*The following information is taken from National Wraparound Initiative (NWI) website. Visit the NWI website for more information on Wraparound as a service model and the system and organizational requirements for implementing Wraparound and other care coordination models.
What is Wraparound?
Wraparound differs from many service delivery strategies, in that it provides a comprehensive, holistic, youth and family-driven way of responding when children or youth experience serious mental health or behavioral challenges. Wraparound puts the child or youth and family at the center. With support from a team of professionals and natural supports, the family’s ideas and perspectives about what they need and what will be helpful drive all of the work in Wraparound.
The young person and their family members work with a Wraparound care coordinator to build their Wraparound team, which can include the family’s friends and people from the wider community, as well as providers of services and supports.
With the help of the team, the family and young person take the lead in developing their family’s vision for the future and identifying the priority needs to be met. The family and team then work to develop an individualized plan for services and supports that will help them meet their needs and achieve their vision. Team members work together to put the plan into action, monitor how well it’s working, and change it as needed.
Wraparound Components
Wraparound is commonly described as taking place across four phases of effort: Engagement and team preparation, Initial plan development, Implementation, and Transition. During the Wraparound process, a team of people who are relevant to the life of the child or youth (e.g., family members, members of the family’s social support network, service providers, and agency representatives) collaboratively develop an individualized plan of care, implement this plan, monitor the efficacy of the plan, and work towards success over time. A hallmark of the Wraparound process is that it is driven by the perspectives of the family and the child or youth. The plan should reflect their goals and their ideas about what sorts of service and support strategies are most likely to be helpful to them in reaching their goals. The Wraparound plan typically includes formal services – including research-based interventions as appropriate to build skills and meet youth and family needs – together with community services and interpersonal support and assistance provided by friends, kin, and other people drawn from the family’s social networks. After the initial plan is developed, the team continues to meet often enough to monitor progress, which it does by measuring the plan’s components against the indicators of success selected by the team. Plan components, interventions and strategies are revised when the team determines that they are not working, i.e., when the relevant indicators of success are not being achieved.
Wraparound Implementation Requirements
High quality implementation of Wraparound requires a supportive organizational context as well as a hospitable system context. A supportive organization ensures that a variety of conditions are in place to support high quality practice. For example, ensuring that staff acquire the skills and competencies they need to carry out their roles in Wraparound; ensuring that caseloads are reasonable and compensation is adequate; and ensuring that data is collected and analyzed so that the organization can monitor practice quality and program outcomes.
Providing comprehensive care through the Wraparound process also requires a high degree of collaboration and coordination among the child- and family-serving agencies and organizations that make up the system context of a Wraparound program. These agencies and organizations need to work together to provide access to flexible resources and a well-developed array of services and supports in the community. In addition other community- or system-level supports are necessary for Wraparound to be successfully implemented and sustained. Research on Wraparound implementation has defined these essential community and system supports for Wraparound, and grouped them into six themes:
Community partnership
Collaborative action
Fiscal policies and sustainability
Access to needed supports and services
Human resource development and support
Accountability
For more detail on implementation, see NWI resources, including the Implementation and Practice Quality Standards and the Implementation Guide. Contact the National Wraparound Implementation Center (NWIC) for assistance with your implementation questions.
Staff Training & Support
Wraparound is a complex process involving many different skill sets. People with key roles for carrying out the Wraparound process therefore require substantial training, as well as ongoing coaching and supervision, to ensure that they have the knowledge and skills they need. Not only do Wraparound facilitators (or care coordinators) and parent and youth support partners require training and coaching to criteria for skillful practice, but also providers in the service array need to be trained and supported to use evidence-based strategies and interventions. Most Wraparound projects, at least in their early stages of development, rely to some extent on outside people for training and for consultation on how to set up ongoing procedures for staff development and quality assurance. Finding a consultant or trainer has not always been easy, however, since Wraparound is not a proprietary model. To address this issue, the NWI launched the National Wraparound Implementation Center (NWIC), which provides training, coaching, and a method that facilitates development of local expertise and sustainability. Regardless of who provides Wraparound training and staff skill development, the NWI urges sites and states to follow the guidance described in its comprehensive Guidelines for Training, Coaching and Supervision for Wraparound Facilitators.
