Evidence Base for Wraparound 

Wraparound is now used as a strategy to coordinate care for youth with complex needs and their families by child serving systems in almost every U.S. state. Thus, it is imperative that the field has access to rigorous research to inform funding and policy decisions and support implementation of Wraparound and other service models for this population. 

Since 2005, UW WERT and its partners have been at the forefront of this research agenda. Below is a summary of selected peer-reviewed publications and what these research studies tell the field. You can also access a full bibliography of WERT’s published papers, or search for more resources at the website of the National Wraparound Initiative. 

Wraparound’s evidence base is strong and growing. 

• Results of a meta-analysis of 16 controlled studies show significant, positive effects across multiple outcome domains. 

  • Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 1353-1366, DOI: 10.1016/j.jaac.2021.02.022. (Read the blog post here) 

• A subsequent editorial by the Journal of the American Academy of Child and Adolescent Psychiatry concludes that Wraparound is “evidence-based” 

  • https://www.jaacap.org/article/S0890-8567(21)00369-5/abstract 

• A narrative review of Wraparound research from 2017 details what has been learned from over 200 published studies of Wraparound. The review found that approximately half these publications were research studies, and 22 compared outcomes for Wraparound to some other condition. 15 of these found more positive outcomes for Wraparound and none found more positive outcomes for the comparison group(s). 

  • Schurer Coldiron, J., Bruns, E.J. & Quick, H. A Comprehensive Review of Wraparound Care Coordination Research, 1986–2014. J Child Fam Stud 26, 1245–1265 (2017). https://doi.org/10.1007/s10826-016-0639-7 

• UW WERT also has documented the extensiveness and nature of Wraparound implementation across the United States via several published studies. The most recent was in 2013, indicating we badly need to conduct a new census! 

  • Sather, A., & Bruns, E. J. (2016). National trends in implementing wraparound: Results of the state wraparound survey, 2013. Journal of Child and Family Studies, 25(10), 3160–3172. https://doi.org/10.1007/s10826-016-0469-7 

• Outcomes of Wraparound are dependent on state approaches to financing and organizing its implementation. This article is one of several studies by UW WERT finding that using Care Management Entities (CMEs) as the locus of Wraparound implementation produces more positive results: https://www.cmhnetwork.org/wp-content/uploads/2021/04/GIRA-Wraparound-and-CMEs.pdf

• In these widely cited papers, research by UW WERT revealed state factors that influence implementation of evidence-based treatments (EBT) for youth and families. A previous paper documented that investment in EBT by states is declining. 

  • Bruns EJ, Parker EM, Hensley S, Pullmann MD, Benjamin PH, Lyon AR, Hoagwood KE. (2019). The role of the outer setting in implementation: associations between state demographic, fiscal, and policy factors and use of evidence-based treatments in mental healthcare. Implement Sci. 2019 Nov 13;14(1):96. doi: 10.1186/s13012-019-0944-9. PMID: 31722738; PMCID: PMC6854683. 

  • Bruns Kerns et al 2016 [ref / link] 

• A randomized study found that an Electronic Health Record (EHR) for Wraparound is feasible and acceptable to its users, and can promote better use of fidelity and outcomes data 

  • Bruns, E. J., Hook, A. N., Parker, E. M., Esposito, I., & Sather, A. (2018). Impact of a Web-Based Electronic Health Record on Behavioral Health Service Delivery for Children and Adolescents: Randomized Controlled Trial. J Med Internet Res, 20(6), e10197. 

• Because youth and families enrolled in Wraparound must have access to a robust array of effective community-based services, we also are invested in improving these practice models. One example is our project to define program and practice standards for Intensive In-Home Treatment. 

  • Manuscript: Defining Quality Standards for Intensive Home Based Treatment Programs for Youth with Serious Emotional Disorders - PubMed (nih.gov) 

• UW WERT is part of the National Wraparound Implementation Center (NWIC), Innovations Institute at UConn, and the UW SMART Center. All provide training, coaching and technical assistance (TA) for Wraparound and behavioral health systems of care. In our quest to be research-based, we have conducted several studies of the impacts of training and TA, so we can apply those findings to our work: 

  • Olson JR, Coldiron JS, Parigoris RM, Zabel MD, Matarese M, Bruns EJ. Developing an Evidence-Based Technical Assistance Model: a Process Evaluation of the National Training and Technical Assistance Center for Child, Youth, and Family Mental Health. J Behav Health Serv Res. 2020 Jul;47(3):312-330. doi: 10.1007/s11414-020-09686-5. PMID: 31974705; PMCID: PMC7324420. 

  • Olson, J. R., Lucy, M., Kellogg, M. A., Schmitz, K., Berntson, T., Stuber, J., & Bruns, E. J. (2021). What Happens When Training Goes Virtual? Adapting Training and Technical Assistance for the School Mental Health Workforce in Response to COVID-19. School Mental Health, 13(1), 160-173.