Best Practices in Wraparound: A Multidimensional View of the Evidence

Abstract

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.

Client perception of a client-centered and occupation-based intervention for at-risk youth

“…The focus of client-centered and occupationbased interventions particularly benefits this youth population in acquisition of skills specific to their developmental status, environment and context, and special needs (3). At-risk youth in this study and other youth in similar predicaments may be eligible for a wide range of community services (33), and client-centered and occupation-based OT deserves consideration as an essential part of the intervention process. As Mia stated: "I'm not gonna say like if OTTP wasn't there I wouldn't survive or something, cuz that's kinda drastic, but I think that I would not be who I am today, you know, kinda happy and happier.…”

Youth with Serious Mental Health Disorders: Wraparound as a Promising Intervention in New Zealand

“…A challenge for investigators and implementers of the Wraparound process is to bridge the gap between the research and practice (Bruns, ; Walter & Petr, ). This requires careful consideration of sample size, intervention and follow‐up times, and the inclusion of control groups.…”

“…Although deemed a promising practice, there is still mixed scientific support on the efficacy of the Wraparound process (Stambaugh, Mustillo, Burns, Stephens, Baxter, Edwards & Dekraai, ; Suter & Bruns, , ). Overall, investigations of the Wraparound process have predominantly used pre‐post methodologies, no control group, small samples sizes, and no measurement of treatment adherence or fidelity (Suter & Bruns, ; Walter & Petr, , ). Irrespective of the research design used, an essential component of building Wraparound's evidence‐base is the inclusion of fidelity measurements in outcomes studies.…”

“…Methodological weaknesses are a key issue in establishing Wraparound as an evidence‐based treatment (Suter & Bruns, ; Walter & Petr, , ). However, evaluating the Wraparound process in practice with strong methodological designs is difficult due to the individualised nature of the process and the client group served (Stambaugh et al., ).…”

A programme evaluation of theFamilyCrisisInterventionProgram (FCIP): relating programme characteristics to change

“…For example, while intensive family preservation programmes in the service stream of child welfare were based primarily on crisis theory, those within the service streams of mental health and juvenile justice were based more on systems theory, theories of stress and coping and social learning theory (Wells & Biegel ). Also, new intervention models have been developed, such as the Wraparound Care model (Suter & Bruns ; Walter & Petr ), which started as a case management model and uses a strong network approach (e.g. Malysiak ).…”