Orientation to Wraparound 9 27 11 by mw3R6a

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									ORIENTATION TO WRAPAROUND –
 A Model for Supporting Children
       and their Families



                    Chris Tiefenbrunn
                            &
                      LuAnn Reese

                     September 2011
       What is Wraparound?
A collaborative, team-based approach to service
 and support planning

Evolved out of practice in field that led to
 research

Defined process with tools and fidelity
 monitoring
   Wraparound is NOT….

 Treatment
 Program
 Service
 Therapy
 A funding pool
             History of Wraparound

 Early - Wraparound started by focusing on children, youth and
  families with complex needs
 Today - Wraparound is being implemented in a variety of
  fields including child welfare, juvenile justice, mental health,
  education and adult re-entry
 Simultaneously similar approaches were/are being developed
  in other fields
   – Person Centered Planning (developmental disabilities)
   – Family Group Decision Making (child welfare)
   – Individualized Education Plans (education)
     History of Wraparound (cont.)

Early Efforts
   Focused on normalization and support from community
    members to keep individuals with complex needs in the
    community as well as needs-based individualized services
    that were unconditional

   Early 1980’s – Dr. Lenore Behar coined term “Wraparound”

   CASSP teams and federal System of Care sites (SAMHSA
    funded)
National Wraparound Initiative (NWI)

2004 – Stakeholders came together in collaborative effort to:
  1.   Better define the Wraparound practice model
  2.   Compile specific strategies and tools
  3.   Disseminate information about how to implement Wraparound in a
       manner that achieves positive outcomes for youth and families

 Includes families, youth, providers, researchers, trainers,
  administrators from a variety of fields

 Nationally recognized by SAMHSA as setting the standards for
  Wraparound
  National Wraparound Initiative
             (NWI)

Four functions

  1. Supporting community-level planning and
     implementation
  2. Promoting professional development of
     wraparound staff
  3. Ensuring accountability
  4. Sustaining a more vibrant and interactive
     national community of practice
         Wraparound has…
10 Principles
4 Phases with defined activities
Skill sets
Theory of Change
Fidelity monitoring
  Ten Principles of Wraparound

1. Family Voice and Choice   6. Culturally competent

2. Team Based                7. Individualized

3. Natural Supports          8. Strengths based

4. Collaboration             9. Unconditional

5. Community-based           10. Outcome based
     Phases of Wraparound
Phases
1. Engagement and Team preparation
2. Initial Plan Development
3. Implementation
4. Transition

   Includes defined activities and skill sets for each
    phase
      Key Roles In Wraparound

           WRAPAROUND                    EDUCATIONAL SETTING




Wraparound Facilitator


Family Support Provider/Parent Partner


Wraparound Coach


Wraparound Trainer
      The Theory of Change
Is why we do wraparound

Is why wraparound works

Is what differentiates wraparound from other
 service coordination processes

Defines expectations for what we hope to
 accomplish through wraparound
Theory of Change for Wraparound
        Why Does Wraparound Work?

                      Self                     Wraparound
                                              addresses the
                 Efficacy
                  NEEDS                       priority needs
                                            identified by the
                                            youth and family
                   Efficacy
                    Natural
                    Support
                    System

               Integrated Plan




            Credited to: Vroon VanDenBerg
       Theory of Change for Wraparound
                     Why Does Wraparound Work?

   Wraparound                       Self
strengthens youth
   and families                Efficacy
                                NEEDS
 confidence that
 they can create
positive change in               Efficacy
    their lives
                                  Natural
                                  Support
                                  System

                             Integrated Plan




                          Credited to: Vroon VanDenBerg
Theory of Change for Wraparound
        Why Does Wraparound Work?

                       Self                     Wraparound
                                              strengthens the
                  Efficacy                     social support
                   NEEDS                     system that helps
                                               the youth and
                    Efficacy                   family succeed

                     Natural
                     Support
                     System

                Integrated Plan




             Credited to: Vroon VanDenBerg
Theory of Change for Wraparound
        Why Does Wraparound Work?

                       Self
                                               Wraparound
                  Efficacy
                   NEEDS
                                               creates an
                                             integrated and
                                             simplified plan
                    Efficacy                  for the whole
                                                  family
                     Natural
                     Support
                     System

                Integrated Plan




             Credited to: Vroon VanDenBerg
                   Research
AS of 2008 – 36 published outcome studies
2009 - Meta-analytic review of 7 studies
   Living situation    -- Youth behavior
   Youth functioning   -- Youth community adjustment

As of 2010 - 9 controlled published studies
Currently being reviewed for inclusion in the
 SAMHSA National Registry of Evidence-based
 Programs and Practices (NREPP)
     Behavioral Outcomes
EDUCATION

  Improved school GPA

  Missed less school

  Less likely to be suspended from school

  Fewer disciplinary actions
      Behavioral Outcomes

DAILY FUNCTIONING

  Improved overall functioning on CAFAS

  Fewer emotional and behavioral problems on
   CBCL

  Improved moods/emotions on CAFAS
   Behavioral Outcomes(cont.)

LIVING ENVIRONMENT

  Fewer out-of-home placements

  More stable living environment

  Residing in less restrictive placements

  Ran away less
   Behavioral Outcomes(cont.)
LEGAL

  Less assaultive

  Less likely to be picked up by police

  Less likely to serve detention

  Reduced recidivism for any offense
          Monitoring Fidelity

Wraparound Fidelity Index (WFI), version 4.0

Measures the nature of the Wraparound process
 that an individual family receives

Conformance to the Wraparound practice model

Adherence to the principles of Wraparound in
 service delivery
 Wraparound Fidelity Index (cont.)

40 items are organized by the 4 phases

4 questions about each 10 principles

Set of four interviews

Caregivers, youth, wraparound facilitators and
 team members
Participating in Wraparound

Levels of Involvement

  Expert temporary team member

  On-going team member

  Implement within school/district –
   PBIS Tier 3
                                              Intensive Interventions
   School-Wide                                      Specialized
 Positive Behavior                                Individualized
                                             Systems for Students with
                                ~5%
      Support                                  High-Risk Behavior


                                                Targeted Interventions
                                                  Specialized Group
                                               Systems for Students with
Universal Interventions        ~15%                At-Risk Behavior
 School-/Classroom-
  Wide Systems for
     All Students,
   Staff, & Settings




                          ~80% of Students                  Illinois PBIS Network,
     Positive Behavior Interventions & Supports:
       A Response to Intervention (RtI) Model

                                            Tier 1/Universal
                                       School-Wide Assessment
                                    School-Wide Prevention Systems


                                                   Tier 2/
    ODRs,                                                                                        Check-in/ Check-
  Attendance,                                                                                   out
Tardies, Grades,
     DIBELS, etc.
                                                 Secondary
                                                                                      Social/Academic
       Daily Progress                                                                Instructional Groups
         Report (DPR)
              (Behavior and                                                  Individualized Check-
                Academic Goals)                        Tier 3/               In/Check-Out, Groups &
                                                                             Mentoring (ex. CnC)
          Competing Behavior                          Tertiary
           Pathway, Functional                                       Brief Functional Behavioral Assessment/
            Assessment Interview,                                    Behavior Intervention Planning (FBA/BIP)
                  Scatter Plots, etc.
                                                                 Complex FBA/BIP
                                  SIMEO Tools:
                                  HSC-T, RD-T, EI-T          Wraparound   Illinois PBIS Network, Revised Aug.,2009
                                                                          Adapted from T. Scott, 2004
                  3-Tiered System of Support
              Necessary Conversations (Teams)
Universal       Secondary          Problem Solving          Tertiary Systems
 Team          Systems Team             Team                      Team
              Uses Process data;                             Uses Process data;
 Plans SW &                        Standing team; uses       determines overall
 Class-wide   determines overall   FBA/BIP process for
                 intervention                                   intervention
  supports                         one youth at a time         effectiveness
                effectiveness




Universal        CICO
Support                                Brief
                  SAIG                                   Complex          WRAP
                                       FBA/
                                        BIP              FBA/BIP
                Mentoring
                 /CnC

                 Brief
                FBA/BIP                                       Illinois PBIS Network,
A defined strength based process that identifies
 needs and develops a comprehensive plan
Complements existing array of interventions
Provides mechanism for working with children
 with more complex needs
Development of additional external resources
Promotes collaborative community network
            Resources

LuAnn Reese - Coordinator, Statewide Family Support
    LuAnn.Reese@dmh.mo.gov

Chris Tiefenbrunn – Wraparound Consultant
    Chris.Tiefenbrunn@dmh.mo.gov


National Wraparound Initiative
    http://www.nwi.pdx.edu/

 Illinois PBIS Network
    http://www.pbisillinois.org/

								
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