The role of fidelity and feedback in the wraparound approach

Wraparound approaches are being implemented with children in many mental health systems around the country. Evidence for the effectiveness of the wraparound approach, however, is limited. In addition, the degree to which wraparound interventions adhere to the principles of wraparound has rarely been assessed. We examined the influence of adherence to wraparound principles and outcome feedback within the wraparound approach. Children participating in family team meetings were enrolled in a feedback or no feedback condition. Teams receiving feedback were given a brief report regarding outcome progress four times over a three-month period. In addition, adherence to wraparound principles was assessed in the initial team meeting and examined in relationship to outcome at three months and nine months. Although youth in both feedback and non-feedback groups improved with intervention, there were few differences between the groups based on outcome feedback. Similarly, adherence was uniformly high and did not influence the outcome for individual cases. Although the wraparound approach was helpful for youth in our sample, outcome feedback and adherence to wraparound principles had limited influence on these effects.