Wraparound is a team-based planning process intended to provide individualized, coordinated, family-driven care to meet the complex needs of children, youth and families who are involved with various child and family serving systems who are at risk of placement in institutional settings, and who may experience emotional, behavioral, safety, or mental health difficulties. The wraparound process brings families, providers, and key members of the family’s social support network together to collaborate to build a customized plan of care that responds to the unique needs of the child and family. By bringing people together from different parts of the family’s life, the family team drafts a plan of care driven by the youth and family that include the family vision, strengths and needs, with the goal of keeping the family together, safe and in the community or least restrictive setting possible. Team members then implement the plan and continue to meet regularly to monitor progress and tailor the plan to meet the changing needs of the family.
Wraparound follows a series of steps to strengthen and support families and help them realize their hopes and dreams. With assistance of facilitators, often referred to as Care Coordinators, along with parent professionals, often referred to as Family Partners, the team works together toward a unified vision and creation of a plan of care.
Wraparound is driven by 10 principles.
- Family Voice and Choice
- Natural Supports
- Unconditional Care
- Culturally Competent
In the spirit of the popular belief, “It takes a village to raise a child,” Wraparound is an intervention strategy in which families are supported and encouraged toward their goals through the joint efforts of the people who are professionally or socially involved in their lives. The wraparound model is based on individualized, needs driven planning and services. It is not a program or a type of service. It is a value base and an unconditional commitment to create services on a “one kid, one family at a time” basis to support normalized and inclusive options for youth and families with complex needs.
Wraparound is not something that you “get”, it’s something you “do”; it’s a process, not a program or a service. These fundamental principles merge with a “whatever it takes” philosophy that embodies an unconditional commitment to team development, family empowerment and outcome based interventions.
Many times children and their families have needs that cross over agency boundaries. Therefore, interagency coordination is an integral part of the Wraparound planning process. It is essential that all services are developed cooperatively and become integrated into the Care Planning process.
A wraparound team shares responsibility, expertise, ownership and mutual support while designing creative services intended to meet an individual’s strengths and needs across all domains of life. Historically, families’ needs had to fit into categorical “one size fits all” types of available services. In wraparound planning, the needs of the family drive the services.
A Wraparound Plan is continually reviewed and modified based on the child and family’s developing strengths and evolving needs. Wraparound interventions are flexible non-categorical services and supports because the approach is multi-faceted, taking all aspects of the child and family history and current life situation into account.
Families, who are referred to Family Team Conferencing (FTC)/Care Planning, benefit from services that are carved out to meet their specific needs. These supports and services are non-categorical, community based and allocated by frequency and duration based upon team consensus.
A person functioning in the role of Wraparound Facilitator/ Care Coordinator guides team development and oversees the process and tasks of the team in order to develop a comprehensive plan of care. While this may sound similar to case management, it is different in that a facilitator works within a team structure that guides collaboration and consensus decision-making as a collective body ensuring youth and family voice and choice throughout the process. Different individuals may assume the role of facilitator, depending on the child/family circumstances. Likewise, the facilitator or team members may take on some functions of case management. The person in this role facilitates the development of a child and family team and plan, insuring the presence of mutual respect, teamwork, shared responsibility, and decision making, which is youth and family driven.
Child/Family Teams – Commonly Asked Questions:
- Who’s on the team? Simply stated, the team consists of the parent(s), the child(ren), (if appropriate), and 4-8 people who know the family best. Ideally, the team should include a mix of natural supports in addition to professionals. There is a 51% rule whereby the majority of the team should consist of natural supports that will remain as a support network to the family to sustain them beyond exit.
- Who determines who’s on the team? The facilitator works with the family to determine who knows them best and who is most likely to help the family meet their needs.
- Where does the team meet? Wherever it is most comfortable for the family.
- How often does the team meet? FTC’s are scheduled based upon acuity and level of need of the family at any time throughout the process. After a plan is put together, the meeting may drop to monthly and eventually maybe only quarterly. There is no set answer to this question; it really depends on the needs of the family.
- What does the team do? The team develops and implements an individualized plan to help the family meet their goals and needs. The process they use will be adherent to the Wraparound Philosophy guided by the Wraparound principles.
- What happens if the plan isn’t working? Wraparound is a blame-free process. Consequently, if the family isn’t experiencing progress, the plan isn’t working and needs to be revisited and the team reconvened.
Research has shown that positive outcomes for families involved in Wraparound directly correspond with the degree to which the team is adhering to the fidelity of the Wraparound Process. High Fidelity Wraparound refers to the degree in which the process is followed in relation to national standards.
Wraparound fidelity became a focus and area of interest of researchers and early adopters as the use of wraparound was becoming more common place in the human services sector.
The emphasis moved from a focus on quality to include fidelity. Hybrid models were surfacing while the practice was advancing significantly and there was no uniform tool or standardized way to validate fidelity or adherence to the principles of practice.
Measuring fidelity was established as a means for determining the degree to which a program or agency utilizing Wraparound Family Teams were actually adhering to the principles of practice to ascertain if positive outcomes were associated with adherence to the model. Early research resulted in evidence that supported the creation of standards to establish and measure adherence as a means to achieve positive outcomes.
The use of a Wraparound Fidelity tool is critical for ongoing monitoring of practice and to:
- Use as a coaching and mentoring tool for staff
- To focus on areas of the system that require training and strategies to promote adherence and;
- To ensure adherence to the principles of practice as there is a direct correlation to more positive outcomes for youth and families when Wraparound is practiced with fidelity
- Families with higher fidelity scores show more favorable outcomes.
- Wraparound programs with higher fidelity scores achieve better outcomes.
- Training and coaching in areas of needed improvement increases fidelity.