Theory Meets Practice: The Localization of Wraparound Services for Youth with Serious Emotional Disturbance

Abstract

This study identified statewide variation in implementation of wraparound for children on the severe emotional disturbance (SED) Waiver in Kansas. SED Waivers allow Community Mental Health Centers (CMHC) to offer an array of community-based services to high risk youth. Qualitative methods, including interviews, reviews of charts and billing records, and a survey, were employed. Stratified random sampling was used to select seven CMHCs, and random sampling was used to select individual cases for interviews. Although CMHCs shared similar wraparound philosophy and service initiation processes, each developed their own localized wraparound model within the confines of Medicaid eligibility and documentation rules. Eight models for wraparound team composition were identified. Findings demonstrate implementation of wraparound with fidelity to a central model is difficult on a large scale. The balance of standardized wraparound practices, localized innovations, and agency compliance with Medicaid is essential for optimizing children's mental health services.

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

“…Examples of such use include an exploration of the experiences of providers who have encountered immigrant patients in their services on a daily basis and to reflect on areas where difficulties may arise and how these are managed in mental health services (Sandu et al, 2012) and an exploration of wraparound services for youth with serious emotional disturbance (Mendenhall et al, 2013). Chew-Graham, Slade, Montana, Stewart, and Gask (2007) used qualitative methods to explore the function of community health teams in managing referral decisions at the primary-specialist interface from the perspectives of both referrers (primary care providers) and referred to (mental health specialists).…”

“…Other methods used in qualitative studies to enhance rigor of analysis include triangulation of viewpoints by purposefully interviewing people in various roles within an organization, peer debriefing and support meetings among research team members, and providing a detailed audit trail during analysis (Harris, Collinson, & das Nair, 2012; Miles & Huberman, 1994; Mendenhall, Kapp, Rand, Robbins, & Stipp, 2013). …”

“…Chew-Graham et al (2007) sampled general practitioners to insure variation in gender, ethnicity, experience, and practice size. Other forms of purposeful sampling have been used in mental health services research, including random sampling (Mendenhall et al, 2013) and convenience sampling (Mittal et al, 2013) or both (Stergiopoulos et al, 2012), but these two in particular are usually considered less likely to obtain information rich participants (Patton, 2002). …”

A systematic literature analysis of wraparound application study for school-aged students with special educational needs

“…질적연구를 진행한 연구는 랩어라운드 참여자에게 인터뷰 를 진행하여 랩어라운드를 통한 변화에 대하여 알아보았다 (Bruns et al, 1995;Eber et al, 2008;Hyde et al, 1996;Mendenhall et al, 2013;Scott & Eber, 2003;West-Olatunji et al, 2011). Bartlett와 14편 선행연구들의 팀 구성을 분석한 결과, 12편의 연구에 공통으로 참여한 구성원은 학생과 가족과 자연스러운 지원이 가능한 친척, 친구, 이웃 등이 참여한 것으로 나타났다 (Bartlett & Freeze, 2018;Bruns et al, 1995;Clark et al, 1996;Eber et al, 2008;Eber et al, 1996;Epstein et al, 2005;Evans et al, 1996;Hyde et al, 1996;Mendenhall et al, 2013;Myaard et al, 2000;Scott & Eber, 2003;Yoe et al, 1996). West-Olatunji 등( 2011 (Eber et al, 2008;Eber et al, 1996;Epstein et al, 2005;Scott & Eber, 2003).…”

Impact of a Care Management Entity on Use of Psychiatric Services Among Youths With Severe Mental or Behavioral Disorders

“…The model with 10 specific core values aims to strengthen the planning process and facilitate links between agencies and health care professionals (15). Implementation of this practice model could vary across communities (16,17). In Maryland, wraparound services have been implemented as part of a care management entity, a nonprofit organization that coordinates a care planning team, delivers individualized health services for youths and their families, and facilitates community-based and home-based supportive services.…”