What is Wraparound?
Wraparound is a unique intervention that provides a comprehensive, holistic, youth and family-driven response to children and young people experiencing serious and complex behavioral health and other needs. In collaboration with natural supports and a team of professionals, the family’s vision and perspectives about their needs drive all the work in Wraparound.
Wraparound is the deliberate organization of services and supports developed in partnership with the child, youth, young adult and/or family being served. The care provided is managed by a dedicate care coordinator alongside the rest of the Wraparound team to ensure continuity across settings and to effectively facilitate access and delivery of needed social, behavioral, and somatic health care. Organizing care involves ongoing engagement, review, and adjustment of relevant providers, natural supports, and other resources to successfully align needs with services and supports.
The National Wraparound Initiative and the National Wraparound Implementation Center (NWIC) have developed a variety of resources designed to help families, researchers, practitioners, and policy makers understand Wraparound.
graph_5 Principles of Wraparound
auto_stories The Wraparound Process User’s Guide – A Handbook for Families
diversity_3 Consultation and Training
Why
Wraparound?
Wraparound began half a century ago as a response to siloed and expert-driven systems that resulted in poor outcomes for young people with serious behavioral health challenges, and their families.
Prior to Wraparound, the intensive services and supports that families needed were not available in most communities. The services that were available focused on what systems wanted families to do rather than on what young people and families needed to succeed and move forward in their lives.
Learn more about why
Traditional, siloed service delivery required families to be involved with multiple systems and providers, each with their own goals and plan. As a result, many children fell through the cracks and ended up placed in psychiatric facilities, foster care, and/or residential treatment far away from their families and communities, often for long periods of time. When children returned home, it was hard for them to reintegrate and do well in school and in their community. Wraparound is designed to provide comprehensive, preventive, and holistic care, keeping young people in their communities and producing better outcomes often at lower cost.
Wraparound
Outcomes
There is strong evidence that, when Wraparound is effectively implemented (i.e., with “fidelity”), young people with complex needs are more likely to stay in their homes and communities, or, should a crisis occur, to be in out-of-home placements only for short periods of time.
Young people receiving care through Wraparound tend to have better outcomes than young people with similar needs who are receiving other types of care, such as uncoordinated “services as usual” or institutional care.
Learn about outcomes
Positive outcomes for youth in Wraparound are observed across multiple areas of their lives including mental health and functioning in their homes, schools, and communities. Wraparound care coordination saves money by minimizing the time that young people spend in out-of-home facilities, such as residential treatment centers, psychiatric hospitals, or juvenile detention, which can cost thousands per day.
Further information is available about cost savings and fidelity. The National Wraparound Initiative works closely with the National Wraparound Implementation Center (NWIC), which provides training and consultation to states and communities seeking to implement Wraparound with fidelity.
What takes place
during the
Wraparound
process?
Wraparound takes place across four phases: engagement, initial plan development, implementation, and transition. During the Wraparound process, a team of people who are important to addressing the well-being and needs of the young person (e.g., family members, members of the family’s social support network, service providers, and agency representatives) work collaboratively to develop an individualized plan of care.
Learn about process
Together them implement this plan, monitor its efficacy, and work towards success over time. A hallmark of the Wraparound process is that it is driven by the perspectives of the young person and their family. The plan should reflect their goals and their ideas about what service and support strategies are most helpful to them. Wraparound plans typically include formal services–including research-based interventions as appropriate to meet youth and family needs–together with community services and interpersonal support from friends, kin, and other people drawn from the family’s social networks. After the initial plan is developed, the team meets regularly to monitor progress by measuring the plan’s components against the family’s indicators of success. If the relevant indicators of success are not being achieved, the Wraparound team can revise the plan components, interventions, and strategies.