A Narrative Review of Wraparound Outcome Studies

T wraparound process has been described as having a promising body of evidence (Burns, Goldman, Faw, & Burchard, 1999; National Advisory Mental Health Council, 2001; New Freedom Commission on Mental Health, 2003), to the point it has been included in two Surgeon General reports (U. S. Department of Health and Human Services, 1999, 2000), recommended for use in federal grant programs (U. S. Department of Health and Human Services, 2005), and presented as a mechanism for improving the delivery of evidence-based practices for children and adolescents with serious emotional and behavioral disorders ([SEBD] Friedman & Drews, 2005; Tolan & Dodge, 2005; Weisz, Sandler, Durlak, & Anton, 2006). Not everyone, however, is convinced. Bickman and colleagues (Bickman, Smith, Lambert, & Andrade, 2003) have stated that “the existing literature does not provide strong support for the effectiveness of wraparound” (p. 138). Farmer, Dorsey, and Mustillo (2004) recently characterized the wraparound evidence base as being “on the weak side of ‘promising’” (p. 869). There are several significant concerns about the state of the wraparound evidence base. As presented in Figure 1, though the number of publications about wraparound has grown steadily over time, the number of outcome studies remains relatively small. Many outcome studies that have been published used less rigorous designs and included relatively small samples. Finally, the wraparound model has developed in a “grassroots” fashion and has been driven largely by local priorities. This means that there has hisJesse Suter, Faculty University of Vermont