Case Management – CJ445-01
Although there is no uniform definition for the wraparound process, the Office of Juvenile Justice and Delinquency Prevention defines it as “a youth-guided, family-driven team planning process that provides coordinated and individualized community-based services for youths and their families to help them achieve positive outcomes. It is a multifaceted, system-level intervention designed to keep youths with serious emotional and behavior disorders (SEBDs) at home and out of institutions whenever possible.” (ojjdp.gov, 2014) This approach creates safe environments for high-needs youth aged 14-24, who have complex, multi-faceted needs, including acute mental health diagnoses and a type of functional impairment.
The methodology was first developed in the 1970’s and evolved until the 1990’s when researchers realized that they should focus their resources on studying the effects of maximizing on the strengths that are already present. By observing that working in the community for one to two hours per week, rather than in an office setting, the Child and Family Team was more at ease meeting with the Wraparound Coordinator and this maximizes the intervention’s success. (Enty, 2009) By fostering collaboration between with their adolescent client and their community (including the client’s family as well as friends of their family) researchers were able to successfully prevent out-of-home placement options and build long-term relationships. (Kamradt & Goldfarb, 2015)
The first step in getting involved in a wraparound process is getting referred to a program. This can come from a juvenile probation officer, the Department of Social Services, the Department of Health and Human Services, or any other agency that has a collaborative partnership between the county and Wraparound Agencies. Once a wraparound agency has accepted the referral, a wraparound coordinator contacts the family to set a meeting to coordinate the process. In addition to assessing the family’s needs, they will also identify ways to improve the family’s quality of life. Lastly, they will look for natural strengths within the family and within the child’s community. As with any other intensive treatment program, the family will be informed at the initial meeting that change does not occur overnight; the wraparound process is expected to last anywhere from 18-24 months. At the next meeting, the wraparound coordinator will work with the family to identify members of the treatment team and collaboratively develop an initial treatment plan. Once the plan is put into motion, the treatment team will begin meeting every couple of weeks to discuss how things are going and areas for improvement. The final phase of the wraparound process is transition; this is the point at which the treatment team agrees that treatment objectives were successful, the desired outcomes have been met, and the mission is complete. (acmh-mi.org, 2016)
The wraparound process incorporates ten core principles for care. Family Voice & Choice is the principle of the provider engaging the family members to discover their perspective and develop a treatment plan which incorporates family values and preferences. The forming of the team is an important principle of the wraparound process because it includes individuals that were selected by the child and their family who have demonstrated willingness to support the family through informal, formal, and community support and service relationships. Natural Supports offer support to the child and their family throughout the treatment process through interpersonal and community relationships. The activities and interventions that are chosen for the child and their family are based on sources of natural support. Collaboration is the basis for most of the wraparound methodology; it is the blending of each team members’ perspectives, mandates, and resources while simultaneously guiding each team member’s work toward meeting the team’s goals. Reintegrating the child into the community through the implementation of service and support strategies is another principle. The wraparound process is culturally competent, which means that it “respects and builds upon the values, preferences, beliefs, culture, and identity of the child/youth and family, and of their community.” (ojjdp.gov, 2014) Each child and family has different needs, so individualized treatment plans maximize effectiveness. This process is strengths-based, so the wraparound provider will work with the child and family to identify, build on, and enhance the capabilities, knowledge, skills, and assets of each team member. The wraparound process is persistent; they enter into the process knowing that they will not be allowed to give up on, blame, or reject children, youths, or their families. Finally, the wraparound process is outcome-based which means that the team will look for measurable indicators of success, monitor progress in terms of these indicators, and adjust the treatment plan accordingly.
As previously stated, family involvement is crucial to the success of the wraparound process. When the family enters counseling, issues such as parenting (areas for improvements, things to sustain, and addressing grievances from the past) and family dynamics are freely discussed with their therapist. The treatment team might include a member that specifically provides treatment for the child’s substance abuse and addiction as well as a member that treats the child for behavioral health concerns. Collaboration between the behavioral health provider and the substance abuse provider creates transparency regarding the medications the child is prescribed and the side effects they might experience. It allows the parents and the child to ask questions, understand causation, and learn how to prevent regression in the future. The therapist can also interject their recommendations for medication and treatment during team meetings.
To address the issue of gang involvement, some multidisciplinary intervention teams conduct case management activities that provides supportive outreach to gang-involved youth in their communities, with the hopes of convincing them that there are alternatives to gang membership and related activities. This is accomplished by empowering their adolescent clients to become self-sufficient (and not need to join a gang) such as job training, personal development, and assistance with finding a job. Some teams provide training on how at-risk youth can become entrepreneurs. Role model and mentor team members do their best to deter a child from skipping school or dropping out entirely. For those teams that are unsuccessful in preventing their child from dropping out of school can provide information about enrolling in GED services. Team members can also assist older adolescents with obtaining higher education and applying for financial aid and other vital resources. In addition to job placement and education resources, treatment teams deter gang involvement by helping the adolescent seek tattoo removal and appearing more professional. (Mukasey & Sedgwick, 2002)
Female offenders, although less commonly seen in the juvenile justice system, generally present with similar victimization profiles and therefore generally commit the same types of crimes. When determining what interventions and approaches should be used for a female offender, the wraparound coordinator should be sensitive to and mindful of the fact that their client has possibly had an extensive history of sexual abuse, sexual assault, and domestic violence and tailor treatment to her needs accordingly. They must also remember that these types of traumas often serve as pathways to juvenile delinquency, substance abuse/addiction, and crime. Their juvenile client very well may have run away from home and experienced homelessness to escape violence and/or sexual or physical abuse. Their offenses may have included prostitution, property crime, and drug use. The treatment for a female offender might rely heavily on natural support and supporters within her community and less on her immediate family since they may have been her abusers. Interventions will likely include trust-building activities especially with the men in her life (if they are the perpetrators of the abuse) and education on how to build meaningful relationships with others.
Since many female offenders have strong histories of sexual abuse as children, they often grow up to be sexually promiscuous as adolescents. Many female offenders become mothers at a young age and lack the knowledge and support to properly take care of their child(ren.) In addition to the stress of growing, experiencing developmental changes, and hormone fluctuations themselves, these young females must also monitor the health and development of their offspring as well; this sometimes occurs while they are either homeless or unemployed. Interventions should be tailored to the female offender much like the gang-involved youth; it should focus on finding government assistance, housing, medical/behavioral health treatment, education, and employment. (Covington, 2017)
When done correctly this process can not only benefit the juvenile offender but can heal the wounds of the family as well. Strong families, ample support, and the distribution of resources can mean reduced rates of recidivism for both the juvenile and criminal justice systems directly because of community-based treatment methods such as this one. Since these programs are more cost effective than sending a juvenile offender to a detention center and build on existing strengths/resources, the process has proven itself to impact the client’s functioning, living situation, engagement, and/or satisfaction, their family’s functioning and/or satisfaction. (Coldiron, Bruns, & Quick, 2017)
For this assignment, I was unable to access the government’s official website about the wraparound process and its methodology, so I referred to literature on the websites of several government agencies that implement this process (such as the Department of Justice, the Department of Health and Human Services, the Department of Social Services, and the Department of Family Services.) Other government agencies I referred to include the Center on Juvenile and Criminal Justice’s website, the Association for Children’s Mental Health’s website, and the Office of Juvenile Justice and Delinquency Prevention’s website. Additionally, I read a publication by the University of Washington and the National Technical Assistance Network For Children’s Behavioral Health.