The Community Supports for Wraparound Inventory: An Assessment of the Implementation Context for Wraparound

Abstract

The wraparound process has emerged as perhaps the most frequently implemented comprehensive approach for planning and providing individualized, community-based care for children and adolescents with serious mental health conditions. Providing comprehensive care through the wraparound process necessarily requires a high level of collaboration across organization and agency boundaries. This need for significant inter-agency or ''system-level'' collaboration creates a complex implementation environment for wraparound. It is therefore not surprising that creating and sustaining a hospitable implementation environment has proven to be extremely challenging. For the people who are responsible for managing the inter-organizational collaboration, it is not easy to evaluate the adequacy of local system-level support for wraparound and to see exactly what kinds of supports are lacking or where system-development efforts should focus. Furthermore, as system-development strategies are put into practice, it can be difficult to assess whether or not meaningful progress is occurring. The Community Supports for Wraparound Inventory (CSWI) was developed to respond to the need for an assessment of the extent to which a community has developed system-level capacity to implement wraparound. This article reports on a study that evaluated the reliability and validity of the CSWI for use in communities implementing wraparound. Findings indicate that the CSWI shows promise as a reliable, valid and useful tool.

Effectiveness of Wraparound Versus Case Management for Children and Adolescents: Results of a Randomized Study

“…Among the key “necessary conditions” for successful wraparound implementation, availability of services and supports is viewed as particularly critical (Bruns, Walker, et al, 2010; Walker et al, 2008; Walker & Sanders, 2011). The ICM group was served by case managers, some of whom could also function as therapists, who functioned within a private mental health provider organization.…”

“…The Community Supports for Wraparound Inventory (CSWI) (Walker & Sanders, 2011) is a 42-item web-based key informant survey that evaluates the presence or absence of system support for wraparound in six areas (community partnership, collaborative action, fiscal supports, service array, human resource support, and accountability). For each item (e.g., “There is centralized monitoring of relevant outcomes for children, youth, and families in wraparound”), respondents rate system development on a 0 (“system is not at all developed”) to 4 (“fully developed”) scale, with item-specific anchor descriptions provided for each end of the scale.…”

“…The CSWI produces scores in each domain and a total score. Internal consistency ranges from α = .94 to α = .96 across the six domains and inter-rater reliability ICC = .78 (Walker & Sanders, 2011). Evidence for CSWI validity is found in an exploratory factor analysis that corresponded to the six domains and significant correlation with other established system assessments (Walker & Sanders, 2011).…”

“…In recent years, concerns about the “black box” of wraparound have led to efforts to better specify the wraparound practice model (Burns & Goldman, 1999; Walker & Bruns, 2006), provide more consistent training and implementation supports (Walker & Matarese, 2011), and develop and deploy fidelity measures (Bruns, Burchard, Suter, Leverentz-Brady, & Force, 2004; Bruns, Leverentz-Brady, & Suter, 2008; Bruns, Suter, Force, & Burchard, 2005; Walker & Sanders, 2011). The evidence base for wraparound has also grown, with 10 controlled studies now published in peer reviewed journals (Bickman, Smith, Lambert, & Andrade, 2003; Bruns, Rast, Peterson, Walker, & Bosworth, 2006; Carney & Buttell, 2003; Clark, Lee, Prange, & McDonald, 1996; Evans, Armstrong, Kuppinger, Huz, & McNulty, 1998; Grimes et al, 2011; Hyde, Burchard, & Woodworth, 1996; Mears, Yaffe, & Harris, 2009; Pullmann et al, 2006; Rauso, Ly, Lee, & Jarosz, 2009).…”

Connecting the Dots: Stages of Implementation, Wraparound Fidelity and Youth Outcomes

“…For example, Walker et al (2003) identified several necessary conditions to support the implementation of high-quality individualized planning, such as wraparound, at the system, organization and team levels. Studies examining the relationship between these necessary conditions and wraparound fidelity and/or outcomes are only just emerging (Bruns et al 2006;Stephens et al 2004;Walker and Sanders 2010). Understanding these relationships is essential to reforming child-serving systems to effectively address the needs of youth and families (Bruns et al 2006).…”