- What is Wraparound?
- What are the benefits of wraparound over traditional services?
- How is Texas implementing wraparound?
- Where can I find out more?
- Letters of Support for Wraparound Planning and System of Care Expansion from the Texas Department of State Health Services and the Texas Juvenile Justice Department: Texas child-serving systems share the goal for children and families with mental health challenges to have access to an array of effective services and supports to remain in their communities. This involves the commitment of the Department of State health Services and the Texas Juvenile Justice Department. Texas has committed to strengthening local and state systems through a System of Care framework. This document provides background information on efforts to develop system of care communities, new efforts to implement high-fidelity wraparound planning, and how local communities can support these activities.
What is Wraparound?
The wraparound practice model is a promising approach targeting children, youth, and families with severe emotional or behavioral needs. Based in an ecological model, wraparound draws upon the strengths and resources of a committed group of family, friends, professionals, and community members. Wraparound mobilizes resources and talents from a variety of sources resulting in the creation of a plan of care that is the best fit between the family vision and story, team mission, strengths, needs, and strategies. During the wraparound process, the youth and family team works collaboratively, utilizing the strengths of the youth and their family, to develop an individualized plan of care for the youth and caregivers. The team meets over time to implement this plan, monitor its effectiveness and work towards success. Providing comprehensive care through the wraparound process requires a high degree of collaboration and coordination among the child- and family-serving agencies and organizations in a community. The values of wraparound are aligned with the system of care framework.
User’s Guide to Wraparound (PDF).
Manual de Usuario del Proceso del Wraparound (Asistencia Integral): Una Guía para Familias (PDF)(Spanish Version of The Wraparound Process User’s Guide).
What are the benefits of wraparound over traditional services?
Unlike traditional treatment planning, wraparound achieves positive outcomes by prioritizing youth and family voice and choice. This means identifying the goals that are most important to the family, building upon the strengths of each family member and the people important in their lives, and using outcomes to guide the need for changes to the plan. Wraparound aims to build the problem-solving skills, coping skills, and self-efficacy of the youth and family members. Wraparound seeks to ensure that families have the community supports they may need when more formal supports and services end.
Wraparound has been implemented throughout the United States and internationally because it works. Adoption of wraparound has been shown to reduce costly hospital and residential care, improve youth functioning, reduce emotional and behavioral problems, and result in greater community adjustment. For more on the effectiveness of wraparound, review this meta-analysis describing the results of seven randomized controlled studies.
Texas System of Care has partnered with the Texas Department of State Health Services (DSHS), the Texas Institute of Excellence in Mental Health at the University of Texas at Austin, the Institute for Innovation and Implementation at the University of Maryland, School of Social Work, and the Department of Psychiatry and Behavioral Science at the University of Washington School of Medicine. The Innovations Institute is the implementation arm of the National Wraparound Initiative (NWI), which has successfully sustained statewide implementation in Maryland and supported several other states in implementation planning and workforce development. The University of Washington’s School of Medicine is the research and evaluation arm of NWI and is providing support for the evaluation portion of the state’s efforts.
Training in wraparound consists of a series of four trainings:
Introduction to Wraparound
First training of the series for frontline wraparound practitioners, supervisors, and directors as well as community partners who may participate in a child and family team process. Through attendance at this training, participants will be able to:
- Gain an understanding of the critical components of the wraparound process in order to provide high fidelity wraparound practice
- Practice these steps of the process to include eliciting the family story from multiple perspectives, reframing the family story from a strengths perspective, identifying functional strengths, developing vision statements, team missions, identifying needs, establishing outcomes, brainstorming strategies, and creating a plan of care and crisis plan that represents the work of the team and learn basic facilitation skills for running a wraparound team meeting.
Engagement in the Wraparound Process
Second training in the series for frontline wraparound practitioners, supervisors, and directors as well as community partners who may participate in a child and family team process. Through attendance at this training, participants will be able to:
- Identify barriers to engagement
- Develop skills around engaging team members and the family
- Utilize research-based strategies of engagement for increased positive outcomes for youth and their families
Intermediate Wraparound Practice—Improving Wraparound Practice
Third training in the series for frontline wraparound practitioners, supervisors, and directors to enhance their skills and move toward higher quality practice. Common implementation challenges are addressed in this training; however, topics can be adjusted based on individual, organizational, or state need. Through attendance at this training, participants will be able to:
- Practice and utilize tools in telling and reframing the family story
- Pull out specific and individualized functional strengths for use in the planning process Identify underlying needs of the youth and caregiver
- Practice developing outcome statements and strategies that tie back to the reason for referral and address underlying needs moving the family closer to attaining their vision
Advanced Wraparound Practice—Supervision in Wraparound: Managing to Quality
Provided for supervisors/managers in wraparound. Through attendance at this training, participants will be able to:
- Identify the essential elements of quality wraparound implementation
- Develop an increased understanding of the role of the supervisor in quality wraparound implementation
- Learn how to manage quality throughout the phases of wraparound implementation
- Learn how to utilize supportive tools to develop quality wraparound practitioners, individualized and strength-based service plans, and team processes
- Learn how to transfer knowledge and skills to the workforce
Conducted by national trainers from the Innovations Institute, the trainings include lecture presentations, demonstrations and skill-based practice sessions with each incrementally building upon the earlier training.
Intensive Case Management (ICM) is the reimbursement structure prescribed in the Texas Administrative Code (TAC) to be used by the public mental health system for the provision of services within LOC 4 which must include Wraparound service planning. Intensive Case Management (ICM) is defined in the TAC as “A focused effort to coordinate community resources that assist a child or adolescent in gaining access to necessary care and services appropriate to the child’s or adolescent’s needs.” Informational slides are available here (Download PDF) that map wraparound planning activities to appropriate case management services and provide guidance related to the mental health case management standards within the public mental health system.
The web-based wraparound training series is intended to provide participants with a broad overview of wraparound. Participants can earn continuing education hours. Take a look at the training webcasts that are now available.
back to top
For more information on wraparound, visit the website of the National Wraparound Initiative.
For more information on implementation within Texas, contact us at email@example.com.
The Implementation Guide is designed to provide a “road map” for this in program and system oversight roles for wraparound, to help keep them focused on the range of important issues in overseeing effective wraparound practice.
The User’s Guide was created to serve as a “road map” for family members. It can be used to make sure families are on the right path, and to make sure the process follows closely to the principles and activities of wraparound. The guide includes information on the wraparound process including descriptions of the 4 phases, as well as notes on how to work through common problems that occur in each phase.
The Resource Guide is a collection of articles, tools, and resources that represent the expertise, experience, and shared work of the members of the National Wraparound Initiative. Within the guide there are a variety of different types of contributions, including:
- Central products from the National Wraparound Initiative, including descriptions of the wraparound principles and practice model;
- Examples of how different communities and programs have implemented wraparound and supported its implementation;
- Stories from youth, families, and communities;
- Review articles about the theory and effectiveness of wraparound; and
- Appendices containing tools and resources that can be used in everyday practice.