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.
References
Anderson, J. A., Wright, E. R., Kooreman, H. E., Mohr, W. K., & Russell, L. A. (2003). The Dawn project: A model for responding to the needs of children with emotional and behavioral challenges and their families. Community Mental Health Journal, 39, 63–74.
Bruns, E. J. (2008). The evidence base and wraparound. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health.
Bruns, E. J., & Hoagwood, K. E. (2008). State implementation of evidence-based practice for youths, Part 1: Responses to the state of the evidence. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 369–373. doi:10.1097/CHI.0b013e31816485f4.
Bruns, E. J., Suter, J. C., & Leverentz-Brady, K. M. (2006). Relations between program and system variables and fidelity to the wraparound process for children and families. Psychiatric Services, 57, 1586–1593. doi:10.1176/appi.ps.57.11.1586.
Bruns, E. J., Walker, J. S., Zabel, M., Matarese, M., Estep, K., Harburger, D., et al. (2010). Intervening in the lives of youth with complex behavioral health challenges and their families: The role of the wraparound process. American Journal of Community Psychology, 46, 314–331.
Bruns, E. J., Walrath, C. M., & Sheehan, A. K. (2007). Who administers wraparound? An examination of the training, beliefs, and implementation supports for wraparound providers. Journal of Emotional and Behavioral Disorders, 15(3), 156–168.
Burchard, J. D., Bruns, E. J., & Burchard, S. N. (2002). The wraparound approach. In B. J. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based Interventions for severe emotional and behavioral disorders (pp. 69–90). Oxford, NY: Oxford University Press.
Burns, B. K. (2002). Reasons for hope for children and families: A perspective and overview. In B. J. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based treatment for severe emotional and behavioral disorders (pp. 3–16). Oxford: Oxford University Press.
Evans, M. E., Armstrong, M. I., Kuppinger, A. D., Huz, S., & McNulty, T. L. (1998). Preliminary outcomes of an experimental study comparing treatment foster care and family-centered intensive case management. In M. H. Epstein, K. Kutash & A. Duchnowski (Eds.), Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices (pp. 543–580). Austin, TX: Pro-Ed.
Faw, L. (1999). The state wraparound survey. In B. J. Burns, & S. K. Goldman (Eds.), Promising practices in wraparound for children with serious emotional disturbance and their families. Systems of care: Promising practices in children’s mental health, 1998 series, (Vol. IV, pp. 61–66). Retrieved from National Collaborative on Workforce and Disability website: http://www.ncwd-youth.info/foundations/010.
Federal Interagency Forum on Child and Family Statistics. (2010). America’s children in brief: Key national indicators of well-being, 2010. Washington, DC: U.S. Government Printing Office.
Grosz, D., Schutte, K., & Walker, J. S. (2001). Strategies for increasing the effectiveness of ISP (wraparound) teams. Retrieved from Research and Training Center on Family Support and Children’s Mental Health Regional Research Institute for Human Services, Portland State University, Pathways website: http://www.pathwaysrtc.pdx.edu/pdf/cp0212.pdf.
ICF Macro. (2011). Children’s Mental Health Initiative (CMHI): National Evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program, Substance Abuse and Mental Health Services Administration (SAMSHA), Center for Mental health Services (CMHS). Retrieved from http://www.macrointernational.com/projects/cmhi/default.aspx.
McGinty, K., McCammon, S. L., & Koeppen, V. P. (2001). The complexities of implementing the wraparound approach to service provision: A view from the field. Journal of Family Social Work, 5, 95–110. doi:10.1300/j039v05n03_07.
Mears, S. L., Yaffe, J., & Harris, N. J. (2009). Evaluation of wraparound services for severely emotionally disturbed youths. Research on Social Work Practice, 19, 678–685. doi:10.1177/1049731508329385.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.
National Resource Network for Child and Family Mental Health Services at the Washington Business Group on Health. (Ed.). (1999). A compilation of lessons learned from the 22 grantees of the 1997 Comprehensive Community Mental Health Services for Children and Their Families Program. In Systems of care: Promising practices in children’s mental health, 1998 series, Volume VII. Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.
Salend, S. J. (1984). Therapy outcome research: Threats to treatment integrity. Behavior Modification, 8, 211–222. doi:10.1177/01454455840082004.
Suter, J. C., & Bruns, E. J. (2009). Effectiveness of the wraparound process for children with emotional and behavioral disorders: A meta-analysis. Clinical Child and Family Psychology Review, 12, 336–351.
U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. (1999). Mental health: A report of the surgeon general—executive summary. Retrieved from http://www.surgeongeneral.gov/library/mentalhealth/summary.html.
VanDenBerg, J. (1993). Integration of individualized mental health services into the system of care for children and adolescents. Administration and Policy in Mental Health and Mental Health Services Research, 20, 247–257. doi:10.1007/bf00709735.
VanDenBerg, J., Bruns, E., & Burchard, J. (2003). History of the wraparound process. Retrieved from National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health website: http://www.nwi.pdx.edu/NWI-book/Chapters/VanDenBerg-1.3-(history-of-wraparound).pdf.
Walker, J. S., & Bruns, E. J. (2007). Wraparound—key information, evidence, and endorsements. Retrieved from Parents Anonymous website: https://panetwork.parentsanonymous.org/aspx5/docs/Wraparound20100427_Key%20information.pdf.
Walker, J. S., & Bruns, E. J. (2008). Phases and activities of the wraparound process: Building agreement about a practice model. Portland, OR: National Wraparound Initiative, Research and Training Center on Family Support and Children’s Mental Health, Portland State University.
Walker, J. S., Bruns, E. J., VanDenBerg, J. D., Rast, J., Osher, T. W., Miles, P. et al. (2004). Phases and activities of the wraparound process. Portland, OR: National Wraparound Initiative, Research and Training. Center on Family Support and Children’s Mental Health, Portland State University.
Walker, J. S., & Koroloff, N. (2007). Grounded theory and backward mapping: Exploring the implementation context for wraparound. The Journal of Behavioral Health Sciences and Research, 34, 443–458. doi:10.1007/s11414-007-9054-6.
Walker, J. S., Koroloff, N., & Schutte, K. (2003). Implementing high quality collaborative individualized service/support planning: Necessary conditions. Portland, OR: Research and Training Center on Family Support and Children’s Mental Health.
Walker, J. S., & Schutte, K. (2005). Quality and individualization in wraparound team planning. Journal of Child and Family Studies, 14, 251–267. doi:10.1007/s10826-005-5052-6.
Walter, U. M. (2008). Best practices in wraparound: A review of the national literature. Retrieved from University of Kansas, School of Social Welfare website: http://www.socwel.ku.edu/occ/index.htm.
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This study was supported through a research contract with the Kansas Department for Aging and Disability Services.
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Mendenhall, A.N., Kapp, S.A., Rand, A. et al. Theory Meets Practice: The Localization of Wraparound Services for Youth with Serious Emotional Disturbance. Community Ment Health J 49, 793–804 (2013). https://doi.org/10.1007/s10597-013-9646-y
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DOI: https://doi.org/10.1007/s10597-013-9646-y