No abstract

Wraparound is a family-driven, youth guided, team-based process for planning and implementing services and supports (Miles et al. 2006). The National Wraparound Initiative (NWI) has identified ten elements of wraparound (i.e., family voice and choice, team based, natural supports, collaborative, community based, culturally competent, individualized, strengths based, persistence and outcomes based) and four phases through which teams consisting of the identified youth, his/her parents or caregivers, family members, community members, mental health professionals, and others are expected to move as they develop and implement a single plan of care. The plan of care includes the services and supports necessary to build on the strengths of the youth and his/her family and addresses the complex needs of the youth involved in the wraparound process.Emerging evidence supports the effectiveness of wraparound for youth who have needs in multiple life domains (e.g., home, school and community). Nine controlled studies of wraparound (see Bruns and Suter 2010;Suter and Bruns 2009) found improved outcomes for youth in wraparound compared to similar youth in other programs, with effect sizes similar to those found in studies of other evidence based interventions implemented in real world practice (Suter and Bruns 2009). However, only one of the nine studies considered the relationship between wraparound fidelity and outcomes (Bruns et al. 2006). Research on other evidencebased practices has repeatedly found that fidelity to the practice model is vital to outcomes (e.g., Henggeler et al. 1997;McGrew et al. 1994;Walton 2006). Additional research on wraparound that includes a measure of fidelity as well as further research on the factors that predict successful outcomes for youth involved in the wraparound process are needed Cox et al. 2010

troul and Friedman (1986) defined a system of care as "a comprehensive spectrum of mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of children and families." During the past 2 decades, the system of care movement has brought about the creation of a variety of innovative approaches to service provision for young people involved in multiple child-serving systems (e.g., mental health, child welfare, juvenile justice, education) and their families. These reform efforts, which are designed to overcome the traditionally fragmented nature of the children's mental heath system (U.S. Department of Health and Human Services [USDHHS], 1999), have initiated political, philosophical, and practical transformations in services provision that are child and family focused, community based, and culturally competent (Stroul & Friedman, 1986). A primary goal of systems of care is to establish mechanisms for circumventing his-torical barriers to interagency collaboration, such as separate funding streams and often competing agency mandates, so that partnerships can be created both across systems and among families and professionals (Handron, Dosser, McCammon, & Powell, 1998). The objective is that children's educational, social, and therapeutic services, along with informal family and community supports, will be organized and coordinated to better meet the multiple and complex needs of children with multisystem needs and their families (Stroul & Friedman, 1986).While the system of care concept continues to gain in popularity, research and evaluation findings from studies of these approaches also are beginning to emerge (e.g.