be equally effective to poor-quality Wraparound delivered in the absence of Wraparound implementation supports and favorable system conditions.

EMQ Children & Family Services (aka Eastfield Ming Quong) is a private, not-for-profit community-based organization that provides a wide range of services, from addiction prevention to Wraparound and Rate Classification Level (RCL) 14 group home care (aka residential treatment services), in four major counties throughout California: (a) Santa Clara, (b) Sacramento, (c) San Bernardino, and (d) Los Angeles. It also provides foster care services in 20 other counties. The agency is over a century old, founded in 1867 with roots as an orphanage (Home of Benevolence, later known as Eastfield’s Children Center) and a rescue mission for Chinese girls (the Presbyterian Mission Home later known as Ming Quong) founded in 1874. In 1970, Jerry Doyle became Executive Director of Eastfield Children’s Center. At that time, the agency had an annual budget of approximately $300,000 to provide residential treatment. In 1987, Eastfield and Ming Quong merged to become Eastfield Ming Quong. Prior to becoming the first Wraparound provider in California in 1994, EMQ operated 130 RCL 14 residential treatment beds, at a cost of $95,000 per year per child. The most common primary diagnosis was related to disruptive behaviors (47%), with some type of depressive disorder as the second most common. The outcomes for these youth, after an average of 18 months of service, reflected the general “treatment as usual” outcomes. Today, residential treatment revenue represents 5% of a $55 million annual revenue stream, as compared to 72% of a $12 million annual revenue stream prior to the implementation of Wraparound. The purpose of this article is twofold: 1) to present a case study of how a child-serving organization transformed itself from residential to innovative, community-based services; and 2) to share issues revealed in the process of implementing Wraparound. The article contains three major sections including Introduction, Current Operations, and Tips to Implement Wraparound, as well as a final section that includes Lesson Learned. Throughout this article, we will reflect on the significant systems change required to implement Wraparound.

The YES Program is a collaboration between Placer County Adult System of Care, Children’s System of Care, and Whole Person Learning.

Poll from webinar about engaging and involving youth in Wraparound.

Sample comprehensive plan

This document was produced by Wraparound Milwaukee (http://county.milwaukee.gov/WraparoundMilwaukee.htm) as an ethical guideline for staff working in Wraparound.

This evaluation from Oklahoma shows better functioning and reduced costs for youth receiving case management/Wraparound versus controls.

Presented by Janet S. Walker, PhD, National Wraparound Initiative, Portland State University Jennifer Schurer Coldiron, PhD & Ryan Parigoris, Wraparound Evaluation and Research Team, University of Washington at the 30th Annual Research and Policy Conference on Child, Adolescent and Young Adult Behavioral Health Conference.

This RFP for Title IV-E Demonstration Project is from the State of Tennessee. It illustrates a schedule of events, proposal requirements, and general contracting information and requirements.

tool and technique for developing an initial plan

tool and technique for describing needs and developing strategies

technique for building initial plan that matches needs, strengths, and strategies

Until recently, family-centered policy and practice used expert models which defined families of children with serious emotional disturbance as dysfunctional A collaborative model, called Wraparound, is emerging which engages these families as decision making participants, using naturally occurring strengths to wrap individualized supports around the child and family. However, because Wraparound has been defined only through value-based principles, the fidelity of the model is threatened by a developmental paradox. Those who have received training and whose careers have been shaped in more traditional expert models of deficit remediation can interpret these value-based principles as an emergent form of case management methodology. Critical and constructivist paradigms, and ecological systems theory, form a basis for negotiating this paradox to maintain fidelity of Wraparound process. Anchored in this base, and derived from Wraparound's value-based principles, a single construct with an operative focus is suggested to ensure the integrity of this collaborative model.

sample complete plan of care

This review summarizes much of the existing research on FYPS, focusing predominantly on the literature relevant to peer support for children and youth with significant mental health and/or physical health challenges.

blank form for use in identifying concerns, strengths, and team members

checklist for eliciting strengths in various life areas

The Wraparound team process has established itself as a standard of care for children and youth with complex needs and their families who require coordination of care and for whom a single intervention is unlikely to suffice. Research results indicate that Wraparound's strongest evidence for positive effects are in the residential, family, and cost domains. In these areas, significant, medium-sized effects have been found across a range of studies. Positive clinical and youth functioning outcomes, on the other hand, have been less consistently found, and when they are found, they tend to be small. This has inspired many Wraparound and system of care advocates to ask how better clinical and functional progress in youths might be promoted through thoughtful application of evidence-based practices within Wraparound. Unfortunately, however, the traditional evidence-based practices, when implemented in "real world" community settings, are often limited in terms of their effectiveness, feasibility, and cost/benefit ratio. This article describes an alternative method for using clinical evidence to structure an individualized approach to clinical care that aligns with the Wraparound philosophy. Instead of strict implementation of one or more manualized treatments, this method is based on a flexible application of the evidence for "what works" in child and family treatments. Components of this approach include the Managing and Adapting Practice (MAP) system, PracticeWise Evidence Based Services (PWEBS) Database, codified clinical supports called Practitioner Guides, and a feedback tool to monitor process and progress of treatment called the Clinical Dashboard. All these tools are supported by an on-line resource library and user interface called PracticeWise.

Wraparound Oregon: Early Childhood Hope for the future

set of items to elicit family strengths, beliefs, and values

Overview of Wraparound

Tool for identifying needs

information about what family partners do as part of the Wraparound team

information about what family partners do as part of the Wraparound team

poll about family partners

survey of family ratios

Marlene Penn shares three stories of families who benefited from having a family partner involved in their Wraparound process.

The Wraparound process is a type of individualized, team-based care coordination that has become central to many state and system efforts to reform children�s mental health service delivery for youths with the most complex needs and their families. Although the emerging Wraparound research base is generally positive regarding placements and costs, effect sizes are smaller for clinical and functional outcomes. This article presents a review of literature on care coordination and Wraparound models, with a focus on theory and research that indicates the need to better connect Wraparound-enrolled children and adolescents to evidence-based treatment (EBT). The article goes on to describe how recently developed applications of EBT that are based on quality improvement and flexible application of �common elements� of research-based care may provide a more individualized approach that better aligns with the philosophy and procedures of the Wraparound process. Finally, this article presents preliminary studies that show the feasibility and potential effectiveness of coordinating Wraparound with the Managing and Adapting Practice system, and discusses intervention development and research options that are currently under way.

This chapter describes our community’s journey toward implementation of Wraparound and system of care, and the role that the use of data has played in that journey

process for developing a team vision or mission

This is an environmental scan exploring home- and community-based services provided by states for children, youth, and young adults with mental health conditions and their families. The scan assesses activities to implement the specific services and supports described in a joint informational bulletin released in 2013 by the federal Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

This is the 2015 edition of an annual an environmental scan that explores implementation of health reform through the lens of services for children, youth and young adults with serious mental health conditions and their families. It identifies new activities and tracks progress in planning for and implementing the various provisions of the ACA.

report on the funding of CMEs in Maryland

overview of funding options for CREs in Massachusetts.

process to develop creative strategies

tips and examples for funding strategies for which money is not readily available

framework for eliciting strengths AND sample strengths

The NWI is a core member of the National Technical Assistance Network for Children's Behavioral Health (TA Network). This TA Network tip sheet was produced by FREDLA (the Family Run Executive Director Leadership Association). It includes information about how to best utilize focus groups to gather input from families and other stakeholders.

A compilation of resources collected by the Family Partner Task Force, focused on strengths-based communication.

Functional Assessment and Preparing Families for Life After Formal Wraparound

Functional Assessment and Preparing Families for Life After Formal Wraparound Poll

overview of funding options for Wraparound

activity to build team cohesiveness

This evaluation reports that Wraparound with homeless youth has positive impacts on living situation

This report from the National Academy for State Health Policy explains some of the major challenges for children's coverage under the Affordable Care Act, and describes policy options for making health care reform work for children. The potential solutions draw upon lessons learned from state Medicaid and Children's Health Insurance Programs (CHIP), federal policy, and relevant research.

a history of the Wraparound process

overview of the ways family partners contribute to the Wraparound process

a look at the ways coordinators and developers support Wraparound

Using the foundation supplied by the specification of the principles and practice model of Wraparound, the National Wraparound Initiative (NWI) has proposed a more detailed theory of change to describe how and why Wraparound works

blank form for strengths discovery with tips/techniques and example

tips/techniques for identifying needs

This brief reports on an assessment approach that is being developed and tested by the National Wraparound Initiative called the Impact of Training and Technical Assistance (IOTTA) for Wraparound. IOTTA assesses stakeholder perceptions of immediate and longer-term benefits in areas that research has linked to effective implementation and practice change.

We used the framework identified by the National Implementation Research Network�s (NIRN) analysis of 35 years of implementation outcomes literature from diverse fields of endeavor to review the current state of Wraparound implementation research. Model definition, model fidelity and intervention outcomes were areas of relatively greater development, while target population, theory base and theory of change, organizational context and readiness, staff selection, training, supervision or coaching, purveyor selection, and program installation were less examined or even overlooked. We conclude with suggestions for building a research agenda on Wraparound implementation.

This article describes how to implement cultural components and offers preliminary comparative findings based on the experience of Connecting Circles of Care (CCOC), a SAMHSA-funded systems of care grantee.

examination of the prerequisite conditions for implementing service/support planning

This brief examines how one locally-initiated program has implemented the Peer Support Specialist role for youth and young adults with serious mental health conditions.

This brief examines how Pennsylvania has implemented and supported the Peer Support Specialist role at the state level.

(From the introduction) Addresses community Wraparound services for children. Traditional approaches to treatment usually assume that mental health problems are individual in nature and stable in duration, with hospital care, if used at all, designed to stabilize the problem quickly with quick referral to another provider. This traditional approach does not always work well with children. Children's problems often are embedded in home and school conflicts, and children have limited power to advocate for change. Consequently, services to children sometimes require home-based Wraparound services. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (introduction)

ways to individualize Wraparound processes

examples of creative plan strategies using informal/natural supports

blank plan of care template

In light of the need to understand best practices for a tiered care coordination model for children, youth and young adults with behavioral health challenges, The National Technical Assistance Network for Children�s Behavioral Health convened a meeting of experts from various sectors to discuss emerging areas of tiered care coordination. The results and findings from the meeting are contained in this document.

We describe the structure for implementation of the Wraparound process within a multi-tiered system of school wide positive behavior support (SWPBS) to address the needs of the 1�5% of students with complex emotional/ behavioral challenges. The installation of prerequisite system features that, based on a 3 year demonstration process, we consider critical to full operation of the Tier 3 Wraparound intervention within a system of SWPBS is also described. We include examples of system implementation benchmarks that occur concurrently with student outcome data and are logically linked to full operation and sustainability of Wraparound implementation. Challenges surrounding implementation and proposed advancements are also discussed.

webinar about putting outcomes for students students with complex with complex emotional/behavioral needs into the context of schools asas systems to educate and systems to educate and support ALL students

In July 2014, the Center for Health Care Strategies published the first state profiles report: Intensive Care Coordination Using High-Quality Wraparound for Children with Serious Behavioral Health Needs: State and Community Profiles. Since publication of that report, much has changed in the way states implement ICC using Wraparound and states have called for an update. In response to the field, this 2019 ICC profiles report provides information on current implementation across 40 states that completed a self-report, with a particular emphasis on using Wraparound. It contains specific information on eligibility criteria, evidence-based screening tools, evidence-based practices, credentialing requirements for care coordinators, integration with physical health care services, role of psychiatry in ICC, financing mechanisms including Medicaid vehicles and managed care organizations, rates and billing structure, staff training and tracking outcomes. This report not only provides a brief overview of the nation's ICC implementation landscape but also details the specifics of implementation enabling interested states to expand and improve ICC strategies.

The Center for Health Care Strategies (www.chcs.org) has collected profiles of established, evolving and emerging intensive care coordination programs across the United States. This resource documents key features of each program including its overall structure, eligibility and screening criteria, requirements for care coordinators, the role of psychiatry, parent/caregiver peer supports, financing, training and evaluation.

This resource provides a point-in-time snapshot of the care coordinator to child and family ratios for each of the intensive care coordination/Wraparound programs profiled, to help states and communities determine their programs� staffing needs and structure.

This resource highlights the billing structure and rates for care coordination and Wraparound services across states and communities. It provides a reference for understanding the variety of billing structures and range of rates for these services.

This resource provides a point-in-time snapshot of the supervisor-to-care coordinator ratios for intensive care coordination/Wraparound programs to help states and communities determine their programs� staffing needs and structure.

This issue brief from the UMass Center for Mental Health Services Research summarizes findings from a study of statewide implementation of Wraparound in Massachusetts in response to the Rosie D. v Romney lawsuit. The study examined how research was used, particularly by "intermediaries" (consultants) who advised practitioners on how to adhere to Wraparound best practices, and who assisted state policymakers in translating the court's directives into state Medicaid managed care program standards.

This�NWI article�was been published in the�American Journal of Community Psychology.

(SPANISH VERSION) This packet brings you introductory information about two measures developed by the Research and Training Center on Family Support and Children s Mental Health: Youth Efficacy/Empowerment Scale-Mental Health (YES-MH) & Youth Participation in Planning Scale (YPP).

This packet brings you introductory information about two measures developed by the Research and Training Center on Family Support and Children s Mental Health: Youth Efficacy/Empowerment Scale-Mental Health (YES-MH) & Youth Participation in Planning Scale (YPP).

This publication was produced by the Research and Training Center on Family Support and Children�s Mental Health at Portland State University. It addresses common questions that people might have about youth participation in education, care, treatment, or service planning. Information from published research is summarized to help answer each question. References included.

Effective child and family centered service planning is crucial to addressing vulnerable children's needs. However, there is limited evidence about what facets of these processes improve service use and outcomes. The current study used a Poisson random effects hazard model to test correlations between fidelity to NC's Child and Family Support Team model and time to service receipt, using case management data for 3396 children served by that program during the 2008�2009 school year. Students were more likely to receive recommended services more quickly when caregivers and the students attended planning meetings, when their plans included services for caregivers, and when child and family team leaders followed up after meetings to verify service receipt. Contrary to the Child and Family Support Team theory of change, match between student needs and the lead agency of the meeting was not associated with the odds of quicker service receipt, nor was attendance by natural supports. Findings from this study demonstrate the potential effectiveness of using case management systems to measure service planning process fidelity, as well as how results thereof can both inform process improvement and potential refinements to models� theories of change.

Form for recording consumer feedback about a contact/session

set of topics for exploring strengths and needs using life domains

Esta publicación describe los valores que guían el proceso de “Wraparound”, esbozando los principios de la práctica de “Wraparound” a nivel de juventud / familia / equipo. Entre los principios explorados estan "Voz y preferencias de la familia", " Culturalmente Competente ", "Fortalezas como Base", y más.

The focus of the Louisiana Children's Cabinet is to synchronize children's policy across the five state departments providing services for young people: Children and Family Services, Departments of Education, Health and Hospitals, Office of Juvenile Justice and the Louisiana Workforce Commission.

This document outlines the departments, agencies, and functions of the Maine Children's Cabinet.

La Guía del Usuario fue creada para que sirva como "hoja de ruta" para los miembros de la familia. Dentro de la Guía, primero verá el resumen de las báses del proceso del “Wraparound”, despues una lista de términos comunes usados en el “Wraparound”, asi como detalles sobre el proceso y notas sobre cómo solucionar problemas comunes que pudieran ocurrir.

This information sheet, originally published in the TA Telescope (January, 2015), describes social marketing strategies for sharing your Wraparound success story.

brief on financing options

This publication defines Intensive Care Coordination in Targeted Case Management Services. It addresses the development and role of a Care Planning Team in services to youth with SED and their families.

an examination of the Wraparound ideal vs. the reality

This article reports on the use of the Wraparound Fidelity Index (WFI) to measure Wraparound fidelity in Erie County, NY. Use of the WFI highlighted areas of improvement for youth engagement and for the transition phase of Wraparound.

Family and youth peer support providers are integral to teams serving children and youth with behavioral health challenges and their families, and they are distinct from traditional mental health service providers in that they operate out of their personal experience and knowledge. Strategies for funding formal family and youth peer support exist in states across the country. This document draws from a national scan of states that are using Medicaid to finance family and youth peer support efforts.

Along with several Congressional staff persons and representatives of the Bazelon Center for Mental Health Law and Human Services Collaborative, leaders of the National Wraparound Initiative recently participated in a series of policy briefings with the Centers for Medicare and Medicaid Services (CMS) regarding care coordination in children's behavioral health services and related Medicaid reimbursement issues. As a result of these conversations, the team developed a memorandum for CMS with policy recommendations regarding Medicaid funding for intensive care coordination.

This document outlines the departments, agencies, and functions of the Mississippi Children's Cabinet.

personal account of Kenyatta Matthews’ nine-year experience with Wraparound Milwaukee

This interim report shows that across all state grantees over the first three waiver years, the Demonstration successfully enabled children and/or youth to either maintain or improve their functional status while in the waiver program. Furthermore, over the first two waiver years, Demonstration treatment costs are totaling no more on average than anticipated aggregate PRTF expenditures in the absence of the Demonstration. In most cases, waiver costs were around 20 percent of the average per capita total Medicaid costs for services in institutions, an average per capita saving of $20,000 to $40,000, excluding high and low outliers.

This report summarizes home- and community-based service outcomes for youth in 9 states that completed a 3-year PRTF waiver demonstration program. Results show that youth in waiver states maintained or improved their functional status and that the delivered services passed a budget neutrality test. The report also shows strong evidence that home- and community-based services actually cost substantially less than institutionalization.

results from the State Wraparound Survey in 2007

The Wraparound process has been promoted in the children�s services field as a mechanism to achieve collaborative service planning and delivery for families of young people with complex emotional and behavioral needs that span multiple agencies. We compared results of two surveys of state children�s mental health directors, completed in 1998 and 2008, to derive estimates of the extent of Wraparound implementation in the United States and to better understand trends in how Wraparound has been implemented and supported over time. Results from 2008 found that 88% of states reported having some type of Wraparound program that conformed to the definition and provided an estimate of 100,000 children and families served via Wraparound in that year. Between 1998 and 2008, states reported increased application of Wraparound standards, a greater number of agencies involved in Wraparound initiatives, and more formal evaluations of Wraparound initiatives. Results provide substantiation of the widespread implementation of Wraparound implementation in the United States, and evidence that the model is becoming more consistently supported by formal implementation structures over time.

This guide describes NWIC's Local Coaching Candidate Certification Program. The purpose of the program is to provide local coaches with the necessary support and training to sustain a high-fidelity and quality Wraparound practice implementation within their state. The program is designed to support local coaches through coaching, training and technical assistance through the phases of the Wraparound process.

This issue brief summarizes an in-press article that describes the role of research and expertise in the process of implementing Wraparound statewide in Massachusetts.

tips/techniques for identifying needs

description of a process for identifying needs

tool for rating/visualizing how well needs are being met in each domain

overview of the funding involved in the New Jersey system of care

systems of care financing model

A survey conducted by the Workforce work group of the National Wraparound Initiative

Frequently asked questions about the NWI core group

results of a survey about the impact of NWI

funding model for Wraparound milwaukee

The purpose of this study was to evaluate outcomes for children ages 5�18 experiencing serious emotional disturbances who received Wraparound in a systems of care community funded through a 6-year federal grant from the Substance Abuse and Mental Health Services Administration, Grant # SM54497-06. This study evaluated the following hypotheses. (1) Youths diagnosed with a SED participating in Wraparound services will experience improved mental health symptoms, improved functioning, and improved behavioral and emotional strengths. (2) Caregivers of youths diagnosed with a serious emotional disturbance participating in Wraparound services will experience decreased levels of caregiver strain. All of the caregiver completed measurement instruments showed statistical and clinical levels of improvement in youth behavioral and emotional strengths, mental health symptoms, and caregiver stress by the 6-month data collection point that was sustained through 24-month.

webinar overview of Wraparound

webinar poll questions

activity to use with whole team to think briefly about each member's strengths

Poster presented at the 28th Annual Children, Youth and Young Adult Mental Health Research & Policy Conference, March 22 - 25, 2015, Tampa, Florida.

agreement form

systems of care financing model

Description of the activities that are necessary for true Wraparound.

activity to elicit information about strengths, culture, and natural supports

Wraparound milwaukee plan of care

information on planning for system change

Poster on work by FidelityEHR to develop an EHR implementation and training model grounded in a Readiness for Change approach, and partnership with the University of Washington, Wraparound Evaluation and Research Team (WERT) on a National Institute of Mental Health (NIMH) Small Business Technology Transfer (STTR) Phase II grant to increase collaboration with Wraparound service organizations in the field. 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health, March 2016, Tampa, FL.

Poster presented at the 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health, March 2016, Tampa, FL. Presented work done by the Wraparound Evaluation and Research Team (WERT) at The University of Washington�s Division of Public Behavioral Health and Justice Policy (UW PBHJP), Henderson Behavioral Health(HBH), ChildNet [a Department of Children and Families (DCF) contractor], and Florida�s Department of Juvenile Justice�s (DJJ) 17th Circuit to evaluate care coordination and case management services delivered to 65 �crossover� youth (dually involved with child welfare and juvenile justice) in Broward County, Florida.

The Wraparound Fidelity Assessment System (WFAS) is a multi-method approach to assessing adherence to Wraparound principles and overall quality of service. This poster summarizes recent analyses of the WFI-4, WFI-EZ, and TOM national means, fidelity scores, and other psychometrics. Presented at the 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health, March 13, 2016, Tampa, FL

This presentation by Janet Walker and John Ossowski was given at the 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health (www.cmhconference.com) in Tampa, Florida on March 15, 2016. Walker and Ossowski describe findings of a study to determine consensus around best practices in Wraparound facilitation and an online training booster developed as a result. The presentation recording is available from the NWI YouTube channel and a PDF version of the slides is linked below. To watch the recording, please access https://youtu.be/ZidHbkv85fo

Presentation on three case studies comparing Wraparound training and coaching outcomes given by Spencer Hensley, University of Washington; Kim Estep, MA and Marlene Matarese, PhD, University of Maryland. 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health, March 2016, Tampa, FL.

Presentation given at the 29th Annual Research & Policy Conference on Child, Youth and Adolescent Behavioral Health on March 14, 2016. Janet Walker, Celeste Seibel and Sharice Jackson with Pathways RTC presented research on a Wraparound enhancement known as "Achieve My Plan" (AMP).

Presentation given at the 29th Annual Research & Policy Conference on Child, Youth and Adolescent Behavioral Health in March 2016. Janet Walker, PhD and Shawn Mehess, PhD Candidate, Portland State University presented latest research on Community Supports for Wraparound Inventory (CSWI) used to assess a community�s system-level support for Wraparound.

This presentation covers core theories and concepts of implementation science, and how it is applied to successful implementation of systems of care and the Wraparound practice model. Learning objectives include using the lens of implementation science to learn of specific strategies to address the major implementation issues often associated with implementing Wraparound, and identifying and addressing implementation barriers and implementation support needs in local or state systems of care.

This presentation reviews results of User Experience (UX) testing of an Electronic Behavioral Health Record, and the way in which that feedback is used to modify the system. 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health, Tuesday, March 15, 2016, Tampa, FL

Conference presentation on use of administrative CANS data for benchmarking and outcomes monitoring in state-wide Wraparound initiatives. Presented at the 29th Annual Research & Policy Conference on Child, Adolescent and Young Adult Behavioral Health. March 14, 2016. Tampa, Florida.

tips/technique for prioritizing needs

an overview of the Catholic Community Service Family Preservation System

Across child- and adult-serving systems, there is interest among communities and organizations to provide transitional support to young adults with a strong focus on youth peer support (YPS).YPS spans both child- and adult-serving systems to support successful transition. The population receiving the support (i.e., young adults) is unique, and YPS must be developmentally appropriate, useful, and appealing to young adults in transition. Providing Youth and Young Adult Peer Support through Medicaid, authored by TA Network core partners CHCS, Inc. and Youth M.O.V.E. National, explores the role of Medicaid, key considerations, and provides point-in-time snapshots of states and communities leveraging Medicaid to fund YPS.

Reliable and valid measures of Wraparound fidelity are needed to ensure effective implementation. This paper discusses one such instrument, the Team Observation Measure (TOM), by examining its psychometrics, reliability, and validity.

The Mental Health Services Program for Youth (MHSPY) model is aligned philosophically with wraparound and systems-of-care but unique in blending public agency dollars to deliver integrated medical, mental health and social services. MHSPY's linked clinical and expense data is useful to study community-based treatment cost-effectiveness.

This guide, authored by TA Network core partners WERT, NWI and NWIC, provides concrete guidance for Wraparound care coordinators on how to apply the essential Wraparound principle of being outcomes-based. It includes information on why routinely and systematically measuring progress and using that information to rapidly adjust a plan of care is a core component of a high quality Wraparound and clinical practice. In addition, it discusses details on ways to be outcomes-based during every phase and activity of the Wraparound process.

This document presents the NWI Family Partner Task Force's final statement describing the experience and capacities that are needed in a person who wants to be employed as a family partner for Wraparound. The document also highlights the particular parts of the statement that aroused some controversy during development, and describes how these controversies were resolved.

list of ideas overarching strengths and possible uses for it

In children�s mental health, collaborative, team-based individualized service planning is most commonly known as Wraparound, and has become one of the primary strategies for improving services and outcomes for children with the highest levels of need. We report on analyses of data gathered at 72 Wraparound team meetings from communities around the United States. We describe the composition of the teams and the quality of the planning process they engaged in, and explore the extent to which these factors were associated with team member satisfaction and the individualization of plans. Teams in our study were numerically dominated by professionals. Parents attended a large majority of meetings, participation by youth and family advocates was frequent, participation by other family members infrequent, and participation by other members of the family�s informal or natural support networks rare. Observed teams varied considerably in the quality of their planning process and the degree of individualization of plans. Higher-quality planning was significantly associated with increased individualization of plans and with team member satisfaction with meeting productivity.

The current study examined the organizational social context in 21 community-based programs serving youth at-risk for out-of-home care due to emotional or behavioral disorders and their families and program performance on five quality indicators of team functioning in teams that included a family support specialist. Results indicate that programs with higher performance on structures to facilitate teamwork, informal communication mechanisms among team members, and the ability to integrate family support specialists as equal members of the team showed more positive organizational functioning. Implications for the role of quality indicators in health care reform efforts are discussed.

Form for information release in Spanish

information request form

This is the first in a series of technical assistance resources created by the NWI to provide an overview of current research and implementation best practices in Wraparound. This resource covers the topic of workforce development and features a collection of links to pertinent documents, webinars and other sources.

This is the second in a series of technical assistance resources created by the NWI to provide an overview of current research and implementation best practices in Wraparound. This resource covers the topic of care management entities and features a collection of links to pertinent documents, webinars and other sources.

This is the third in a series of technical assistance resources created by the NWI to provide an overview of current research and implementation best practices in Wraparound. This resource features a collection of links to documents, webinars and other sources about coordinating Wraparound with evidence-based clinical care.

This is the fourth in a series of technical assistance resources created by the NWI to provide an overview of current research and implementation best practices in Wraparound. This resource focuses on quality improvement and accountability in Wraparound. It features a collection of links to pertinent documents, webinars and other sources.

This is the fifth in a series of technical assistance resources created by the NWI to provide an overview of current research and implementation best practices in Wraparound. This resource focuses on peer support and other strategies to engage families and youth in Wraparound. It features a collection of links to pertinent documents, webinars and other sources.

Published by the National Technical Assistance Center for Children's Mental Health, this report documents the latest knowledge about return on investment (specifically cost savings) in systems of care. It summarizes data from national studies and from states and other communities.

This is a summary of a larger work by the National Technical Assistance Center for Children's Mental Health (available from: http://www.nwi.pdx.edu/pdf/ReturnonInvestmentinSOCsReport6-15-14.pdf).

The authors used the framework identified by the National Implementation Research Network’s (NIRN) analysis of 35 years of implementation outcomes literature from diverse fields of endeavor to review the current state of Wraparound implementation research. Model definition, model fidelity and intervention outcomes were areas of relatively greater development, while target population, theory base and theory of change, organizational context and readiness, staff selection, training, supervision or coaching, purveyor selection, and program installation were less examined or even overlooked. They conclude with suggestions for building a research agenda on Wraparound implementation.

This paper provides a review of the place of the Wraparound process in behavioral health, including a discussion of the opportunities it presents to the field, needs for further development and research, and recommendations for federal actions that have the potential to improve the model's positive contribution to child and family well-being.

a look at the evolution of the Wraparound process

Tool for reviewing service history from a parent/family perspective.

This intensive single case study highlights the impact of the local Wraparound program (WRAP) on a 16-year old probation youth of immigrant background.

This document summarizes the of the findings of 22 controlled Wraparound effectiveness studies that were found between 1986 and 2014.

Complete sample plan including strengths, goals, activities and method for tracking outcomes (last page)

Complete sample plan including strengths, goals, activities and method for tracking outcomes (last page)

sample plan of care arranged by life domains

sample strengths summary

job description

list of areas for strengths and competencies

Blank template for safety plan

blank template for recording strengths by domain

blank plan template

blank matrix of types of social support and sources

tips/techniques for ensuring that Wraparound is strengths based

This flowchart describes NWIC's training and coaching process for all line staff and supervisors.

assessment of information management system

tips for identifying natural supports

This article, originally published in the TA Telescope (January, 2015), introduces the National Wraparound Implementation Center's (NWIC) model of parent peer support. It describes the importance of parent peer support specialists in Wraparound and best practices for Wraparound sites that incorporate these roles in their programs.

This article, originally published in the TA Telescope (January, 2015), highlights a unique collaborative model in New Jersey that is helping youth and families address behavioral health issues and create long-term plans for recovery. It gives some background on Care Management Entities (CMEs) in general and illustrates their implementation in New Jersey.

tool for eliciting strengths and visualizing family connections through strengths

list of domains for exploring--and form for recording--strengths, needs, culture

summary of evidence base

a look at what Wraparound Milwaukee has taught us

emerging themes for developing your system

overview of Wraparound implementation and support

poll about Wraparound implementation and support

This article, published in the TA Telescope (January, 2015), discusses opportunities for taking Wraparound to scale through provisions in the Affordable Care Act and other federal funding options.

list of expectations for team members

structure for reviewing possible natural/community supports

structure for reviewing family connections

This is a study of a nationally-representative sample of teens that documents teen internet use. It also documents teens' use of newer technologies for health, such as mobile apps, social networking sites, electronic gaming and wearable devices. This study examines how often teens use these tools, what topics they are most concerned with, how satisfied they are with the health information they get through these means and whether they have ever changed their behavior due to online or other digital health tools. It also covers details such as how teens look for health information online, the degree to which they use social media for this purpose, how much they trust various types of health information sites, and why some teens are not satisfied with online health information.

Describes the values that guide the Wraparound process.

This document briefly describes what the Family Partner does on Wraparound teams to put each of the Ten Principles of the Wraparound process into practice

webinar about Wraparound in child welfare contexts

poll about Wraparound in child welfare contexts

The Community Supports for Wraparound Inventory (CSWI) was developed to respond to the need for an assessment of the extent to which a community has developed system-level capacity to implement Wraparound. This article reports on a study that evaluated the reliability and validity of the CSWI for use in communities implementing Wraparound. Findings indicate that the CSWI shows promise as a reliable, valid and useful tool.

This handbook was written for staff who are employees of agencies implementing the Directive Supervision System. Pat Miles supplied this sample handbook as a supplement to the NWI sponsored webinar, "Strengthening Practice through Directive Supervision," that took place April 13, 2011.

resource guide

lessons learned over the course of Wraparound history

questions for strengths interview and format for summarizing

A guide for building family teams

A guide for building family teams

Overview of the Wraparound process, intended for families

A compilation of resources collected by the Family Partner Task Force, focused on strengths-based communication.

Residential programs for children and youth are increasingly implementing engagement strategies to promote family-centered and family-driven models of care (Leichtman, 2008). The practice of engagement is a fairly new area of research, especially in residential care. Prior to implementing a family-centered approach to care, residential administrators and key stakeholders will want to consider the existing knowledge base of evidence-based activities and implementation strategies...Specific recommendations emerged from the synthesis of the literature, and align with current policy and advocacy efforts surrounding family-centered and family-driven care models. It is imperative to note that the dearth of research on family engagement strategies and family-centered models of care does not allow for precise recommendations to be made on individual engagement activities. Broader recommendations are made for service delivery options or program models instead.

North Carolina is one of a growing number of states to implement family meeting models in child welfare as a way to engage families, while simultaneously addressing complex familial needs and child safety issues. However, much is still unknown regarding how family meetings actually operate in child welfare, underscoring a clear need for further evaluation of this process. Utilizing direct observational data of Child and Family Team (CFT) meetings, collected as part of two separate evaluations of the North Carolina Division of Social Service�s Multiple Response System (MRS) and System of Care (SOC) initiatives, the purpose of the current study was to examine whether the support provided by SOC improved fidelity to the CFT model in child welfare. The observations were conducted using the Team Observation Measure consisting of 78 indicators that measure adherence to ten domains associated with high quality family team meetings (e.g., collaborative, individualized, natural supports, outcomes based, strengths-based). Findings indicate that receiving SOC support in child welfare leads to a more collaborative and individualized decision-making process with families. Meeting facilitators in SOC counties were better prepared for CFTs, and had greater ability to lead a more robust and creative brainstorming process to develop a family-driven case plan. The current study also provides a much needed description of the CFT meeting process within child welfare using a direct observational measure.

Understanding the implementation of Wraparound in child welfare is essential to its continued use in the field. The purpose of this study was to understand the implementation of Wraparound in regard to organizational and systems-related factors and contexts. Wraparound was implemented and evaluated in five counties as part of California�s Title IV-E Child Welfare Waiver Demonstration Project, from 1999 to 2004. The three areas of inquiry include the models of Wraparound used, important aspects of the implementation efforts, and the interaction between the principles and values of Wraparound and those of the child welfare system. A multiple case study design provided the structure for data collection and analysis. Focus groups with a convenience sample of administrators and direct-service staff from the public agencies and private community-based agencies implementing Wraparound were conducted annually. While the Wraparound models were similar in configuration there were also unique characteristics that developed in response to local conditions. Issues and solutions emerged regarding referrals and case closures, staffing and training, management information systems, funding, and contextual factors. The values and principles of the child welfare departments, group home providers, and families interacted with the values and principles of Wraparound. The results highlight the importance of organization and systems-level characteristics. Building on the solutions developed in California will help to ensure the sustainability of Wraparound.

This document outlines Maryland's strategic plan to better serve youth and families in the following domains: Family and Youth Partnership; Interagency Structures; Workforce Development and Training; Information-Sharing; Improving Access to Opportunities and Care; Continuum of Opportunities, Supports, and Care; Financing; Education

Overview of the Wraparound process, intended for families

One of the most significant recent trends in the field of children's mental health has been the shift in the conceptualization of authority and expertise. Increasingly, there are demands to recognize and to respond to the perspectives of people who have traditionally been seen more as passive targets of interventions and other change efforts. This has led to a variety of efforts to blend perspectives and/or build partnerships between consumers and providers or between researchers and practitioners. This article explores how a commitment to blending perspectives as a way of providing children's mental health services was a central factor in the emergence of Wraparound, a widely implemented care-planning approach for children with complex needs and their families. The commitment to blending perspectives is also a central organizing principle of the collaborative work of a community of practice called the National Wraparound Initiative (NWI), which has worked to support Wraparound and to generate knowledge about Wraparound practice and implementation. The article goes on to describe some of the benefits, challenges, and tensions that have emerged in the work of the community of practice and to consider what the experience of the NWI may have to offer to others engaged in similar efforts.

tells of personal experiences in the phases of Wraparound

This quick reference was produced by The National Technical Assistance Network for Children's Behavioral Health. It describes how including the voices of families and children created changes in the process of how permanency is monitored and achieved for youth involved in Wraparound Milwaukee.

The purpose of the current study is to contribute to the knowledge base on the use of family education and support (FES) services by examining the longitudinal trajectories of FES receipt and multiple domains of child and family functioning. Using an extant data set of more than 9,000 youth and their caregivers, results indicate that families who received FES on entry into services had greater caregiver strain, and their children experienced greater emotional challenges than families who did not receive FES services. Furthermore, for families who received FES, the longitudinal results revealed an immediate effect of seeking additional services, decreasing caregiver strain 6 months after receipt of FES services, and improving child emotional functioning 6 to 18 months after initial receipt of FES services. The complex, lagged effects in the results are discussed in the context of the theorized cyclical course of family stress as exemplified by the Double ABCX model of adjustment and adaptation. Implications for future research of FES services are discussed, especially the need to develop a functional logic model and an operational definition of FES and its components.

This presentation provides an overview of results from the Impact of Training and Technical Assistance (IOTTA) survey, and reflects on next steps in IOTTA development and implementation.

Defining the role of the Wraparound Clinician

Wraparound model for Orange County

Overview of the Wraparound process designed for families--reflects the National Wraparound Initiative's definition of the Wraparound process

overview of the basic principles of Wraparound implementations

Using Kansas as an example, this study demonstrates the difficulties of implementing high fidelity Wraparound on a large scale. It addresses these challenges by recommending a balance of standardized Wraparound practices, localized innovations, and agency compliance with Medicaid.

(SPANISH VERSION) This tip sheet offers suggestions and strategies to help young people become more involved in their team meetings.

This tip sheet offers suggestions and strategies to help young people become more involved in their team meetings.

supporting Wraparound implementation

This document addresses three phases in the professional development of Wraparound facilitators, taking facilitators from orientation to competence.

plan sample

This report focuses on turnover among care coordinators and provides findings from a national survey and follow-up interviews with selected survey participants.

This article, originally published in the TA Telescope (January, 2015), highlights research-based best practices for keeping young people engaged in the Wraparound process.

tools and resources of evaluation

webinar about service funding

tool for eliciting and visualizing social connections and supports, sample product

This study describes services provided by family support specialists (FSS), peer advocates in programs for children with serious psychiatric conditions, to delineate differences between recommended components of FSS services and services actually provided. An analysis of qualitative interview and observational data and quantitative survey data from 63 staff at 21 mental health programs in New York identified that FSS and other staff have generally similar ideas about FSS services, and that these perceptions of activities are generally congruent with what FSS actually did. Implications of findings are discussed in the context of developing competencies and quality indicators for FSS.

information on youth coordinators

This article, originally published in the TA Telescope (January, 2015), addresses the need for culturally competent Wraparound in working with diverse communities. It highlights exemplar interventions and links to additional resources for further reading.

funding model

A compilation of resources collected by the Family Partner Task Force, focused on strengths-based communication.

A compilation of resources collected by the Family Partner Task Force, focused on strengths-based communication.

A compilation of resources relating to the NWI sponsored webinar, "The Art of Wraparound in the Child Welfare Environment," that took place January 25, 2011.

This publication defines Wraparound and describes the Wraparound process. The evidence base supporting the use of Wraparound and requirements for authentic Wraparound implementation are also introduced.

WFAS Document Review - October 2007

WFAS - Team Observation Measure, October 2007

WFI-4 demographics form, March 2008

WFI-4, caregiver form, Spanish translation

This resource takes prior work by the NWI to a level of greater specificity, by providing a summary of research-, theory-, and practice-based standards to be attended to across five implementation-related areas (staff, leadership, organization, accountability, and system) and two output-related areas (fidelity and outcomes).

implementation guide

This article examines some recent research on outcomes from poorly-implemented Wraparound services and provides evidence that Wraparound has the best chance of succeeding when it is implemented with fidelity.

This snapshot highlights the results of a mental health service use and cost study on children and youth enrolled in Wraparound Maine. Results of the study from the Office of Continuous Quality Improvement Services indicate a 28% reduction in overall average per-child mental health expenditures following the initiation of Wraparound and significant expenditure reductions in several service areas.

plan of care form with some example sections filled in

funding model

Wraparound practice model

Wraparound brochure

description of practice

evaluation brochure

This document outlines an agreement between the state of Oregon and various child-serving agencies regarding joint cooperation in improving services for children and families.

partially filled sample plan of care

example of filled-out strengths and needs summary

a form for recording, visualizing, and tracking outcomes

Form for a plan of care

information on the how and why of implementing a team-based Wraparound model

defines three levels of focus for any Wraparound supervisor

This paper describes: (1) how the Wraparound process can be integrated into schools through SWPBS, (2) differences between Wraparound and typical school-based practices, including special education, and (3) how SWPBS systems can support and strengthen the Wraparound process and its ability to improve quality of life for youth with unique emotional/behavioral needs, and for their families and teachers

Sam Waterston introduces this video documenting Wraparound Milwaukee's community-based system of care which provides comprehensive, highly individualized, family-directed services to youth with emotional and mental health needs and their families. The program is a 2009 winner of the Innovations in American Government Awards.

An introduction to Wraparound for youth.

information about youth advocates

template for exploring strengths and including in plan-- designed for youth with juvenile justice involvement

information on youth engagement

The goal for Youth Involvement in Systems of Care: A Guide to Empowerment is to provide a resource to youth, youth coordinators, family members, professionals, and other adults working with young people. This guide is a starting point for understanding youth involvement and engagement in order to develop and fully integrate a youth-directed movement within local systems of care.

a valuable guide to help youth and adults understand how to cultivate youth voice

why and how to promote youth participation in Wraparound Team Planning

This evaluation attempts to comprehensively document service utilization across child serving systems. This comprehensive system analysis provides information regarding the factors that impact youth outcomes to possibly lead to more effective intervention and coordination of services between systems.

Youth with serious mental health disorders present with a complexity of challenges for the mental health system, schools, youth justice, care and protection, and their communities. Research shows their needs are best achieved by providing coordinated intensive, multidisciplinary, and individualised services. This article outlines the prevalence and characteristics of youth with serious mental health disorders. It also discusses community-based interventions used in New Zealand and their limitations. It introduces Wraparound, an intensive individualised coordination and care planning process as a promising practice for youth with serious mental health disorders and their families. Key principles and phases underpinning the Wraparound process are presented along with a case vignette to exemplify the process. Its theory of change, the challenges experienced in practice, and a brief overview of the evidence-base are also discussed.