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Comprehensive Community-Based Interventions for Youth with Severe Emotional Disorders: Multisystemic Therapy and the Wraparound Process

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Abstract

Two comprehensive community-based interventions for youth with severe emotional disorders are contrasted and compared. The interventions are multisystemic therapy (MST)—a brief but intensive, clinician-provided, and home-based treatment; and wraparound—a long-term approach to planning and coordinating the provision of both formal and informal services in the community. Both approaches are spreading rapidly across the country. As this occurs, it is important for families, clinicians, and policymakers to have sufficient information to understand the requirements and the research base for each. This paper provides a description of both MST and wraparound across multiple dimensions (i.e., origin, theory, target population, principles, role of family, cultural competence, staffing, training, quality monitoring, costs, and the evidence base). The respective similarities and differences are discussed and options for utilizing both for selected youth and families who require intensive and long-term care are explored briefly.

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REFERENCES

  • Borduin, C.M., Henggeler, S.W., Blaske, D.M., & Stein, R. (1990). Multisystemic treatment of adolescent sexual offenders. International Journal of Offender Therapy and Comparative Criminology, 35, 105–114.

    Google Scholar 

  • Borduin, C.M., Mann, B.J., Cone, L.T., Henggeler, S.W., Fucci, B.R., Blaske, D.M., & Williams, R.A. (1995). Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence. Journal of Consulting and Clinical Psychology, 63, 569–578.

    Google Scholar 

  • Brondino, M.J., Henggeler, S.W., Rowland, M.D., Pickrel, S.G., Cunningham, P.B., & Schoenwald, S.K. (1997). Multisystemic therapy and the minority client: Culturally responsive and clinically effective. In: D.K. Wilson, J.R. Rodrigue, & W.C. Taylor (Eds.). Health and behavior in minority adolescent populations (pp. 229–250). Washington, DC: APA Books.

    Google Scholar 

  • Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Brunk, M., Henggeler, S.W., & Whelan, J.P. (1987). A comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect. Journal of Consulting and Clinical Psychology, 55, 311–318.

    Google Scholar 

  • Bruns, E., Burchard, J., & Yoe, J.T. (1995). Evaluating the Vermont system of care: Outcomes associated with community-based wraparound services. Journal of Child and Family Studies, 4, 321–339.

    Google Scholar 

  • Burchard, J., Burchard, S., Sewell, R., & VanDenBerg, J. (1993). One kid at a time: Evaluative case studies and description of the Alaska Youth Initiative Demonstration Project. Washington D.C.: Georgetown University Child Development Center.

    Google Scholar 

  • Burchard, J. & Clarke, R. (1990). The role of individualized care in a service delivery system for children and adolescents with severely maladjusted behavior. Journal of Mental Health Administration, 17, 48–60.

    Google Scholar 

  • Burns, B.J. (1999). A call for a mental health services research agenda for youth with serious emotional disturbance. Mental Health Services Research, 1, 5–20.

    Google Scholar 

  • Burns, B.J. & Goldman, S.K. (Eds.) (1999). Promising practices in wraparound for children with severe emotional disorders and their families. Rockville, MD: Center for Mental Health Services. Child, Adolescent, and Family Branch.

    Google Scholar 

  • Burns, B.J., Goldman, S.K., Faw, L., & Burchard, J.D. (1999). The wraparound evidence base. In: B.J. Burns & S.K. Goldman (Eds.), Promising practices in wraparound for children with severe emotional disorders and their families (pp. 77–95). Rockville, MD: Center for Mental Health Services. Child, Adolescent, and Family Branch.

    Google Scholar 

  • Clark, H., Prange, M., Lee, B., Stewart, E., McDonald, B., & Boyd, L. (1998). An individualized wraparound process for children in foster care with emotional/behavioral disturbances: Follow-up findings and implications from a controlled study. In: M.E. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with behavioral and Emotional disorders and their families: Programs and evaluation best practices (pp. 513–542). Austin, TX: Pro-Ed Publishing.

    Google Scholar 

  • Clarke, R., Schaefer, M., Burchard, J., & Welkowitz, J. (1992). Wrapping community-based mental health services around children with a severe behavioral disorder: An evaluation of Project Wraparound. Journal of Child and Family Studies, 1, 241–61.

    Google Scholar 

  • Cumblad, C. (1996). The pathways children and families follow prior to, during, and after contact with an intensive, family-based, social service intervention in urban settings. Ph.D. dissertation, Department of Educational Psychology, Counseling, and Special Education, Northern Illinois University.

  • Eber, L. & Osuch, R. (1995). Bringing the wraparound approach to school: A model for inclusion. In: C. Liberton, K. Kutash, & R. Friedman (Eds.), The 7 th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 143–152). Tampa, FL: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

    Google Scholar 

  • Eber, L., Osuch, R., & Redditt, C. (1996a). School-based applications of the wraparound process: Early results on service provision and student outcomes. Journal of Child and Family Studies 5, 83–99.

    Google Scholar 

  • Eber, L., Osuch, R., & Rolf, K. (1996b). School-based wraparound: How implementation and evaluation can lead to system change. In: C. Liberton, K. Kutash, & R. Friedman (Eds.) The 8th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 143–148). Tampa, FL: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

    Google Scholar 

  • Epstein, M., Jayanthi, M., McKelvey, J., Frankenberry, E., Hary, R., Potter, K., & Dennis, K. (1998). Reliability of the Wraparound Observation Form: An instrument to measure the wraparound process. Journal of Child and Family Studies, 7, 161–170.

    Google Scholar 

  • Evans, M., Armstrong, M., & Kuppinger, A. (1996). Family-centered intensive case management: A step toward understanding individualized care. Journal of Child and Family Studies, 5, 55–65.

    Google Scholar 

  • Evans, M., Armstrong, M., Kuppinger, A., Huz, S., & S. Johnson. (1998). A randomized trial of family-centered intensive case management and family-based treatment: Outcomes of two community-based programs for children with serious emotional disturbance. Tampa, FL: College of Nursing.

    Google Scholar 

  • Faw, L. (1999). The state wraparound survey. In: B.J. Burns & S.K. Goldman (Eds.), Promising practices in wraparound for children with severe emotional disorders and their families (pp. 61–65). Rockville, MD: Center for Mental Health Services. Child, Adolescent, and Family Branch.

    Google Scholar 

  • Goldman, S.K. (1999). The conceptual framework for wraparound. In: B.J. Burns & S.K. Goldman (Eds.), Promising practices in wraparound for children with severe emotional disorders and their families (pp. 9–14). Rockville, MD: Center for Mental Health Services. Child, Adolescent, and Family Branch.

    Google Scholar 

  • Henggeler, S.W., Borduin, C.M., Melton, G.B., Mann, B.J., Smith, L., Hall, J.A., Cone, L., & Fucci, B.R. (1991). Effects of multisystemic therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics of Addiction Quarterly, 1, 40–51.

    Google Scholar 

  • Henggeler, S.W., Melton, G.B., Brondino, M.J., Scherer, D.G., & Hanley, J.H. (1997). Multisystemic therapy with violent and chronic juvenile offenders and their families: The role of treatment fidelity in successful dissemination. Journal of Consulting and Clinical Psychology, 65, 821–833.

    Google Scholar 

  • Henggeler, S.W., Melton, G.B., & Smith, L.A. (1992). Family preservation using multisystemic therapy: An effective alternative to incarcerating serious juvenile offenders. Journal of Consulting and Clinical Psychology, 60, 953–961.

    Google Scholar 

  • Henggeler, S.W., Melton, G.B., Smith, L.A., Schoenwald, S.K., & Hanley, J.H. (1993). Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders. Journal of Child and Family Studies, 2, 283–293.

    Google Scholar 

  • Henggeler, S.W., Pickrel, S.G., & Brondino, M.J. (2000). Multisystemic treatment of substance-abusing and-dependent delinquents: Outcomes, treatment fidelity, and transportability. Mental Health Services Research, 1, 171–184.

    Google Scholar 

  • Henggeler, S.W., Rodick, J.D., Borduin, C.M., Hanson, C.L., Watson, S.M., & Urey, J.R. (1986). Multisystemic treatment of juvenile offenders: Effects on adolescent behavior and family interactions. Developmental Psychology, 22, 132–141.

    Google Scholar 

  • Henggeler, S.W., Rowland, M.D., Randall, J., Ward, D.M., Pickrel, S.G., Cunningham, P.B., Miller, S.L, Zealberg, J.J., Hand, L.D., & Santos, A.B. (1999). Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1331–1339.

    Google Scholar 

  • Henggeler, S.W., Schoenwald, S.K., Borduin, C.M., Rowland, M.D., & Cunningham, P.B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York: Guilford Press.

    Google Scholar 

  • Hyde, K., Burchard, J., & Woodworth, K. (1996). Wrapping services in an urban setting. Journal of Child and Family Studies, 5, 67–82.

    Google Scholar 

  • Hyde, K., Woodworth, K., Jordan, K., & Burchard, J. (1995). Wrapping services in an urban setting: Outcomes of service reform in Baltimore. In: Liberton, C.J., Kutash, K., Friedman, R.M. (Eds.), The 7th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 255–260). Tampa, FL: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

    Google Scholar 

  • Illback, R., Neill, T., Call, J., & Andis, P. (1993). Description and formative evaluation of the Kentucky IMPACT program for children with serious emotional disturbance. Special Services in the Schools, 7, 87–109.

    Google Scholar 

  • Johnson, S. (1998). Cost study. In: M.E. Evans, M.I. Armstrong, A.D. Kuppinger, S. Huz, & S. Johnson (Eds.) A randomized trial of family-centered intensive case management and family-based treatment: Final report (p. 75–109). Tampa, FL: University of South Florida.

    Google Scholar 

  • Kamradt, B. (1996). The 25 Kid Project: How Milwaukee utilized a pilot project to achieve buyin among stakeholders in changing the system of care for children with severe emotional problems. Paper presented to the Washington Business Group on Health.

  • Leschied, A.W. & Cunningham, A. (1998). Alternatives to custody for high-risk young offenders: The multisystemic therapy approach. European Journal on Criminal Policy and Research, 6, 545–560.

    Google Scholar 

  • Lonigan, C.J., Elbert, J.C., & Johnson, S.B. (1998). Empirically supported psychosocial interventions for children: an overview. Journal of Clinical Child Psychology, 24, 138–145.

    Google Scholar 

  • Miller, M.L. (1997). The multisystemic therapy pilot program: Fifth quarter status report. Wilmington: Delaware Department of Services to Children, Youth, and Their Families.

    Google Scholar 

  • Munger, R.L. (1998). The ecology of troubled children. Cambridge, MA: Brookline Books.

    Google Scholar 

  • Plas, J.M. (1992). The development of systems thinking: A historical perspective. In: M.J. Fine & C. Carlson (Eds.), The handbook of family-school intervention: A systems perspective (pp. 45–56). Needham Heights, MA: Allyn & Bacon.

    Google Scholar 

  • Rosenblatt, A. (1996). Bows and ribbons, tape and twine: Wrapping the wraparound process for children with multisystem needs. Journal of Child and Family Studies, 5, 101–17.

    Google Scholar 

  • Russell, L., Rotto, K., & Matthews, B. (1999). Preliminary evaluation findings from Indiana's DAWN Project. In: The 11th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 55–58). Tampa, FL: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

    Google Scholar 

  • Schoenwald, S.K., Ward, D.M., Henggeler, S.W., & Rowland, M.D. (2000). Multisystemic therapy versus hospitalization for crisis stabilization of youth: Placement outcomes 4 months postreferral. Mental Health Services Research, 2, 3–12.

    Google Scholar 

  • Schoenwald, S.K., Ward, D.M., Henggeler, S.W., Pickrel, S.G., & Patel, H. (1996). MST treatment of substance abusing or dependent adolescent offenders: Costs of reducing incarceration, inpatient, and residential placement. Journal of Child and Family Studies, 5, 431–444.

    Google Scholar 

  • Stroul, B. & Friedman, R. (1986). A System of Care for Severely Emotionally Disturbed Children and Youth. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

    Google Scholar 

  • Sutphen, R.D., Thyer, B.A., & Kurtz, P.D. (1995). Multisystemic treatment of high-risk juvenile offenders. International Journal of Offender Therapy and Comparative Criminology, 39, 329–334.

    Google Scholar 

  • Thomas, C.R. (1994). Island youth programs. Galveston, TX: University of Texas Medical Branch.

    Google Scholar 

  • VanDenBerg, J. & Grealish, M. (1996). Individualized services and supports through the wraparound process: Philosophy and procedures. Journal of Child and Family Studies, 5, 7–21.

    Google Scholar 

  • VanDenBerg, J. & Grealish, M. (1998). The wraparound process training manual. Pittsburgh, PA: The Community Partnerships Group.

    Google Scholar 

  • VanDenBerg, J. (1999). History of the wraparound process. In: B.J. Burns & S.K. Goldman (Eds.), Promising practices in wraparound for children with severe emotional disorders and their families (pp. 93–118). Rockville, MD: Center for Mental Health Services. Child, Adolescent, and Family Branch.

    Google Scholar 

  • Washington State Institute for Public Policy. (January, 1998).Watching the bottom line: cost-effective interventions for reducing crime in Washington: Preliminary technical report.

  • Yoe, J., Santarcangelo, S., Atkins, M., & Burchard, J. (1996). Wraparound care in Vermont: Program development, implementation, and evaluation of a statewide system of individualized services. Journal of Child and Family Studies, 5, 23–39.

    Google Scholar 

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Burns, B.J., Schoenwald, S.K., Burchard, J.D. et al. Comprehensive Community-Based Interventions for Youth with Severe Emotional Disorders: Multisystemic Therapy and the Wraparound Process. Journal of Child and Family Studies 9, 283–314 (2000). https://doi.org/10.1023/A:1026440406435

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