Transcript VALUES OF THE WRAPAROUND PROCESS

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Wraparound 101 for Professional
Team Members
John VanDenBerg, Ph.D.
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Wraparound
• Wraparound is a facilitated team based practice
model designed to integrate natural and
professional supports, with the family/youth in
the driver’s seat
• A wraparound team is formed to help define and
refine family/youth strengths, culture, vision
and needs; prioritize needs and create the plan;
and then carry out the plan one prioritized need
at a time until the formal team is no longer
needed because the vision of the family/youth
has been achieved.
Phases and Activities of the Wraparound Process
Engagement and Team
Preparation
• Orient the family to Wraparound
• Stabilize crises
• Facilitate conversations about
strengths, needs, culture, and
vision of the family
• Engage other potential team
members
• Make needed meeting
arrangements
Initial Plan Development
• Develop a plan of care
• Develop a detailed crisis/safety
plan
Implementation
• Implement the plan
• Revisit and update the plan
• Maintain team cohesiveness
and trust
• Complete documentation and
handle logistics
Transition
• Plan for cessation of wrap
• Conduct commencement
ceremonies
• Follow-up with the family after
graduation
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Practice Model Fidelity Matters
• Does a child and family team exist and are
informal team members present? Is safety of the
child and community the first priority?
• Have the facilitators done a true strengths,
culture, and needs assessment/discovery?
• Are all key system partners in attendance,
assuming parents/custodial agents want them
there?
Fidelity Matters…
• Is the plan truly strengths-based and culturally
competent?
• Do team members help implement the plan?
• Is the facilitator facilitating or doing all of the
plan?
• Is there an effective crisis and/or safety plan?
• Is a transition plan in place?
• Is the facilitator tracking progress and
outcomes?
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Integration
Implications for Professionals
• Does the team go beyond behavioral health?
• Do non-behavioral health professionals working
with the family have separate and possibly
competing plans?
• Are local system of care efforts moving beyond
collaboration to integration? Do MOAs exist?
Are staff co-trained?
• Do wraparound staff have a core understanding
of societal mandates of all systems?
Infrastructure Matters…
• Does the local county governance committee clearly
understand system of care and wraparound?
• Does an empowered system of care and wraparound
management team exist that clearly sees their link to the
priorities of Child Welfare and other systems?
• Does this management team have the needed leadership
and staff time?
• Does this management team include representatives of
the informal community?
• Has the team decided on core values across systems?
Infrastructure…
• Has this team hammered out basic agreements about
roles: How are decisions made? What if a system partner
disagrees with a CFT made plan? What are viable
referrals?
• Are supervisors on board and operating consistently?
• Do supervisors understand strengths-based supervision
models?
• Are supervisors practicing strengths-based collaborative
practice?
• Are supervisors meeting to identify barriers?
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When Wrap is truly Integrated…
1. Broader referral base, through education and
outreach, and successes.
2. Team represents all those involved with the
family
3. Professional team members get tailored
support to be on team
4. Team has a clear mission
5. All team members are prepared for the first
meeting
6. Results drive process
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Team Mission
• The Team reviews the big concerns and the family’s long range
vision and develops a team mission which describes what the team
commits to accomplish together.
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First phase of transforming individuals into a team
Creates a shared understanding of the group’s purpose
Answers the question of “Why do we exist?”
Engages team members
Guides work
Vision/Mission
Vision: Six months from now, my children will
be living with me, and I will be able to keep
them safe at all times
Mission: The team commits to supporting
Marge to learn to keep the children safe, to
support a safe transition from group care to
home, and to work closely with Child Welfare
to ensure safety.
Vision/Mission
Vision: We want Bobby to graduate high
school.
Mission: The team commits to help the family
with their desire to partner with the staff at
the high school, support Bobby to gradually
learn to succeed in school by helping him
further his natural gift of artistic ability, and
by supporting and celebrating each academic
step he is able to make
Vision/Mission
Vision: Life would be better for our family if
(the parents) Marge and Ellen would learn to
resolve their relationship differences and
develop a unified parenting strategy.
Mission: The team commits to help support
Marge and Ellen’s chosen method of learning
to be happy together and learn to raise the
children together, through individualized
direct support, mentoring, modeling, and
cheering each baby step of progress.
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Challenges for Advanced Degree
Behavioral Health Professionals
• Not being the “Team Leader”
• What to do when the family/youth disagree with
professional recommendations
• Dealing with family cultural practices which
exclude many traditional clinical interventions
• Historic lack of system integration and presence
of multiple (sometimes competing) planning
processes can lead to family/youth alienation
with all helping professionals – and at times,
families feel blamed
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Challenges for Child Welfare Team
Members
• Wraparound is often seen as a service, not a
process
• Child welfare may want to refer to a service, not
join a process
• Often, FGDM and Wraparound seen as
competitive rather than part of a continuum of
individualization
• Child safety focus is non-negotiable, high case
loads often mean that caseworkers have
difficulty attending meetings
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Challenges for Juvenile Justice
• Societal expectations produce “heat” which
focuses JJ staff on public safety
• Nationally, case loads for probation officers are
much higher than other systems, team
participation is difficult
• Courts are often ultimate determiners of plans, if
court does not embrace the wraparound
principles, confusion occurs
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Challenges for Educators
• Easier if the schools have embraced Positive
Behavior Supports (PBS) models
• Potential conflicts between the IEP and the
Wrap Plan – must be resolved
• Current focus on school-wide test scores may
mean less focus on individual students,
wraparound can help here
• It is hard for educators to be in team meetings
due to school duties
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Challenges for DD
• Often, state policies fund DD separately and do
not consider implications of co-occurring
disorders
• Most other professionals on teams not trained in
DD areas
• DD case managers may see conflict with
personal futures planning models and
wraparound
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Solutions
• Infrastructure for wraparound is in place
• You can be on the wrap team and not in all of the
meetings
• Wrap staff have high skill levels at contacting
and partnering with professional team members
• State policy dictates “No more single system
plans for multi-system families”!
• Others?