Improving Wraparound Teamwork and Outcomes Using the Managing and Adapting Practice (MAP) System

T wraparound team process has established itself as a standard of care for children and youth with complex needs and their families who require coordination of care and for whom a single intervention is unlikely to suffice. The wraparound practice model operationalizes critical system of care principles such as family driven and youth guided, community based, and collaborative; it is extremely popular with families; and the process is locally adaptive in that it can be flexibly applied in a range of public service systems. Moreover, evidence continues to accumulate for its effectiveness (Bruns, et al., 2010; Suter & Bruns, 2009). Research results indicate that wraparound’s strongest evidence for positive effects are in the residential, family, and cost domains. In these areas, significant, medium-sized effects have been found across a range of studies. Positive clinical and youth functioning outcomes, on the other hand, have been less consistently found. Where significant, effects on these outcomes have been found to be small (Suter & Bruns, 2009). It is perhaps not surprising that more positive results are found for residential, family, and cost outcomes. Wraparound’s primary innovation is to focus on teamwork that yields individualized strategies to keep children in their home communities with their families. Wraparound teams actively consider the multiple levels of a child’s social ecology (family, friends and neighbors, providers, systems, comEric Bruns, Co-Director, National Wraparound Initiative, and Associate Professor, University of Washington School of Medicine