Wraparound Planning and RENEW

What is the practice? 

Wraparound is a team-based planning process that is intended to support the provision of individualized and coordinated family-driven care. The wraparound process brings families, providers, and the family’s natural support system together to build a plan in which all team members contribute to achieving the goals. The plan is implemented, monitored, and adjusted over time. Wraparound planning is grounded in the values of youth and family-driven, culturally competent, and community-based care. Wraparound is “strengths-based,” helping the child and family recognize, utilize, and build talents, assets, and positive capacities. 

Who is the practice for? 

Wraparound planning is utilized with children with complex needs who are involved with multiple child and family-serving systems (e.g., child welfare, juvenile justice, special education, mental health) and are at risk for out-of-home care due to emotional, behavioral, or mental health difficulties. Wraparound is appropriate for children ages 4 to 17. 

What outcomes does the practice produce? 

• Improved mental health symptoms 
• Improved mental health functioning 
• Improved school functioning 
• Decrease out-of-home placements

What is the evidence? 

Olson, J. R., Benjamin, P. H., Azman, A., Kellogg, M. A., Pullman, M. D., Suter, J. C., & Bruns, E. (2021). Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 60(11), 1353-1366. https://doi.org/10.1016/j.jaac.2021.02.022  

This systematic review and meta-analysis estimated effects on youth outcomes (symptoms, functioning, school, juvenile justice, and residential placement) and costs. Results showed positive effects for Wraparound, with small positive effects for school functioning, mental health symptoms, and mental health functioning, and a medium effect size for maintaining youths with serious emotional disturbance in the home and community. The review noted that many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research.  

Carney, M. M., & Butell, F. (2003). Reducing juvenile recidivism: Evaluating the wraparound services model. Research on Social Work Practice, 13(5), 551–568. https://doi.org/10.1177/1049731503253364 

The purpose of the study was to (a) evaluate the relative effectiveness of wraparound services versus conventional services for juvenile delinquent youth and (b) create a predictive model that would assist the juvenile court system in correctly identifying youth at greatest risk of reoffending. Participants were randomly assigned to Wraparound services or conventional services conditions. Results indicate youth in the Wraparound group had fewer absences and suspensions from school and fewer incidents of running away from home. They were also less assaultive and less likely to be picked up by police. No significant differences were found in arrests or incarceration during the course of the evaluation at 6, 12, and 18 months. 

Coldiron, J. S., Hensley, S. W., Parigoris, R. M., & Bruns, E. J. (2019). Randomized control trial findings of a wraparound program for dually involved youth. Journal of Emotional and Behavioral Disorders, 27(4), 195-208. https://doi.org/10.1177/1063426619861074 

The purpose of the study was to examine a Wraparound program for youth involved in both foster care and the juvenile justice system. Participants were randomized to either  Wraparound (n=24) or community treatment as usual (TAU; n=23). Results indicate youth in both groups experienced significantly improved outcomes, including fewer arrests and greater residential stability. Wraparound youth were less likely to be rearrested, and survival analysis found they went longer before doing so than TAU youth. Wraparound youth were also more likely to be educationally on track than TAU youth by the end of the study. Although these findings were nonsignificant due to small sample sizes, effect sizes were medium to large, and no such trends were found for the TAU group.  

How is the practice implemented? 

Wraparound planning is implemented within a supportive organization and requires a high degree of collaboration and coordination among the child- and family-serving agencies and organizations that need to work together to provide access to a well-developed array of services and supports within the community. serves to arrange or link families to mental health and other social services and supports. Organizations interested in implementing wraparound first ensure organizational readiness. A series of staff trainings are followed by supportive coaching by an expert to ensure staff are gaining competencies in the practice. Wraparound fidelity is monitored regularly and additional coaching targeted to program needs. 

A specific adaptation for school-based wraparound is the RENEW model, focused on transition planning for high school students with emotional and/or behavioral challenges and disabilities. RENEW focuses specifically on increasing effective school engagement, employment, post-secondary education and high school completion. RENEW has shown success in reducing school dropout and school push out, while increasing high school participation and completion for students with emotional and behavioral challenges. 

Who can implement the practice? 

While the wraparound facilitator needs to be well-trained, and have prior experience working with youth with complex behavioral health needs, a mental health license is not required. Similarly, the RENEW model can be implemented by any caring adult, with proper training and time to engage in the practice with students. 

In Texas, all Local Mental Health Authorities (LMHAs) offer wraparound planning, both through the service array and the Youth Empowerment Services (YES) Waiver. Wraparound facilitators, with permission from families, will seek to involve appropriate school personnel in the wraparound process to ensure that the coordinated plan addresses any social, emotional, behavioral, or academic needs of the student. 

What are the costs and commitments associated with becoming trained in this practice? 

Training in Wraparound is available from the University of Maryland’s Texas Center. Organizations interested in training in wraparound planning complete two online training modules, Wraparound Overview and Team Roles in Wraparound. This is followed by a training series: Introduction to Wraparound (3 days), Engagement in the Wraparound Process (1 day), Intermediate Wraparound (2 days), and Advanced Supervision in Wraparound (2 days). 

Training in RENEW is available from the Center for RENEW Implementation at the University of New Hampshire. Facilitator training is conducted through a 3-day Institute.

Wraparound training is currently provided free of charge through LMHAs.

What resources are useful for understanding or implementing the practice? 

• Website: https://nwi.pdx.edu/  
• Texas YES Waiver: https://www.hhs.texas.gov/services/mental-health-substance-use/childrens-mental-health/yes-waiver  
• Center for RENEW Implementation: https://iod.unh.edu/resilience-empowerment-natural-supports-education-work-renew  
• RENEW Overview Video: https://vimeo.com/142248928  

Rating: Promising Practice 

Secondary components: Positive Youth Development; Positive, Safe, and Supportive School Climates; Grief and Trauma-Informed Practices