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Wraparound services for pregnant/postpartum women in treatment for substance use disorders

Substance Use Disorders: Treatment for Adults
  Literature review updated September 2016.

Wraparound was originally developed as an intensive, individualized care planning and management process for children with complex emotional and behavioral needs. The single study in the analysis applied the same approach to pregnant women in in treatment for substance use disorders. During the wraparound process, a team of people who are relevant to the life of the woman 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.
 
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 Primary or secondary participant 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
Substance use disorder
A non-specified alcohol or drug use disorder. Typically, a collection of different types of disorders reported by study authors. 
 27 Primary 1 43 0.072 0.218 28 0.072 0.742
Post-traumatic stress
Clinical diagnosis of post-traumatic stress disorder (PTSD) or symptoms measured on a validated scale.
 27 Primary 1 35 0.122 0.251 28 0.122 0.628
Child abuse and neglect
Substantiated or founded reports to child protective services.
 0 Secondary 1 35 -0.030 0.310 1 -0.030 0.923
Out-of-home placement
The removal of a child from parental care, most often to foster care.
 0 Secondary 1 35 0.124 0.335 1 0.124 0.711

Citations Used in the Meta-Analysis

Teel, M.K, Rosenberg, S.A., Taylor, J.A., Rinehart, D.J., Blumhage, R. Weitzenkamp, D. (n.d.) Improving mental health and family outcomes through high fidelity wraparound with mothers in early recovery. Unpublished manuscript.