A Comparison of School-Based and Community-Based Adherence to Wraparound during Family Planning Meetings

Abstract A number of recent studies have begun to examine how the wraparound approach is adhered to during family planning meetings in community-based settings. However, no studies have compared wraparound family planning meetings across community-based and school-based settings. The purpose of this study was to examine adherence to the wraparound process during family planning meetings across these two settings to determine if there is a difference in the participants, domains discussed, and key characteristics of wraparound. Over the course of 9 months, observations were conducted during community-based (N = 85) and school-based (N = 109) wraparound family planning meetings. Results indicate a number of similarities and a few differences between the settings. Implications, limitations, and suggestions for future research are discussed. ********** Children and youth with emotional and behavioral disorders (EBD) evidence a range of behaviors that adversely affect their educational performance and cannot be explained by intellectual, sensory, or other health factors (Individuals with Disabilities Education Act, 1997). These behaviors can include a number of internalizing and externalizing characteristics that inhibit their ability to build and maintain successful social relationships with peers, teachers, and adults. Historically, educational programs for these students have not been associated with positive outcomes (Kauffman, 2001). When compared to other disability groups, students with EBD have lower reading and math scores, lower rates of graduation, and are less likely to attend post-secondary school (Kauffman, 2001). As a result, youth with EBD traditionally experience problems in education and employment, and over half will be arrested at least once within 3 to 5 years of leaving high school (Wagner & Blackorby, 1996). A national study of school programs demonstrated that a lack of appropriate services, inadequate coordination and integration with service agencies, and limited support for families contributed to these poor outcomes (Knitzer, Steinber, & Fleisch, 1990). Historically, therapeutic and support services for children with EBD and their families have been supplied by a variety of agencies including mental health, child welfare, and juvenile justice agencies (Knitzer, 1982). Over the last two decades there has been increasing recognition that these services have been inadequate, fragmented, and increasingly reliant on institutional care (Knitzer, 1982; U.S. Department of Health and Human Services, 1999). In response to the lack of individualized and coordinated services for children with EBD and their families, the wraparound approach was developed to provide services within a system of care. A system of care is a framework for providing a comprehensive array of mental health and related services that are organized into a coordinated network to meet the needs of children and youth with EBD and their families (Stroul & Friedman, 1996). Within the system of care framework, wraparound has evolved as an approach for delivering individualized services to children with EBD and their families (Lourie, Katz-Leavy, and Stroul, 1996). Wraparound has been defined as "a philosophy of care that includes a definable planning process involving the child and family that results in a unique set of community services and natural supports individualized for that child and family to achieve a positive set of outcomes" (Goldman, 1999, p. 29). There are 10 key characteristics of the wraparound approach: (a) services and supports must be community-based; (b) services and supports should be individualized, strength-based, and address the needs of children and families across multiple life domains; (c) the approach must be culturally competent and focus on the unique values, strengths, and social and racial make-up of the families; (d) families must be viewed as full and active partners in the approach; (e) the approach must be a team-driven process where the team works together to develop, implement, and evaluate the plan of care; (f) wraparound agencies must have access to flexible, non-categorized funding; (g) wraparound plans must include a balance of formal and informal supports; (h) communities, agencies, and teams must provide services on an unconditional basis; (i) treatment plans should be developed and implemented on an interagency basis; and (j) outcomes must be identified and measured for the child and family at every level of service (Burns & Goldman, 1999). …