Effectiveness of Wraparound Versus Case Management for Children and Adolescents: Results of a Randomized Study

Abstract

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.

Intensive community treatment and support “Youth Wraparound” service in Western Australia: A case and feasibility study

“…This is a conservative estimate as it excludes other costs and risks to the service (eg, staff injury due to assaults, disruptions to important services such as inpatient wards and emergency departments), together with the personal and capital costs associated with disease burden. These positive results in a young person with very complex needs are in line with other studies documenting improved health, functional and personal outcomes of the “wraparound” models in the United States (Barfield et al, ; Bloom & Farragher, ; Bruns et al, ; Burns & Goldman, ), and provide proof of concept and feasibility model for an application in Australia.…”

“…Where possible, services are provided in residential settings. Evaluation of the model shows that it is effective in improving health, functional and personal outcomes, in a costeffective way and in avoiding prevent prolonged stays in detention centres or mental health inpatient units (Barfield, Corrigan, Chamberlain, Hong, & Barket, 2006;Bloom & Farragher, 2010;Bruns, Pullmann, Sather, Brinson, & Ramey, 2015;Burns & Goldman, 1999).…”

The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

“…Members of advocacy organizations would be expected to report higher empowerment scores than parents living in underserved communities raising similarly affected children. The final mean total FES score for the CATTS caregivers was comparable to the mean score for parents who received Wraparound services in a public mental health system for six months ( M = 132.8) (Bruns, Pullmann, Sather, Brinson, & Ramey, 2015.…”

Juvenile justice, mental health, and the transition to adulthood: A review of service system involvement and unmet needs in the U.S.

“…Similar programs have also shown promise in reducing recidivism (Anderson, Wright, Kooreman, Mohr, & Russell, 2003; Kamradt, 2000), though one program produced positive effects on educational outcomes and police contacts but not on arrests or incarceration (Carney & Buttell, 2003). However, the comparative effectiveness of the wraparound approaches compared to case management for reduction of mental health symptoms has not been established (see Bruns et al, 2015). Moreover, evaluations have not focused on older transition age youth (i.e., over age 17).…”