Effectively Engaging Young People
with Wraparound Principles
in your Individual Practise
Otago Youth Wellness Trust 20 year Celebration
“ADOLESCENCE” – A window of opportunity
1st September 2016
University of Otago – Dunedin, NZ
Ruth A Gammon, PhD, MSW
Sr Lecturer / Clinic Director
Massey University Psychology Clinic
Wellington Campus
Mental Health and Young People
• Mental health disorders are the most common
cause of disability in youth aged 10 -24
(World Health Organisation)
• In New Zealand, it is estimated that 25-43% of
youth meet the criteria for at least one mental
health diagnosis
(Fergusson & Horwood, 2001; Horwood & Fergusson, 1998; Oakley-Browne,
Wells, & Scott, 2006).
• 3% of NZ youth meet the criteria for a serious
mental health disorder
(Fergusson & Horwood, 2001; Oakley-Browne et al., 2006)
;
Barriers for
Young People and their Families
• Only 10% of the youth made a mental health
visit to a health care professional (15 – 33% of
youth with a mental health condition receive no
treatment)
• A larger gap of youth not receiving services
among non-European youth, with Pacific youth
being the least likely group to make a visit for a
mental health issue (7.9%) and Maori at a rate of
9.3%
(Mental Health Commission Report, 2011)
Barriers for
Young People and their Families
• Youth and families don’t feel services meet their
needs;
• Families feel overwhelmed and blamed;
• They need for a holistic approach;
• There is a lack of coordination of services;
• Services are difficult to access due to physical
environment, location, and/or hours of operation;
• They have a need for in-home intensive
services, long term support and a continuum of
care and services
“Imagine trying to get your car fixed after it breaks down
and finding that you have to take it to a different garage to
fix each part – one to change the brake cable, another to fix
the windscreen, a third to change the tyres and so on. Even
worse, each garage is in a different area and none of them
share information, so you have to repeatedly explain the
problem and fill out separate forms at each visit”
(quoted in Rosengard, Laing, Ridley, & Hunter, 2007, p. 31).
Overcoming the Barriers
• Accessibility
– Meet in the community (at school, youth
centres, their home, over coffee)
– Meet after 5pm – not during their school day
• Partnering with youth and families
regarding their needs
• Multi-service centres for youth – one stop
shop
• Holistic and flexible services
Where Do We Start…
Engagement
Engagement – begins before you meet the
youth & their family!
Your:
– Attitude
– Values & Beliefs
– Approach to the issues
– Theoretical Orientation / Beliefs
WILL impact the engagement process.
Engagement with Families
•
•
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Explain the process and what to expect
Build a collaborative relationship
Empathy
Understood
Strength based approach
Reinforce youth and family for coming to the
table
• Value the youths’ perception
…..Instill Hope
Shift in Thinking about
Youth and Families
Modern 
Absolutes Exist
Single Model(s)



Objective, empirical, science
(quantitative, logical, linear)
Universals Sought
Individualism, hierarchy, boundaries
Theories ahistorical, acontextual
Problem located in the family
Professional knowledge is privileged &
therapist is the expert
Post Modern
“Truths” are socially created
Multiple lenses and embrace,
diversity
Subjective, interpretive, non-linear
multi-directional
Unique solutions valued
The collective, interdependence &
cooperation valued
Contextual view inc historical,
socio-political & cultural context
Location of problem incl. socioenvironmental context/inner and
outer world
Collaborative process
client is the expert
Wraparound
• An evidenced based model of care planning in a system
of care
• Wraparound is NOT a package of services wrapped
around families as it is defined in many NZ programs.
• Wraparound is NOT a funding stream
• It is a philosophical approach to care planning with
specific guiding principles, a model of delivery and a
theory of change – it is the combination of these factors
which make wraparound effective, not the services per
say.
What is Wraparound
“ A philosophy of care that includes a
definable planning process involving the
child and family that results in a unique set
of community services and natural
supports individualized for that child and
family to achieve a positive set of
outcomes”
(Burns & Goldman, 1999, p. 13)
Wraparound Principles and Phases
(Bruns, E.J., Walker, J.S., Adams, J., Miles, P., Osher, T.W., Rast, J., VanDenBerg, J.D. & National Wraparound
Initiative Advisory Group (2004). Ten principles of the wraparound process. Portland, OR: National Wraparound Initiative, Research and Training Center on
Family Support and Children’s Mental Health, Portland State University.)
Family voice and choice
Outcome-based
Team based
Persistence
Natural supports
Collaboration
Strength Based
Individualized
Community based services
Culturally competent
Principles of Wraparound
Individualized
Outcome-Based
Team-Based
Strengths-Based
Natural
Supports
Family Voice &
Choice
Culturally
Competent
Collaboration
Community-Based
Persistence
Family Voice
& Choice
Family and youth/child perspectives are
intentionally elicited and prioritized during all
phases of the wraparound process.
Planning is grounded in family members’
perspectives, and the team strives to
provide options and choices such that the
plan reflects family values and preferences.
Individualized
To achieve the goals laid out in the
wraparound plan, the team develops and
implements a customized set of strategies,
supports, and services.
Strengths Based
The wraparound process and the
wraparound plan identify, build on, and
enhance the capabilities, knowledge, skills,
and assets of the child and family, their
community, and other team members.
CulturallyCompetent
The wraparound process demonstrates respect
for and builds on the values, preferences, beliefs,
culture, and identity of the child/youth and family,
and their community.
Integrating appropriate cultural models of
wellbeing, such as Te Whare Tapa Wha or the
Meihana Model for Maori or Pacifika health
models, such as Fonofale
Natural Supports
The team actively seeks out and encourages the
full participation of team members drawn from
family members’ networks of interpersonal and
community relationships. The wraparound plan
reflects activities and interventions that draw on
sources of natural support.
Building support networks for the youth and family
is essential for sustainability.
Team Based
The wraparound team consists of
individuals agreed upon by the family and
committed to them through informal, formal,
and community support and service
relationships.
Collaboration
Team members work cooperatively and
share responsibility for developing,
implementing, monitoring, and evaluating a
single wraparound plan. The plan reflects a
blending of team members’ perspectives,
mandates, and resources. The plan guides
and coordinates each team member’s work
towards meeting the team’s goals.
Collaboration
•
•
•
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Role modeling collaboration to the families
Everyone involved with the family around the same table
One Family = One Plan
Sound communication and relationships between those
working with the family and ongoing contact –
empowering families to ask for what they need from
providers
• Help to ensure this and do the follow up with families and
providers between sessions – encourages families to
start to coordinate their own services
Outcome Based
The team ties the goals and strategies of the
wraparound plan to observable or measurable
indicators of success, monitors progress in terms
of these indicators, and revises the plan
accordingly.
Determining when therapy will end from the start –
working towards goals and reviewing through out
the therapy process.
Community Based
The wraparound team implements service and
support strategies which take place in the most
inclusive, most responsive, most accessible, and
least restrictive settings possible; and that safely
promote child and family integration into home
and community life.
It is important for the youth and family to have
resources in their community, to support them
when you are no longer there.
Persistence
Despite challenges, the team persists in
working toward the goals included in the
wraparound plan until the team reaches
agreement that a formal wraparound
process is no longer required.
Phases of
Wraparound
Phase1
A
Engagement and Support
Phase1
B
Team Preparation
Phase2
Initial Plan Development
Phase3
Phase4
Implementation
Transition
Wraparound
Theory of Change (Walker, 2008)
~ Thank You ~
Questions?