The role of individualized care in a service delivery system for children and adolescents with severely maladjusted behavior

Abstract

Individualized care is a total system of care that is tailored to a child with severely maladjusted behavior. The services are unconditional, flexible, child and family focused, and interagency coordinated. The services follow the child until the child is adjusting in a normalized, mainstream environment. Individualized care is illustrated through two different projects. One is the Alaska Youth Initiative where individualized care was used to return children from out-of-state, residential programs. The other is Project Wraparound where it was used to prevent children from being removed from their families. This paper begins with the principles of individualized care and then describes the ecological, multilevel assessment process that coincides with the delivery of services. A case example from Project Wraparound is provided for clarification. Following the case example is a discussion of the need for evaluation data with some suggested strategies for documenting effectiveness. The final section focuses on two barriers to the implementation of individualized care. One is the tendency to think in terms of component programs rather than individualized services. The other barrier is the competition for scarce resources. Strategies are presented for overcoming both barriers.

Outcomes of children with emotional disturbance in residential treatment for educational purposes

“…In one county's model of a community-based continuum of care, interagency coordinated services in a school-based day treatment program resulted in measured academic gains for students, and in a reduction in recidivism, residential placement, and costs of mental health services (Jordan & Hernandez, 1990). In another state's model for transitioning children from out-of-state residential programs back to their community, educational services were a key component of collaborative interagency coordination in providing individualized care (Burchard & Clarke, 1990).…”

Parent Advocates in Children’s Mental Health: Program Implementation Processes and Considerations

“…The wraparound approach (Burchard and Clarke 1990;VanDenBerg and Grealish 1998) requires practitioner knowledge at many levels of service implementation. For example, the wraparound practitioner must know how to access a vast array of resources, including flexible service funds and a vast array of community resources; effectively collaborate with and manage care teams that include the child, family members, natural family supports, and professional providers across child serving systems; individualize culturally responsive care; and gather and utilize outcome data.…”

Using a Theory of Change to Drive Human Resource Development for Wraparound

“…Wraparound emerged in the 1980s as an alternative to institutionalization for children and adolescents with high levels of mental health and related needs (Burchard et al 1993;Burchard and Clarke 1990;VanDenBerg 1992;VanDenBerg and Grealish 1996). The term "wraparound" was coined in the early 1980s to describe the array of flexible, comprehensive, community-based services that the state of North Carolina implemented in response to a class action lawsuit.…”