One day I showed up to do the initial engagement with a woman who had not come to the door the first two times I had come to her house. Today I could hear children in the house and after waiting a few minutes, she came to the door. She said two of her children were home sick and she had six loads of laundry to hang. She suggested another time might be better. I asked her what the kids would do when she hung clothes and she said “watch TV.” I said, “Let me help you.” We carried the clothes to the backyard and talked about what it was like growing up as young girls in southeast Kansas, helping our mothers do chores. Then we talked about her concerns and I explained what I did and how wraparound could help. Engagement with her was not always totally smooth, but on that day we went from her hiding in her house when I showed up to active involvement.
Think of some particular reasonably happy family you know. What kinds of things do they do outside their homes? They have jobs, go to school, and participate in clubs and sports teams – maybe they attend a church. People who participate in their communities tend to be better supported, more able to cope with change and crisis, and overall just happier.
The principle of community-based recognizes that families and young people who receive wraparound, like all people, should have the opportunity to participate fully in family and community life. This means that the team will strive to implement service and support strategies that are accessible to the family and that are located within the community where the family chooses to live.
Teams will also work to ensure that family members receiving wraparound have the greatest possible access to the range of activities and environments that are available to other families, children, and youth within their communities, and that support positive functioning and development.
Sometimes, for reasons beyond our control, children or adult family members need to be placed in an institution outside of the community or in a segregated and specialized education or rehabilitation program. When this happens, plans should be made to integrate them safely and successfully back into the community as quickly as possible.
We all have people in our lives we depend on. They might be the people we turn to for practical help, spiritual guidance, or a fun night out. We have friends who have stood by us in hard times, and family members with whom we have fought and reconciled.
Our mental and often physical well-being hinges on having a good social support network. The principle of natural supports recognizes the central importance of the support that a youth’s, parent’s, and other family members receive “naturally.”
In this case, naturally means independently from any formal service system. These sources of natural support are sustainable and most likely to be available for the youth/child and family after wraparound and other formal services have ended.
The wraparound process recognizes the importance of long-term connections between people, particularly the bonds between friends and family members, because we know that people who have long-term relationships with a child or family have a unique stake in and commitment to the family’s outcomes.
The primary source of natural support is the family’s network of interpersonal relationships. This includes friends, extended family, neighbors, co-workers, church members, and so on. Natural support is also available to the family through community institutions, organizations, and associations such as churches, clubs, libraries, or sports leagues.
Professionals and paraprofessionals who interact with the family primarily offer paid support. However, they can also become connected to family members through caring relationships that exceed the boundaries, expectations and time limits of their formal roles. When they act in this way, professionals and paraprofessionals too can become sources of natural support.
Practical experience with wraparound has shown that formal service providers often fail to access or engage potential team members from the family’s community and informal support networks.
There is a tendency for these important relationships to be underrepresented on wraparound teams. Letting this happen is a mistake. People who represent sources of natural support often have a high degree of importance and influence within family members’ lives. These relationships bring value to the wraparound process by broadening the diversity of support, knowledge, skills, perspectives, and strategies available to the team.
Such individuals and organizations also may be able to provide certain types of support that more formal or professional providers find hard to provide. The principle of natural support emphasizes the need for the team to act intentionally to encourage the full participation of team members representing sources of natural support.
There is a difficult equation at play when you are trying to make major program changes. Change is usually difficult or at least uncomfortable. It is easier to do things the familiar, safe way. Existing processes (such as billing requirements, paperwork, and peer support) were usually created to support the old way of doing things. On top of that, wraparound providers rarely have the luxury of extra time in their schedules. All of this together means that there is a lot of support for the status quo (whatever that is) and very little naturally occurring support for change.
Notice that I didn’t list a lack of training, or a shortage of resources to support the new way. This formula assumes that you have or brought in an expert who can provide high quality training for the new process. That is the minimum requirement, but it is almost never enough by itself.
So what do you need to make a major change – like implementing High Fidelity Wraparound? We have to change some of those variables listed above. Today, we are going to talk about the first variable. We will get into the second and third in the next few weeks.
The first variable is often the one that seems the most difficult to change, but is usually the easiest. Look at your processes: What does your paperwork look like for wraparound staff to fill out after meetings and visits? What counts as a billable hour? What kinds of requirements are in place for meetings, visits, and extras to “count”? Which activities are reported on?
For each piece of paperwork and every requirement, you are placing constraints and priorities on your staff members. When they are busy (like they almost always are), they will do the things they have to do, and the rest will fall by the wayside. Your job, if you want these changes to be successful, is to take each and every process and procedure and ask yourself: Does this actively promote good wraparound?
Some processes (like requiring a fixed number of natural supports at each team meeting, or making team meetings follow a schedule instead of needs), actively hinder High Fidelity Wraparound. These need to be changed before you can start.
Others (like focusing paperwork on deficits instead of strengths and strength based planning) don’t actively hinder wraparound, but don’t promote it either. Those policies are really supporting something else (like a traditional deficit-services based style of planning). When rubber hits the road, you can bet that most of your facilitators will revert to what they must document. These kinds of policies are just as important to revisit.
You goal is to have all of your processes actively support wraparound the way you want it to be done. This means going beyond paying lip service to services, into actively making changes to support the process. For example, have your SNCD forms mimic the SNCD process you want your facilitators to pursue.
Staff engagement is just as important as family engagement, and for very similar reasons. Next week, we will look at how to get your staff to buy in to the new style of wraparound.
We have all heard that high fidelity wraparound cannot happen in a vacuum. We need our system partners on board, we need our community to pitch in. We need strong systems of care. But what exactly does that mean?
Systems of Care and the wraparound process are different from most other forms of service delivery systems and processes in that they are based on a partnership approach. The wraparound process is based on a partnership between the family and a child and family team selected by the family. This partnership may take different forms based on family composition and cohesion, legal status of the involved children, and age of the child. Systems of Care are how a community comes together to support the children and families of the community. Both are team approaches built on partnership.
Many families, policy makers, funders, and providers of human services have in recent years participated in developing any number of interagency or collaborative partnerships. Indeed, many people talk about going to large numbers of different collaborative partnerships. Collaboration may have become an overused buzzword in today’s service arena, and many communities find themselves inundated with interagency groups serving various targeted populations. There are, in fact, many community boards in existence today.
However, it is rare that communities have come together in effective partnerships and embraced Systems of Care as a total community process to be utilized for all children and their families. It is this overarching community process that ties the community together in developing broad based public administrative and community supports for wraparound that we are discussing. It is imperative that communities begin discussions about what values and beliefs will guide the community in developing the infrastructure that provides support to the wraparound process and drives the community capacity building efforts.
Communities will quickly come to difficult and important discussions about what outcomes are desired in their own communities. These community conversations about outcomes and values are critical to any future success. These conversations are not activities in futility – they are essential elements in trust building and values clarification between and among the partners. It is in these discussions that communities begin to create links, combining efforts between different target populations and different programmatic initiatives in a meaningful way. It is these mechanisms of connection between community efforts and the teaming of those efforts that truly begin to increase the community’s capacity to go to scale in embracing the wraparound process.
These efforts are worth it. Let’s look at examples of some of the things that can occur in a System of Care. The members have come together and know the mandates, goals, and requirements of each program. They have developed an integrated vision of what they want for their community and have committed to common values for how they support families, partner with each other, and support strong family involvement in system development. They have developed a comprehensive resource directory, know what to expect from each resource, and who to contact to help families access the resource. The community team does ongoing assessment of program needs, gaps in services, access and integration challenges, and outcomes for children and families.
Examples of Collaborative System Work
Working together to develop a common set of values
Developing a comprehensive list of services and who to contact
Working together to identify gaps in services and supports and working to fill the gaps
Working together to identify access and integration challenges, and addressing them together
Working together to develop a joint resource or program
Working together to address a common need
Working together to develop a single plan of care format
These mechanisms created by system of care work can create truly transformative outcomes. Some of the priorities developed and successfully addressed by community teams include: truancy prevention programs, teenage pregnancy prevention, education programs for teen mothers and their children, substance abuse prevention, summer education and recreation programs with free lunches and snacks for any elementary age children, free after school recreation centers, GED programs, scholarship programs for summer camps and recreation programs, sexual abuse prevention programs, community-based crisis services, and community-based alternatives to residential care. System of Care programs have supported more youth to seek and complete education past high school, universal early education and care programs, increased immunizations and well child health care. System of Care programs have expanded childhood screen programs to access early intervention programs before problems become severe.
We’ve spent a lot of time on this blog talking about coaches. That is because adding certified coaches to your wraparound program is one of the easiest, most sustainable ways to reach and maintain fidelity, improve family outcomes, and improve staff retention.
Want to build a learning community and continually improve the quality of wraparound at your site? You need your own coaches. Want to cut ties with costly consultants and endless rounds of outside training classes? You need your own coaches. Want to improve working conditions, keep your best staff, cut down on training and hiring costs, and generally build a program that can stand the test of time? You guessed it – that takes coaches.
Today, we are bringing all of our coaching articles together in one place for easy reference:
- You can read more about the benefits of coaches to agencies here and here.
- See an example of what coaches do here.
- Read about how coaches fit in to creating a self-sustainable wraparound agency here, here, and here.
- Find some ideas about using coaches to improve your outcomes here and here.
- Read more about our certification process here.
If this sounds like something you want to pursue, you can find information about our next Coaching Workshop here. We hope you can join us and coaches from across the country in beautiful Red Rocks this March (Coaching Workshop 2015).