Wraparound 101 for Professional Team Members

1. Wraparound 101 for Professional Team Members John VanDenBerg, Ph.D.

2. 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.

3. 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

4. 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?

5. 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?

6. IntegrationImplications 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?

7. 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?

8. 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?

9. When Wrap is truly Integrated… • Broader referral base, through education and outreach, and successes. • Team represents all those involved with the family • Professional team members get tailored support to be on team • Team has a clear mission • All team members are prepared for the first meeting • Results drive process

10. 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. • 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

11. 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.

12. 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

13. 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.

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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?