Child and Family Team Meeting Characteristics and Outcomes in a Statewide System of Care

Abstract

Systems of care (SOC) have relied on the wraparound care process to individualize community‐based services for children and youth with serious emotional and behavioral difficulties. A core element of wraparound care is Child and Family Team meetings (CFTs), which are designed to give youth and families a leadership role in developing and guiding their plan of care. The National Wraparound Initiative (NWI) has identified Practice Standards regarding CFT implementation. This study examined CFT characteristics and the association between those characteristics and youth and family outcomes in a statewide SOC. Participants were 363 youth (Mage = 10.89, SD = 3.72) and their caregivers. Families completed measures of youth and caregiver functioning and symptoms at enrollment and 6‐month follow‐up. Care coordinators completed a survey assessing CFT implementation and characteristics following each meeting. Multiple regression analyses were used to examine the relationship between CFT characteristics and youth and caregiver outcomes. Results indicated that a higher number of CFTs was associated with poorer outcomes, while a higher percentage of natural supports at meetings was associated with better youth outcomes. Number of days to the first CFT was associated with greater caregiver strain. Implications for CFT implementation within wraparound are discussed.

Trauma Symptoms and Relationship With Child and Family Team Meeting Characteristics and Outcomes in a Statewide System of Care

“…Similar patterns were found for duration of CFT meetings and the number of days to the first CFT, such that longer meetings and more days to the first meeting were associated with poorer outcomes. This article hypothesized that these characteristics could reflect a higher level of family need, in that families experiencing elevated stress may struggle to schedule and attend appointments (Schreier, Horwitz, et al, 2019). Consistent with previous research demonstrating that exposure to trauma and its sequelae may be barriers to service seeking (Gopalan et al, 2010), it is possible that these relationships may be driven by the increased needs and stress in families of youth experiencing significant trauma symptoms.…”

“…Care coordination has been an integral component of the Connecticut SOC, including training and coaching provided to care coordinators by Connecticut's Wraparound workforce development initiative. Data on CFT characteristics within the Connecticut SOC are reported in Schreier, Horwitz, et al (2019).…”

“…We also expected that there would be significant relationships between youth exposure to PTEs, youth trauma symptoms, and characteristics of CFT meetings (i.e., number of CFT meetings, number of days to the first CFT, and duration of CFT meetings), based on previous literature identifying relationships between trauma and service participation (e.g., Briggs et al, 2013;Gopalan et al, 2010). Finally, we expected that youth exposure to PTEs and trauma symptoms would moderate the previously established relationships between CFT and youth and family outcomes (Schreier, Horwitz, et al, 2019).…”

“…There were no significant differences between families with or without trauma data on any demographic variables; thus, these families were excluded from all analyses leading to a sample of 400. The PROCESS macro for SPSS was used to conduct moderated multiple regression analyses to test the conditional effects of youth trauma symptoms on the previously established relationships (Schreier, Horwitz, et al, 2019) between CFT characteristics and youth and caregiver outcomes (Hayes, 2012(Hayes, , 2013; Model 1). Because rates of trauma exposure were so high in this sample, the decision was made to examine only trauma symptoms as a moderator, rather than exposure to PTEs overall.…”

“…While much literature has demonstrated the effectiveness of the wraparound model (Coldiron et al, 2017;Suter & Bruns, 2009), to date, only one study has examined the relationship between specific CFT practice elements or characteristics and youth and family outcomes (Schreier, Horwitz, et al, 2019). Schreier, Horwitz, and colleagues found that families with poorer outcomes, including higher caregiver ratings of youth problem behaviors, lower caregiver ratings of youth functioning, higher caregiver ratings of youth impairment, and higher ratings across dimensions of caregiver strain, tended to have more CFT meetings.…”