From the first meeting, MiiWrap focuses on what is needed to make long-term change. Change that lasts after MiiWrap is done and we’ve moved on to other families. This success comes from supporting the development of a combination of self-efficacy and identified assets needed through and after transition. Transition assets may include connections or relationships in the community, individual skills, family values and strengths, vocational or monetary goals, or anything that helps a person in sustaining change. Self-efficacy and transition assets serve a person long after MiiWrap has ended and in all areas of life.
Lessons on transition from Wraparound
One lesson from Wraparound was facilitating the process without support and control from the individual led to short-term, but not long-term, change. Even with adherence to the process, a significant percentage of people end up back in services or residential care. After transition, the person must rely on themselves and their resources to sustain change. This is known from the beginning, services don’t last forever, so it makes sense to prepare for a transition from the beginning.
It also seen from Wraparound that most families won’t continue with team meetings after services end. So relying on the voice of the team, instead of the individual, may not be the best way to plan for success after services end.
Focusing on transition in MiiWrap
These lessons and experiences informed the development of purposeful transition as an important change process for MiiWrap. It’s not enough to think about the future and hope families are learning the skills they need. Transition must concentrate on preparing youth and families to be successful after MiiWrap ends.
It’s more important for long-term success to guide youth and families to develop the skills and self-efficacy to address future needs without provider support than to address present needs. This process should lead to continually improving and individualizing MiiWrap for each youth and family. As the youth and family become more comfortable with the process and their self-efficacy to manage parts of it increases, they will begin to take over both the preparation and follow up for each activity. Assuming control of the process will be at a pace that challenges them, but in small enough steps they can be consistently successful.
The tools of transition
To support success in transition, Vroon VDB developed the first version of the Transition Assets Tool in 2009. Use of the tool begins in early in the implementation phase and focuses on identifying family strengths related to eight transition assets. By 2013, the tool was revised three times based on field trials and an implementation study with four sites in two states.
Baseline information from these programs measured the percentage of youth who remained out of residential services or intensive community-based services two years after wraparound ended. Staff were trained to use the tool and then the same outcomes were measured again. Before training, 39% of youth required intensive services two years after Wraparound. After training, the number dropped to 28%.
While progress was promising, more than a quarter of youth returned to intense services even after training staff in the transition tool. Follow-up with families revealed a common theme: planning for transition happened only by team meeting, but team meetings largely stopped after Wraparound ended. Most (85%) families reported they had two or fewer team meetings after Wraparound ended. Through the traditional process, families were prepared to sustain change through the process of team meetings. But team meetings stopped after Wraparound stopped. So how could change sustain?
The next version of the transition assets tool addressed the culture of support. The purpose was to determine how each family, using their own culture, could continue planning after Wraparound ended. With this addition to the transition toolkit, staff shaped the transition process using the family’s culture and support. Before services ended. Follow-up research on this implementation found that 93% of the youth had received no higher-level services two years after Wraparound was completed.
Begin with the end in mind. Transition is an ongoing process that is team supported, but ultimately extends past the MiiWrap team. Considering how change will be sustained after formal supports are over is integral to success. Supporting the growth of self-efficacy and person and family assets is at the heart of the MiiWrap process from day one, setting up for a successful transition for many years to come.