Effectiveness of the Wraparound Process for Children with Emotional and Behavioral Disorders: A Meta-Analysis

Abstract

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.

Research on the Wraparound Process: Intervention Components and Implementation Supports

“…Wraparound's principles, practice model, and organizational and system support conditions have undergone systematic examination over the past 10 years, in a way that intends to provide adequate specificity to permit replicability and quality assurance while maintaining the strategy's ability to be adapted to local conditions and populations Walker and Bruns 2006;Walker et al 2011). Nine controlled studies of wraparound are now in the peer reviewed literature (Bruns and Suter 2010), with a recently completed meta-analysis demonstrating significant positive effects and mean effect sizes ranging from 0.31 for mental health symptomotology to 0.44 for residential placement (Suter and Bruns 2009).…”

“…The initiatives studied in the above reviews and meta-analysis span mental health, juvenile justice, and child welfare (Suter and Bruns 2009), and the wraparound process is now frequently referenced as a practice model that can facilitate integration of care for complex populations of all ages. Achieving such integration of care-and the quality improvement and cost savings that are proposed to occur as a result-is one of the goals of current federal health care legislation (Thorpe and Ogden 2010).…”

The Impact of Child and Family Team Composition on Wraparound Fidelity: Examining Links Between Team Attendance Consistency and Functioning

“…The wraparound model consists of ten principles, including a team-based model for planning and implementation of services (Suter and Bruns 2009). These child and family teams (CFTs) are a central component of wraparound implementation.…”

Demographic, Clinical, and Geographic Predictors of Placement Disruption among Foster Care Youth Receiving Wraparound Services

“…A much smaller body of research suggests that community interventions such as those using a wraparound model can improve the placement outcomes of youth in the foster care system by increasing the breadth, flexibility, and coordination of service provision (e.g., Clark et al 1996). Wraparound approaches have been shown to be successful in the mental health, child welfare, and juvenile justice systems (Burchard et al 2002;Suter and Bruns 2009). Using existing community services and natural supports, the wraparound system is a family-centered and child-focused intervention that capitalizes on youth strengths, creating an Introduction individualized, community-based treatment program that is interagency-coordinated and culturally competent (Walker et al 2004;Burchard et al 2002;Walker and Bruns 2008).…”