Children's Mental Health
What is Wraparound Process? 
It looks like a treatment team meeting at first, but it is much more than that. It goes way beyond and never quits.
- It’s the process of bringing people together from different parts of the family’s whole life. With help from a facilitator, people from the family’s life work together, add their perspectives about the family’s strengths, and coordinate their activities to support the family,
What is a Wraparound Process Facilitator?
- A person who is trained to coordinate the wraparound process for an individual family.
What is a Wraparound Process Team?
- A group of people, chosen by the family, who are connected to them through natural, community, and formal support relationships. With the family, the team develops and implements the family’s plan, addresses unmet needs, and works toward the family’s vision.
What do we know about Wraparound process?
It works! But fidelity to the process is the key to success. Research indicates that there were significantly higher success rates in communities practicing High Fidelity Wraparound. The more a wraparound team sticks to the established principles, the better the results in both measured outcomes and in family satisfaction.
There are different ways to measure fidelity- through surveys asking the participants questions regarding their experience; through assessment tools, and/or through structured team observation.
How is Montana implementing a System of Care based on Wraparound process?
Montana is implementing Wraparound Process facilitation by offering training to grow our own experts. The goal is to train trainers, as well as increase the number of wrap around facilitators available in communities. To assure that wrap around facilitation is high fidelity, the Children’s Mental Health Bureau is developing a certification process for wraparound facilitators.
Progress to date includes:
- Three rounds of intensive wrap around facilitation training have been completed. (Helena, Billings, and Great Falls)
- Another wrap around training is planned. The location will be announced after 1/1/09.
- Montana is in the process of developing a certification process to endorse Wraparound Process facilitation
- Completion of basic training curriculum involving including ongoing peer to peer coaching.
- Demonstration of knowledge about Wraparound Process and principles through a written examination.
- Documentation of competency through observation and supervision of Wraparound facilitation.
Ongoing certification requirements may include…..
- Required data collection using a fidelity questionnaire administered to youth and families receiving services.
- Required outcome data collection demonstrating family improvement.
For more information on Wraparound training visit www.wraparoundmt.org
Outcomes so far in Montana’s System of Care!
As of September 02, 2008 Montana’s System of care has served 120 families. Of these families 67 have been enrolled in an extensive longitudinal study which follows families for three years after enrollment into services.
Also as of September 02, 2008 22 families have baseline and 6 month follow up data collected from numerous different instruments. So far the Child Behavioral Checklist (CBCL) has been analyzed comparing the 22 families who have been served by our Montana system of Care. Below is a chart showing averages of eleven different CBCL scores at intake into System of Care Services and the averages at the six month follow up interview.
Scale |
Baseline T score mean |
6 month follow-up T score mean |
Significance Level |
Change |
1. Anxious Depressed |
76.04 |
68.3 |
0.01 |
7.74 |
2. Withdrawn 3.Depressed |
72.04 |
66.65 |
0.05 |
5.39 |
4.Thought Problems |
76.22 |
72.65 |
0.05 |
3.57 |
5.Attention Problems |
76.61 |
70.09 |
0.01 |
6.52 |
6.Rule Breaking 7.Behavior |
71.65 |
66.78 |
0.05 |
4.87 |
8.Aggressive Behavior |
77.26 |
71.96 |
0.05 |
5.3 |
9.Internalizing |
74.3 |
68.74 |
0.05 |
5.56 |
10.Externalizing |
74.04 |
69.43 |
0.05 |
4.61 |
11.Total Problem |
76.65 |
72.3 |
0.05 |
4.35 |
Score Interpretation
For the first eight scales: (syndrome scales)
- T scores less than 67 are considered in the normal range
- T-scores ranging from 67-70 are considered to be borderline clinical, and
- T scores above 70 are in the clinical range.
For scales nine through eleven: (competency scales)
- T scores less than 60 are considered in the normal range
- 60-63 represent borderline scores, and
- Scores greater than 63 are in the clinical range.
Highlights:
1. All scales show a reduction at the 6 month interview.
2. The largest reduction occurred in the Anxious/Depressed scale going from an average T-score above clinical range to an average T-score within borderline range.
3. All eight syndrome scales averaged within clinical range. At six months the depressed scale and rule breaking behavior scale presented within “normal” range.
