Process and Approach
Wraparound Milwaukee: Aiding Youth With Mental Health Needs

The Wraparound philosophy began with John Brown, a Canadian service provider who developed the idea of placing youth in small group homes with individualized care, flexible programming, and a "never give up" philosophy (Behar, 1985). Karl Dennis' Kaleidoscope program in Chicago, IL, and John Van Den Berg's Alaska Youth Initiative adapted these concepts. The Kaleidoscope program—the oldest Wraparound initiative in the United States—used unconditional care and flexible, integrated services to meet youth and family needs (Burns and Goldman, 1998). The Alaska Youth Initiative used cross-system collaboration and funding and individualized planning to bring youth back to the community from out-of-State residential treatment placements (Burchard et al., 1993). Dr. Ira Laurie, National Director of the U.S. Department of Health and Human Services' Child and Adolescent Services System Program (CASSP), further conceptualized the process. His descriptions of the values of CASSP in treating children with serious emotional problems, including the development of individualized, child-centered, family-focused, community-based, and culturally competent services, have been adopted by Wraparound (Laurie and Katy-Leavy, 1987).

The evolution of Wraparound in systems design was further enhanced by the implementation and growth of system of care models, developed under demonstration grants from the U.S. Department of Health and Human Services' Center for Mental Health Services. This grant program incorporated the values, philosophy, and approaches of Wraparound to promote integrated service systems for youth with serious emotional problems operating across the mental health, juvenile justice, child welfare, and education systems.

Demographics of the Delinquent Population in Wraparound Milwaukee

  • Eighty percent are male.
  • The average age is 14.7.
  • Sixty-five percent are African American, 28 percent are Caucasian, and 7 percent are Hispanic.
  • Sixty-five percent are from mother-maintained households.
  • Fifty-three percent of the population's families are at or below the poverty level.

Although there are many components to Wraparound, the following elements have been of particular importance in working with children in the juvenile justice and child welfare systems:

Bullet Strength-based approach to children and families. Mental health and juvenile justice systems have focused largely on identifying a child's deficits or a family's problems. This is not the most effective way to engage a child or family in the treatment process. Focusing on a family's strengths, learning about the family's culture, and building on the natural supports that exist within the family, neighborhood, or community is a much more effective approach. Examples of such supports include peer groups, recreational basketball leagues, parenting classes, and positive relationships a child may have with grandparents, uncles, aunts, peers, and others.

Bullet Family involvement in the treatment process. Families are the most important resource in any youth's life. Juvenile justice, child welfare, and mental health practitioners often have been too quick to identify families as the source of the youth's problems. The tendency is to remove youth from the home and institutionalize them in order to "fix" them. Youth, however, usually prefer to live with their families. Whenever possible, service providers should engage families in the treatment process. Accordingly, it is important that providers view families as capable and knowledgeable about their children's needs and enhance families' abilities to parent their troubled children.

Treatment plans that are tailored to address the unique needs of each child work best.

Bullet Needs-based service planning and delivery. If families are to be involved as active partners, it is essential to listen to their assessment of their needs. Juvenile justice, child welfare, and mental health practitioners tend to assume that as "experts" they are best equipped to decide the programs and services youth need. If, for example, a youth and family have identified a need for respite care, a tutor, or a mentor to serve as a positive role model, why do some practitioners insist on providing outpatient therapy, day treatment, or residential care? The failure to listen to what a child and family identify as their needs, and to address those needs, can cause programs and services to fail.

Bullet Individualized service plans. Treatment plans that are tailored to address the unique needs of each child and family work best. Individualized plans for youth, particularly those involved in the juvenile justice system, must address the typical needs of persons of like age, gender, or culture. These can involve living situations; legal status; and medical, health, and psychological needs.

Bullet Outcome-focused approach. The Wraparound process does not rely on subjective assessments of what does or does not work. Clear goals for the youth and family—established by the youth and family in partnership with the professionals—are continually measured and evaluated. The key to this approach is to manage the process to ensure desired outcomes.

Juvenile Justice - Youth With Mental Health Disorders:
Issues and Emerging Responses
April 2000,
Volume VII · Number 1