Effectiveness of the wraparound process for children with emotional and behavioral disorders: a meta-analysis.
Wraparound is a team-based service planning and coordination process intended to improve outcomes for children and youth with serious emotional and behavioral disorders and support them in their homes, schools, and communities. Given the substantial resources devoted to implementing wraparound, a meta-analysis of outcome studies was conducted to better understand current empirical support for this process. A literature search identified seven studies between 1986 and 2008 that documented the effects of youth receiving wraparound compared to control groups. Mean treatment effects across outcome domains ranged from medium for youth living situation (0.44) to small for mental health outcomes (0.31), overall youth functioning (0.25), school functioning (0.27), and juvenile justice-related outcomes (0.21). The overall mean effect size across studies was 0.33. Interpretation of results was complicated by the lack of consistent documentation of implementation fidelity across studies and conditions, variations in target population and intended outcomes, and methodological concerns. The authors conclude that, though the published wraparound research base is expanding and findings are largely positive, it continues to be in a preliminary state of development. However, there are insufficient data to support calls for wraparound's acceptance or dismissal based on the strength of existing studies.
Suter
Jesse C
JC
Center on Disability and Community Inclusion, University of Vermont, 311 Mann Hall, 208 Colchester Avenue, Burlington, VT 05405, USA. jesse.suter@uvm.edu
Bruns
Eric J
EJ
D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002669:Child Welfare; D002675:Child, Preschool; D018849:Controlled Clinical Trials as Topic; D003299:Cooperative Behavior; D055317:Evidence-Based Practice; D006801:Humans; D033183:Interdisciplinary Communication; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D055502:Secondary Prevention; D014481:United States; D055815:Young Adult