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Full fidelity wraparound for youth with serious emotional disturbance (SED)

Children's Mental Health: Serious Emotional Disturbance
  Literature review updated July 2018.

Wraparound is an intensive, individualized care planning and management process for children with complex emotional and behavioral needs. Commonly, children are also diagnosed with one or more mental health disorders including: conduct disorder, oppositional defiant disorder, attention deficit or hyperactivity disorder, or anxiety disorder. During the wraparound process, a team of people who are relevant to the child or youth collaboratively develop an individualized plan of care, implement this plan, monitor the efficacy of the plan, and work towards success over time. The wraparound plan typically includes formal services and interventions, together with community services and interpersonal support and assistance provided by friends, kin, and other people drawn from the family’s social networks. After the initial plan is developed, the team continues to meet to monitor progress and revise interventions and strategies when needed. Typically, families can be expected to receive case management for a minimum of eight weeks.
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Disruptive behavior disorder symptoms
Clinical diagnosis of a disruptive behavior disorder (e.g., conduct disorder, oppositional defiant disorder) or symptoms measured on a validated scale.
 11 4 166 -0.491 0.141 13 -0.491 0.001
Internalizing symptoms
Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale.
 11 4 166 -0.259 0.136 13 -0.259 0.056
Out-of-home placement
The removal of a child from parental care, most often to foster care.
 11 1 47 0.194 0.317 12 0.194 0.540
Permanent placement
“Final” placement in a permanent home, which can include reunification with parents, formalized guardianships, or legal adoption.
11 1 54 0.418 0.219 15 0.418 0.056

Citations Used in the Meta-Analysis

Clark, H.B., Prange, M.E., Lee, B., Stewart, E.S., McDonald, B.A., & Boyd, L.A. (1998) An individualized wraparound process for children in foster care with emotional/behavioral disturbances: follow-up findings and implications from a controlled study. In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices (pp. 513-542). Austin, TX: Pro-Ed.

Evans, M. E., Armstrong, M. I., Kuppinger, A. D., Huz, S., & McNulty, T. L. (1998). Preliminary outcomes of an experimental study comparing treatment foster care and family-centered intensive case management. In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes For Children And Youth With Emotional and Behavioral Disorders and Their Families: Programs and Evaluation Best Practices (pp. 543-580). Austin, TX: Pro-Ed.

Mears, S., Yaffe, J., & Harris, N. (2009). Evaluation of wraparound services for severely emotionally disturbed youths. Research on Social Work Practice, 19(6), 678-685.

Rast, J., Bruns, E.J., Brown, E.C., & Peterson, C.R. (2007). Wraparound for youth in child welfare custody: Results of a matched comparison study. Unpublished program evaluation.

Swenson, C.C., Randall, J., Henggeler, S.W., & Ward, D. (2000). The outcomes and costs of an interagency partnership to serve maltreated children in state custody. Children’s Services, 3(4), 191-209.