Over the past several years, consensus has begun to emerge on the principles, procedures, and implementation measures for the wraparound service model (WSM), a popular individualized and team based care management process for children with serious emotional disturbance (SED) and their families. The proposed study will use a randomized design to pilot test a well-specified and manualized WSM for children and adolescents experiencing SED and being served within the Clark County, Nevada, system of care. This exploratory study of a standardized WSM will serve as an important first pilot test; despite being implemented in hundreds of communities nationally, determination of WSM's potential for impact has been hampered by inadequate specification of the intervention procedures and a poorly-developed research base. Capitalizing on an opportunity presented through a legislatively mandated behavioral health care services redesign in Nevada, associated with the state's SAMHSA-funded system-of-care grant, and supported by the state's recent receipt of a SAMHSA state infrastructure grant (SIG), the proposed study will accomplish three primary aims. First, it will determine if implementation of WSM in Nevada using manualized and standardized quality assurance methods results in greater adherence to wraparound principles than for children randomized to a non-wraparound case management program (typical case management or TCM). Second, it will determine if children and adolescents experiencing SED and randomized to WSM experience superior behavioral and functional outcomes than children randomized to the TCM condition and determine the role of fidelity to the WSM process as a moderator of clinical and functional outcomes. Third, in keeping with the study's exploratory nature, data will be analyzed to extend the current understanding of psychometrics of the WSM fidelity measures employed in the study, examine outcomes for subpopulations of children and youth, and explore differences in services received by the two study groups. Given the widespread interest and implementation of """"""""wraparound"""""""" type processes in systems of care nationwide, results of the study will have immediate policy implications, as well as set the stage for further large scale efficacy and effectiveness studies. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH072759-02
Application #
7254116
Study Section
Services Research Review Committee (SRV)
Program Officer
Chambers, David A
Project Start
2006-07-01
Project End
2009-06-30
Budget Start
2007-07-01
Budget End
2008-06-30
Support Year
2
Fiscal Year
2007
Total Cost
$172,552
Indirect Cost
Name
University of Washington
Department
Psychiatry
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Bruns, Eric J; Weathers, Ericka S; Suter, Jesse C et al. (2015) Psychometrics, Reliability, and Validity of a Wraparound Team Observation Measure. J Child Fam Stud 24:979-991
Bruns, Eric J; Pullmann, Michael D; Sather, April et al. (2015) Effectiveness of wraparound versus case management for children and adolescents: results of a randomized study. Adm Policy Ment Health 42:309-22
Bruns, Eric J; Walker, Janet S; Bernstein, Adam et al. (2014) Family voice with informed choice: coordinating wraparound with research-based treatment for children and adolescents. J Clin Child Adolesc Psychol 43:256-69
Pullmann, Michael D; Bruns, Eric J; Sather, April K (2013) Evaluating fidelity to the wraparound service model for youth: application of item response theory to the Wraparound Fidelity Index. Psychol Assess 25:583-98
Walker, Janet S; Pullmann, Michael D; Moser, Celeste L et al. (2012) Does team-based planning ""work"" for adolescents? Findings from studies of wraparound. Psychiatr Rehabil J 35:189-98
Bruns, Eric J; Walker, Janet S; Zabel, Michelle et al. (2010) Intervening in the lives of youth with complex behavioral health challenges and their families: the role of the wraparound process. Am J Community Psychol 46:314-31