Transcript Marge and Tom

Wraparound Across Systems
An Introduction
John VanDenBerg Ph.D.
North Sound Systems of Care
Training Institute
Marge and Tom
• Both age 37; three kids ages 8-16
• Tom is unemployed due to his untreated alcohol addiction, Marge
has diagnosis of major depression
• Oldest son has dropped out of school, has been charged with
breaking and entering, has court date in May, is on house arrest
• Middle child has a dual diagnosis of mental retardation, attention
deficit hyperactivity disorder and is in special education.
• Youngest child is very quiet, withdrawn
• Relatives in the area are “hands off” due to burn out of
relationships; no family friends other than Tom’s drinking friends
and one of Marge’s sisters who has been in a similar situation.
Typical Services
for Marge and Tom
• Tom referred to Alcohol and Drug Treatment, AA;
refuses to go to either because he does not think he is
the problem in the family
• Marge has a therapist and is on meds.
• Oldest son has a probation officer and a therapist he
refuses to go to; he is likely to enter detention for 90120 days, is at high risk for adult corrections
• Middle child has a different therapist, meds, is in
special education
• Youngest child slips below the noise level yet her
teachers have their eyes on her and are concerned
What are the predicted
outcomes for this family?
• They are involved with at least mental health, drug and
alcohol services, DD, education and special education,
juvenile court, and adult services (6) and are at high risk for
involvement with child welfare and welfare. Each of these
systems can legally develop their own plans for the family,
and each may see the family differently.
• Research shows that likely outcomes involve divorce,
poverty, loss of housing, long term public support of
parents and kids, school drop out, out-of-home care for
children, and high potential of the cycle repeating in the
next generation
• Five year cost to taxpayers often reaches $250,000 for
Washington families like this one.
Wraparound for the Family
• Referral could be made by any system. In most
Washington counties implementing wraparound, the
family could self refer
• A Wraparound Facilitator who worked for all systems
would be assigned if family agreed or court ordered
involvement. Staff would engage the family, do a
strengths discovery on what works in the family, and
ask them what they see their needs as being, and
prioritize these needs
• The family would choose a Wraparound Team to help
get every system on the same page, to brainstorm
options to meet needs, and help carry out options
Strengths of Family
• Tom has a father who has his best interest at heart, but is currently
angry at Tom. Tom’s dad has a business.
• Marge’s sister belongs to a local church who has helped her with
support, Marge would like to attend again but is embarrassed over
her situation
• Marge and Tom have goals for their children and a vision for the
future of grandchildren and the family being together
• The oldest son has mechanical ability and a grasp of math, he had a
middle school math teacher he clicked with
• The middle child has a close friend at school and excels at activities
that are fast paced and physical
• The youngest child wants friends but does not know how to
develop friends, loves her parents, and loves going to school.
What Marge and Tom
see as their top needs….
• The family to stay together
• The oldest child to be crime free and not in jail
• The kids to finish high school and maybe go to
technical school or college or have a vocation
that fits
• Marge to get off meds or have happier days
• For their children to have healthy friends that
they have fun with
The Wraparound Team for this Family
•
•
•
•
The entire family
Tom’s Dad
Marge’s sister
One of Tom’s drinking buddies who is the best
dad
• One of the oldest child’s friends who is cool
• The therapists, the probation officer, and the
school counselor, DD case manager
The Initial Wraparound
Plan for the Family
1. The oldest son goes to court with a restitution plan
(Restorative Justice) to compensate his victims. The plan
involves a Mentor from a local Kiwanis who is a mechanic.
The oldest son and the Mentor will maintain the vehicles
of the victims for one year.
2. Marge will re-connect with her sister’s church for support
from a women’s group
3. The middle child will get more involved with sports and
activities like bike riding, with support from Tom’s father
and Tom
4. Marge’s sister, Marge, and Marge’s therapist will help the
youngest child learn the skills of making friends, starting
with one of the child’s cousins
The eventual wrap plan…
• Focuses on Tom getting into AA, leveraging his desire
for his family to be together
• Gets the oldest child back in school and on track for
going to the Community College
• Gets the extended family back in the picture through
improvement of relationships and a positive “buzz”
• Supports all children
• Includes informal fathering support from one of Tom’s
sober friends whom he trusts
• As family stabilizes, either parent could be recruited to
become Family Support Partners and give back to other
families.
Why Does Wraparound Work?
• The family, not professionals, choose their
needs and prioritize the needs
• The family accesses their own natural
supports or uses surrogate supports until they
get their own back
• The family learns to handle life on their own
without professional help
• All systems involved with the family get on the
same page.
Collaboration and Integration Definitions
Collaboration: Agencies are familiar with each other’s missions
and roles, key staff work with each other at the child/family
level, but often retain single system decision making power
and planning.
Integration: Agencies are familiar with each other’s missions and
roles, key staff work with each other at the child/family level,
sharing decision making in a team format that includes the
family, producing a single plan that meets all system
mandates and that is owned by the entire team.
Copyright Vroon VanDenBerg 2010
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Integration
• Could Marge and her Family have achieved
outcomes without being in a process of
integration (wraparound)?
Discussion Questions
• What is currently working in the area of
integration in Washington State?
• What are the major barriers to achieving an
Integrated System of Care?