How
Do We Know This Works?
What
Does the Research Say?
Since
1996, CFRP has created, used and studied many different family-based
team decision making models, including our own, to see if they work
any better than the typical, traditional kinds of service (e.g.,
residential treatment, general counseling, etc.)
They
do.
Family
Network Conference Results Since 1996:
Team members:
Number of children: 645
Number of family members/friends: 1,347
Number of associated professionals: 2,196
Number of team meetings in the date range: 2,513
Average size of team: 12.01
Family Goal Attainment: 88%
Reduction in out-of-home placement for Marin County: 30%
Placement Avoidance for Family Network Families: 91%
Improved Family Functioning: 89%
Families reporting that Family Network had “significant impact” on
their success: 83%
Professionals reporting “very high” rate of satisfaction with their
Family Network experience: 92%
These
models have been subject to considerable study.
Here is just a sample of what's in the research:
Wraparound
Milwaukee's Outcomes:
Wraparound
lessened the need for residential treatment.
Average daily Residential Treatment population reduced from
375 placements to 60 placements
Wraparound
lessened the need for psychiatric hospitalization.
Psychiatric Inpatient Utilization reduced from 5000 days per year
to under 200 days (ave. LOS of 2.8 days)
Wraparound
reduced Juvenile Correctional Commitments from 385 per year
to 285
Wraparound
was a lot less costly.
Cost = 60% of what residential placement would have cost.
Wraparound
helped kids get better.
Clinical outcomes, as measured by the Child and Adolescent
Functional Assessment Scale (CAFAS) (Hodges, 1994), have improved significantly
for delinquent youth.
MORE
RESEARCH compiled by National Wraparound Initiative:
STUDY
1: Randomized control study (18 months) of youth in child
welfare custody in Florida: 54 in wraparound vs. 78 in standard
practice foster care.
REFERENCES: Clark, Lee, Prange, & McDonald, 1996;
Clark et al., 1998.
RESULTS: Significantly fewer placement changes for youths
in the wraparound program, fewer days on runaway, fewer days incarcerated
(for subset of incarcerated youths), and older youths were significantly
more likely to be in a permanency plan at follow-up.
STUDY 2: Matched comparison study (18 months) of youth
in child welfare custody in Nevada: 33 in wraparound vs. 32 receiving
Mental Health services as usual
REFERENCES: Bruns, Rast, Walker, Bosworth, & Peterson,
2006; Rast, Bruns, Brown, Peterson, & Mears (in submission).
RESULTS: After 18 months, 27 of the 33 youth (approximately
82%) who received wraparound moved to less restrictive environments,
compared to only 12 of the 32 comparison group youth (approximately 38%),
and family members were identified to provide care for 11 of the 33 youth
in the wraparound group compared to only six in the comparison group.
Mean CAFAS scores for youth in wraparound decreased significantly across
all waves of data collection (6, 12, 18 months) in comparison to the
traditional services group. More positive outcomes were also found for
the wraparound cohort on school attendance, school disciplinary actions,
and grade point averages. No significant differences were found in favor
of the comparison group.
STUDY 3: Randomized control study (18 months) of “at
risk” and juvenile justice involved (adjudicated) youth in Ohio:
73 in wraparound vs. 68 in conventional services
REFERENCES: Carney & Buttell, 2003.
RESULTS: Study supported the hypothesis that youth who
received wraparound services were less likely to engage in subsequent
at-risk and delinquent behavior.
STUDY 4: Matched comparison study (>2 years) of youth
involved in juvenile justice and receiving MH services: 110 youth in
wraparound vs. 98 in conventional Mental Health services
REFERENCES: Pullmann, Kerbs, Koroloff, Veach-White,
Gaylor, & Sieler, 2006.
RESULTS: Youths in the comparison group were three times
more likely to commit a felony offense than youths in the wraparound
group. Among youth in the wraparound program, 72% served detention “at
some point in the 790 day post identification window” (p. 388),
while all youth in the comparison group served detention. And of youth
in the wraparound program who did serve detention, they did so significantly
less often than their peers. Wraparound youth also took three times longer
to recidivate than those in the comparison group. According to the authors,
a previous study by Pullman and colleagues showed “significant
improvement on standardized measures of behavioral and emotional problems,
increases in behavioral and emotional strengths, and improved functioning
at home at school, and in the community” (p. 388) among Wraparound
youth.
STUDY 5: Randomized control study (12 months) of youths
referred to out-of-home placements for serious mental health problems
in New York State: 27 to family centered intensive case management (wraparound)
vs. 15 to treatment foster care.
REFERENCES: Evans, Armstrong, & Kuppinger, 1996;
Evans, Armstrong, Kuppinger, Huz, & McNulty,1998
RESULTS: Significant group differences were found in
favor of the case management/ wraparound program for behavioral and mood
functioning.
STUDY 6: Quasi-experimental (multiple-baseline case
study) of four youths referred to wraparound because of serious mental
health issues in rural Michigan.
REFERENCES: Myaard, Crawford, Jackson, & Alessi
(2000).
RESULTS: The multiple baseline case study design was
used to evaluate the impact of wraparound by assessing whether outcome
change occurred with (and only with) the introduction of wraparound at
different points in time. The authors tracked occurrence of five behaviors
(compliance, peer interactions, physical aggression, alcohol and drug
use, and extreme verbal abuse) for each of the youths. Participants began
receiving wraparound after 12, 15, 19, and 22 weeks. For all four participants,
on all five behaviors, dramatic improvements occurred immediately following
the introduction of wraparound.
