What Are Wraparound Services? Key Principles, How It Works, and More

Wraparound services are a way to effectively coordinate care for children and young adults experiencing mental health and behavioral issues, and provide support for individuals with intellectual or developmental disabilities. Instead of tackling mental health challenges through isolated services, wraparound brings providers, caregivers, schools, community supports, and other key people together as part of a coordinated plan.

These services are becoming more widely adopted, with around 100,000 young people in the United States using wraparound each year. Although it is increasingly popular, wraparound can be difficult to understand due to its complexity. This article will provide you with an overview of how wraparound services work, their key principles, and more.

What Are Wraparound Services?

Wraparound services are a type of service delivery strategy that provides comprehensive, holistic, family-driven support for children and young adults experiencing serious mental health or behavioral challenges. It works by building a network of trusted peers and professionals and having them work together to understand what is required to support the individual and their family.

Wraparound services are designed to create a support network that ‘wraps around’ the individual and the family based on their needs. Families typically work alongside a wraparound facilitator to create a support team, which may include:

• Family friends
• Local community members
• Specialized service providers

This support team helps guide the family towards a specific outcome or goal by devising creative and individualized services and support. The team then works together to carry out the plan effectively, monitor its effectiveness, and make changes as required.

Wraparound services align with the system-of-care (SOC) framework and the Child and Adolescent Service Program (CASSP). These frameworks provide the blueprints to build support networks that can handle the diverse needs of children and young adults struggling with mental health issues and their families. Wraparound services are a way to provide a customized service within an SOC.

Who Are Wraparound Services For?

Wraparound services are designed to support children, young people, and their families who require support from multiple places to address complex behavioral health needs. Wraparound programs are most commonly used to support young people with significant emotional, behavioral, or mental health challenges that impact day-to-day life. This includes individuals and families who need help from mental health providers, schools, Medicaid programs, and community-based organizations.

Wraparound services aim to support children and young people who:

• Have serious emotional disturbance (SED)
• Struggle with behavioral or mental health challenges
• Are at risk of psychiatric hospitalization or residential treatment
• Require support to safely live at home, go to school, or stay in the community
• Are involved in child welfare, foster care, juvenile justice systems, or special education
• Have mental health or substance use concerns
• Need coordinated support in multiple areas of life, such as therapy, school, housing, or crisis planning

As a comprehensive approach to support, wraparound programs usually have provisions to help family members and other caregivers. This is because a young person’s mental health is usually linked to their home life, relationships, routines, and access to support.

By establishing a coordinated plan that reflects the young person’s individuality, including their strengths, culture, and life priorities, families don’t have to work through a series of disconnected services alone.

What Services Can Be Included in a Wraparound Plan?

Studies show that an estimated 80 % of young people who were defined as needing mental health services did not receive the support they required. Wraparound plans aim to address this gap by providing all-encompassing care, support, and resources for affected individuals and their families. This is achieved by establishing a tailored wraparound plan, which may include:

• Behavioral health services: This might include therapy, psychiatric care, medication management, crisis care, or substance use support.
• Family and caregiver support: This covers parent coaching, respite care, family-based therapy, or family peer support.
• School-based support: This type of support includes individualized education programs, 504 coordination, behavior plans, tutoring, attendance support, or school liaisons.
• Community and social support: This can include transportation, housing assistance, food support, recreation, mentoring, and legal advocacy.
• Natural support: Wraparound plans may also bring together relatives, friends, coaches, faith leaders, neighbors, teachers, or other trusted individuals in the young person’s life.

Key Principles of Wraparound Services

The National Wraparound Initiative (NWI) is a resource and research initiative that aims to improve the understanding and implementation of wraparound programs. They have created 10 key principles of the wraparound process to ensure that programs use the most suitable tools and approaches for young people with complex behavioral needs.

Voice and choice

Wraparound implementation needs to involve both the young person and their family, working as active partners at every level of the wraparound process. Family members are fully empowered and essential contributors to the solutions the young person needs.

Youth and family team

Wraparound services rely on a team consisting of family members, the young person, natural supports, and community services. The family needs to agree on who will be part of the team, as it takes a collaborative effort to develop, implement, and evaluate the tailored plan for the young person.

Community-based services

These services work across community, residential, and school environments. Interventions to change behavior should happen in natural settings whenever possible, with wraparound teams providing healthy activities and positive reinforcement for the young person.

Cultural competence

Wraparound programs should accommodate different cultures, beliefs, values, behaviors, and customs for better outcomes. Understanding and acknowledging these cultural differences is an important part of the process for wraparound teams.

Individualized and strength-based services

The services provided by wraparound need to be built around the individual and based on the family’s needs and strengths. There should also be clearly designed plans that document the services and support offered. To reach that point, family members need to collaborate to create plans that harness collective strength, creativity, and knowledge of strategies and available resources.

Natural supports

Wraparound plans need to balance formal services with informal community and family supports. These natural supports are useful for their unique perspective on problem-solving, as well as being a trusted way to provide childcare, recreation, and transportation.

Continuation of care

When utilizing wraparound services, there must be an unconditional commitment to serve children and their family members. That means the team should focus on maintaining a child-centric approach to wraparound that doesn’t ascribe blame to the young person for their needs.

Collaboration

Team members should cooperate and share responsibility for the development, implementation, monitoring, and evaluation of wraparound plans. The plan itself reflects the blended team members’ perspectives, resources, and approaches. It should ultimately guide and coordinate each individual’s work towards meeting the overall goals of the program.

Flexible resources

Wraparound programs greatly benefit from flexible approaches and flexible funding. When wraparound is rolled out in a way that acknowledges all of the other principles, the result is a flexible solution tailored to fit the family. In many cases, only a portion of the help and support required comes from existing formal services. So, allocation of flexible funding is necessary to facilitate the family’s strengths and needs.

Outcome-based services

Finally, the wraparound process should harness outcomes to guide further decision-making. These outcomes should be measured and determined for the system, program, individual, and family. In doing so, the team ensures that everyone involved is working towards the same shared goals.

How Does the Wraparound Process Work?

Care coordinators typically lead the wraparound process and monitor progress with care coordination software. They work closely with family members and professionals such as clinicians, resource coordinators, and in-home behavioral support specialists to facilitate wraparound care.

Care coordinators need to be flexible in how they work, as they may have to provide a wide range of services. Their work looks to address barriers related to language, culture, transportation, communication, bias, and fear. They may also help people transition between healthcare providers and settings. Generally speaking, the wraparound process usually occurs across four distinct phases:

Engagement and team preparation

The first stage of the process aims to help the young person and their family understand the wraparound program. This involves the care coordinator, who will address any legal or ethical concerns, stabilize any immediate crises, develop conversations between the child and family member, and engage with other wraparound team members.

Initial plan development

From here, plan development will help outline a plan of care and a crisis or safety plan for the individual. Care coordinators will complete documentation and address logistical issues, such as scheduling appointments with healthcare professionals. During this stage, care coordinators and associated team members will begin to build rapport and trust with the child, the family, and the rest of the wraparound team.

Implementation

Once the plan has been developed, it is time to implement it. Care coordinators and other team members will monitor and evaluate the progress of the carer plan. When required, they will step in to revise the plan to realign work with desired goals. When the team achieves its final goals, formal wraparound services will wind down, bringing this phase to an end.

Transition, monitoring, and evaluation

The final phase of the wraparound process focuses on facilitating a transition out of the formal program. Many people switch to a blend of formal and natural supports found in their community. Care coordinators and other wraparound team members will monitor individuals after the transition.

Wraparound Services in Schools

Wraparound services in schools are a useful way to support students with complex behavioral, emotional, social, or mental health needs by providing coordinated support in an educational setting. Instead of treating school challenges as a separate issue from home life or mental health care, wraparound brings the right people together to create a unified plan to help the student.

In many cases, academic difficulties are tied to wider needs. Young people may struggle with anxiety, family stress, housing instability, or a host of other issues that impact their schooling. Wraparound services can help schools look beyond the behavior itself to understand what support the young person might actually benefit from. Wraparound support in schools may include:

• Coordinating mental health services with school-based support
• Developing or reviewing an Individualized Education Program, also known as an IEP, or a 504 Plan
• Creating a behavior support plan
• Addressing attendance, truancy, or school avoidance
• Connecting the family with transportation, housing, food, or community resources
• Providing tutoring, mentoring, counseling, or peer support
• Planning for crisis response and de-escalation
• Supporting transitions between grade levels, schools, or care settings

Functional Behavioral Assessments (FBAs)

Schools might use tools such as a Functional Behavioral Assessment (FBA) to understand why a student’s behavior is happening. If a student is frequently leaving the classroom, for example, they may be doing this to avoid overwhelming work, to seek attention, or to cope with anxiety. Once the team knows why the behavior is happening, they can devise a plan that provides the student with more suitable tools to meet their needs.

Challenges in Wraparound Services

While wraparound services can provide valuable, coordinated support for children, youth, and families, they can also be challenging to implement well. Some of the most common challenges found in wraparound services include:

Coordinating with team members

As wraparound brings together many individuals with different skills and experiences, it can be difficult to coordinate team members successfully. Although a good care coordinator or case manager can help with this, it’s still difficult to effectively value and harness the strengths of each team member.

Identifying natural supports is another challenge, as it requires an intimate understanding of the relationships in that young person’s life. Normally, building trust with the family members is required before asking about support. In cases where there are no natural supports, care coordinators may need to source surrogate supports from volunteer groups, church members, or coaches.

Funding and resources

Wraparound programs require flexible funding to facilitate proper care. However, a lack of funding or a shortage of trained professionals (like child psychiatrists) can become a big hurdle to overcome. Wraparound works best with flexible resources, a range of services, and support in the community.

Assessing success

Although initiatives like the NWI provide resources to support wraparound services, there are no nationally recognized manuals or program standards available. This, coupled with the bespoke nature of the programs, can make it hard to assess the success of the services provided. It also means that care coordinators and other team members have no clear expectations for practice.

State and local organizations are relied on to develop training plans. They are often hyper-local, though, which means they aren’t suited for use across different regions.

Despite these challenges, wraparound services are a powerful way to provide comprehensive care and support for individuals and their families with complex needs. Wraparound services can help people across a variety of settings, giving young people individualized support based on their strengths and needs.

Helping Families Access Connected Support With Wraparound Services

Wraparound services offer a coordinated, individualized approach to supporting children, youth, and families with complex behavioral health needs. By bringing together caregivers, providers, schools, community organizations, and natural supports, the wraparound model helps create one shared plan built around the young person’s strengths, needs, goals, and family priorities.

When implemented well, wraparound services can reduce fragmented care, improve communication between systems, and help young people receive support in the places where they live, learn, and spend time. This can be especially valuable for families working across multiple services, such as behavioral health care, school-based support, Medicaid programs, child welfare, juvenile justice, or community resources.

At its best, wraparound helps families feel heard, supported, and better equipped to move toward long-term stability.