ISP/Wraparound Teamwork in Practice: An Examination of Multiple Perspectives on Collaboration, Team Functioning, Facilitation, and Effectiveness

Personnel	Study methods
Problem and background	Key findings
Theoretical model	Outputs
Research questions	References
Latest Updates

Personnel

Janet Walker, Ph.D., Principal Investigator;
Kathryn Schutte, M.S., Research Assistant;
Paul Koren, Ph.D., Methodologist

Problem and background

In recent years, communities across the country have responded to the multifaceted needs of children with serious emotional and behavioral disorders by using a variety of creative approaches for coordinating, designing, and delivering services. One of these approaches is team-based Individualized Service/Support Planning (ISP), which is known by a number of different names, including Wraparound, individualized and tailored care, and child-and-family teams. These approaches are also similar to family-provider collaborative planning teams working in the contexts of juvenile justice, developmental disabilities, and child welfare. In children’s mental health, ISP/Wraparound approaches have become one of the primary strategies for implementing the system of care philosophy for children with the highest levels of need, reaching perhaps as many as 200,000 children and their families (Faw, 1999).

ISP/Wraparound is a philosophically appealing approach to service delivery. Team members (family, the child if practicable, service providers, and members of the family’s informal and community support networks) are to work together collaboratively. The goal of the planning process is to develop and implement a unique set of services and supports that will assist the child and family in achieving positive clinical and functional outcomes. The ISP planning process itself, as well as the set of services and supports included in the plan, are to be family driven, collaborative, individualized, culturally competent, and community and strengths based.

Achieving high quality implementation of ISP has proven to be difficult, however (Burchard, Bruns, & Burchard, 2002; Farmer, 2000; Walker, Koroloff, & Schutte, 2003). In large part, this difficulty stems from the fact that while there is agreement about the values that should guide ISP, there exists no generally agreed-upon model or manual for ISP practice. Wide variation in ISP practice has been observed, and there is concern that many teams do not operate in ways that truly promote the ISP values and vision (Burchard et al., 2002; Walker et al., 2003). Difficulties in reaching agreement about guidelines or standards for ISP practice are exacerbated by a lack of a well-developed theory describing how the ISP process produces positive outcomes.

• To develop a model of effectiveness for ISP teamwork that links team member practices to child and family outcomes,
• To use the model as the basis for describing the types of practices that are likely to promote positive outcomes,
• To compare these “candidate” practices as derived from research and theoretical sources to ISP team members’ understanding of practices that contribute to effective ISP teamwork, and to develop recommendations for practices that are consistent with both perspectives,
• To explore whether or not there are systematic differences in perspective between and among team members (e.g. family versus professional or case manager versus therapist) regarding practices and team member interactions that promote high quality teamwork,
• To identify barriers to implementation of the recommended types of practices, and
• To provide information and tools that will help ISP programs to clearly define a practice model for ISP that includes recommended practices, and to monitor adherence to the practice model

To achieve these goals, the project has gathered data using a variety of methods and has synthesized information from a variety of sources including: existing research and theory, experts in ISP practice (including family members and professionals), experts in the provision of support for ISP practice (nationally recognized trainers, program managers, administrators), and team members on representative teams.

Theoretical model

The work in this project is based on the model of ISP team effectiveness developed in the early stages of the project’s work. The model is a variation on the type of model that is most commonly used in research and theory on team effectiveness (Hackman & Morris, 1975). In the model, the main route to effectiveness is from inputs through practices and processes to outcomes (This model is described in detail in Walker et al., 2003). ISP inputs include team member skills, knowledge, and background, as well as organizational and system support. ISP practices are specific techniques and procedures that team members intentionally employ as they work to develop the plan and operationalize the ISP value base. Practices include specific techniques and procedures for defining and prioritizing goals, stimulating the exchange of information, making decisions, obtaining feedback, building an appreciation of strengths, ensuring family-centeredness, and so on. Practices take place within a short time frame, though the same practice may occur on many occasions. ISP practices are translated into outcomes through their impact on two team-level processes: the planning process and the process of building team cohesiveness. On cohesive teams, team members have developed the shared belief that they are willing and able to work together to achieve goals held in common. The model describes the two processes in terms of a series of attributes that have been linked to effectiveness in numerous team studies across a variety of contexts. These attributes are marked with asterisks in the figure. Other attributes of the two processes reflect the special nature of ISP by incorporating elements of the value base. The two team-level processes are complex, and each is continually affected not only by team practices but also by feedback loops that operate both within each process and between the two.

The model of ISP effectiveness assumes that success in both processes is required if teams are to be effective in achieving desired ISP outcomes (e.g. improved fit between services/supports and needs, increased family empowerment, and improved quality of life). In turn, effective practice is based on a clear understanding of how a given technique or procedure can be expected to impact team-level processes. In addition to being knowledgeable about practices, team members must also have skills that will enable them to implement practices at the appropriate times. These types of skills and knowledge are contained in a practice model for ISP.

The model highlights several key assumptions built into the goals and methods of the project, namely

• An understanding of the links between inputs, practices, processes, and outcomes is a necessary first step in the larger process of defining ISP team practice parameters,
• A variety of different practices may function similarly (i.e. they produce similar impacts on team processes)
• Team members require not only knowledge of recommended practices, but also the skills necessary to implement the practices
• Clear definition, at the organizational level, of practice parameters can translate to improved outcomes through their impact on team members’ skills and practices.

Research Questions

The specific questions addressed by this project are as follows:

• Does the conceptual model of ISP team functioning and effectiveness, derived largely from research on teams in other settings, match the understanding of expert ISP team members regarding what makes teams successful?
• Do recommendations for effective ISP teamwork derived from research and theory match recommendations of expert team members?
• To what extent do representative teams employ recommended practices, and to what extent do the plans produced by these teams reflect the values and goals of the ISP process?
• Do different groups of team members (e.g. family versus professionals or care coordinators versus therapists) have different views regarding the types of practices and interactions that promote high quality teamwork?
• Do these different team members evaluate team interactions and practices differently in terms of the extent to which they promote high-quality planning and/or team cohesiveness?
• Do teams that use a higher number of recommended practices during meetings tend to have higher levels of team member satisfaction?

Several themes within these questions reflect consumer needs. Most obviously, this research systematically examines potential differences between and among family and professional team members regarding the extent to which teamwork is truly proceeding in a family/youth-centered, strengths-based, and culturally competent manner. A number of studies have found that professionals consistently rate their collaborativeness with families higher than do the family members themselves (Bruns, Suter, & Burchard, 2002; DeChillo, 1993), and this discrepancy is an ongoing theme in the comments of families and youth involved in systems of care (Simpson, Koroloff, Friesen, & Gac, 1999). More generally, families are generally highly supportive of ISP/wraparound as a model of service delivery. However, the recognized lack of specificity regarding standards or guidelines for practice contributes not only to the variability of quality from program to program, but also to the lack of evidence (or even the possibility of gathering evidence) for the effectiveness of the approach. Unless clearer practice guidelines or parameters are developed, it is quite possible that, despite its promise, the ISP/wraparound approach will be gradually abandoned and perhaps even discredited.

Study methods

1.1 Literature review and model development. Preliminary work for the project began with a literature search for relevant sources on teamwork and individualized services planning. The focus was on locating information on teams that undertake a long-term planning process during which they define their own goals, devise strategies for meeting those goals, and monitor implementation and effectiveness of the strategies. This information was synthesized to yield the first draft of the model of ISP team effectiveness. This model identified two clusters of attributes of effective team process. One cluster of attributes was related to the quality of the planning process, while the other cluster was related to the level of team cohesiveness.

1.2 Expert team member interviews: Practice description and model validation. Staff conducted semi-structured interviews with 28 expert team members, each of whom had worked with multiple teams in roles that included facilitator, care coordinator, resource developer, and parent partner/advocate. Interviewees were nominated as most expert within sites receiving national recognition for best practice in ISP. The semi-structured interviews with expert team members lasted about an hour each, and focused on interviewee perceptions of factors that influenced the success or failure of ISP teams.

To analyze the data from the expert interviews, a coding system was developed that was based on the two clusters of attributes of for team effectiveness described above. The coding system was designed to capture interviewees’ perceptions regarding the essential elements of effective ISP teamwork, barriers to achieving effective teamwork, and strategies for overcoming these barriers. Satisfactory inter-rater agreement > 85% was achieved for a sub-sample of the interviews. The high level of inter-rater agreement provides a strong indication that the coding system—developed from the model of ISP team effectiveness—provided a good fit for the comments and concerns raised by the expert team members. Interviewees included four African Americans, two Latinos and three Native Americans.

1.3 Expert review. A document describing the model of team effectiveness was reviewed in a group discussion format by seven experts in the field of children’s mental health representing stakeholders from the service, organization, and system levels. Following revisions, 11 additional reviewers with high levels of expertise regarding ISP teamwork critiqued the document during individual feedback sessions. This group of reviewers represented the service, organization and system perspectives and included family members, practitioners and administrators from diverse backgrounds. Revisions were made, and a series of assessments were developed and added to the document. The assessments examine ISP implementation at the team, organization, and system levels. The document and assessments then underwent another review from the first group, and the assessments were further reviewed during two group feedback sessions with stakeholders from around the country (see note below). Final revisions were then made to the document and the assessments (Walker et al., 2003). After these revisions, the model was formally adopted by a group of 28 nationally recognized experts in ISP/wraparound as part of a framework to guide the “Wraparound Model Definition Initiative” described in phase 4.

note:
Of the total 45 expert reviews of the framework, twelve were given by parents, four by youth or young adult consumers, ten by researchers, eight by ISP facilitators or care coordinators, five by state level administrators, five by system-level administrators, six by ISP program administrators, and two by consultants. (This total is greater than 45 due to reviewers in multiple roles relative to ISP teams and programs.) Among the 45 reviews, seven were provided by African Americans, three by Native Americans, and three by Latinos. The rest of our reviewers were Caucasian, or their ethnicity was unknown.

Research staff collected data during observations and follow-up of 72 meetings of 26 different collaborative family-provider ISP teams. The teams that were observed were diverse in a variety of ways. In terms of geographic diversity, participating teams represented 13 different communities in eight different states. Three of these communities were located in the core areas of large cities, two in smaller cities, three in established suburban areas, and eight in developing “edge” areas where farmland and newer suburbs were intermixed. Teams were also diverse in terms of the overall levels of organizational and system support they received. For example, nine of the teams were from programs recognized by the Center for Mental Health Services (CMHS) as having implemented promising practices related to ISP. Members of some of the observed teams received extensive training and support from the organizations and systems in which they were embedded, while other teams received almost no such support.

One or two members of our research staff attended each observed meeting. Research staff collected any materials created by the team for use during the meeting (e.g. agendas, lists of goals), and took notes during the meeting about the structural characteristics of the team and elements of team process and planning. Copies of minutes or other team records produced as a result of the meeting were also provided to the research staff. At the end of the meeting, team members were asked to fill out a post-meeting survey.

At a later date, after all meeting materials had been gathered, each staff member who had attended the meeting separately reviewed notes and team materials, and completed a checklist summarizing various attributes of the team and its activities during the meeting. The checklist was developed from the model of team effectiveness developed in phase 1, and focused on observable elements of practice during the meetings. The checklist was used to rate whether or not various indicators of team process, practice, and planning were evident during the meeting. It was created as a means of assessing the extent to which there was evidence, during the observed meeting, that the team had the ability to promote both effective planning and the value base of ISP. Additional information collected included: sex, race, and role of each team member in attendance; portion of the meeting attended by each member; and location, time, and length of the meeting. Using the ratings of two observers over nine of the meetings that were attended by two staff members, a mean agreement greater than 85% was achieved over the 28 items. This checklist was modified slightly and is now called the Checklist of Indicators for Process and Planning (ChIPP). The checklist was reviewed by experts participating in the final two stages of the expert review process described in phase 1.

Analyses from the data gathered during observations include:

• Descriptive statistics regarding team composition (role, race, gender, etc.), length and location of meeting, number of key team members present/absent
• Descriptive statistics regarding the presence or absence of indicators as recorded using the ChIPP
• Use of multivariate techniques (primarily multivariate analysis of variance/covariance) to model team member ratings of the quality of the meeting planning process and the level of team cohesiveness as rated in the survey. Independent variables include scores from the ChIPP
• Using loglinear methods to examine group differences in frequency of mentioning particular meeting attributes as either the “best” or “worst” aspect of the meeting (from open-ended questions on the questionnaire, coded using the categories developed for the expert team member interviews in phase 1)

During phase 3, 11 team meetings were videotaped. The 11 teams were drawn from seven different ISP programs in six different states. Five of the teams were drawn from communities recognized by the CMHS for best practices related to ISP. Within two days of the meeting, the videotape of the meeting was reviewed separately by the “key participants” from the team—family member caregivers, youth (where appropriate), facilitators, and practitioners. After showing a 5-minute segment (9 segments in all), the videotape was paused for debriefing. Participants then responded to a series of open- and closed-ended questions that probed for the their impressions regarding both the quality of the planning process and the team’s cohesiveness during that segment. A non-participant, experienced parent-facilitator also reviewed each tape and participated in the same cued recall procedure. All comments during the cued recall were taped and transcribed. A total of 62 team members (558 segments rated) from the 11 teams participated in the cued recall procedure.

A coding system, once again based on the two clusters of meeting attributes linked to effectiveness (described in figure 1, developed and used in phases 1 and 2 of the project), was developed to code transcripts from the cued recall. The coding was designed to classify the rationale offered by participants for their ratings of the quality of the planning process and the level of team cohesiveness during each segment of the meeting. Coders trained for 40 hours and achieved reliability in excess of 85% for the presence of a given code in the portion of the transcript related to a given segment of a meeting. Ongoing reliability checks were preformed to maintain this level of agreement. The transcripts of the meetings were also coded—segment by segment—for data related to the number of speaking turns by each team member, length of speaking turn, and salient aspects of the content (this portion of the coding system was developed from an approaches used in the study of conflict resolution (Kimsey, Fuller, Bell, & McKinney, 1994; Pearson & Thoennes, 1989)).

Analyses from phase 3 include:

• Description of team meetings in terms of distribution of talking terms by role of team member and length of talking turn
  
• Use of loglinear methods to examine group differences regarding evaluation rationale offered during the cued recall.
  
• Use of multivariate techniques (primarily multivariate analysis of variance/covariance) to model team member ratings of the quality of the planning process and the level of team cohesiveness. Independent variables include measures of distribution and length of speaking turns within a segment.

Project staff, in collaboration with researchers from the Universities of Maryland and Vermont, and the Center for Mental Health Services, have begun work on a process that is designed to lead to a higher level of shared understanding about specific practices that promote effectiveness in ISP/Wraparound. The Wraparound Model Definition Initiative is driven by an effort to build consensus within two areas: first, the definition of specific strategies that promote high-quality ISP/Wraparound at the team, program, and system levels; and second, to the definition of minimum standards for high-quality ISP/Wraparound across these same levels.

During a meeting of national experts (including family members, national trainers, representatives from highly regarded programs, and researchers) in ISP/Wraparound, the framework developed by this RTC (including the model of team effectiveness, the ChIPP, and supporting documentation) was formally accepted by the group as a conceptual framework within which the group’s future work would occur. Work on compiling strategies and defining practice is proceeding using an Internet-mediated Delphi process (Webler, Levine, Rakel, & Renn, 1991; Woudenberg, 1991) coordinated by a core group of researchers and trainers (including staff of this project).

Key findings

• Model of effectiveness for ISP/Wraparound teamwork received validation from several sources. There was a high level of support across the expert reviewer groups for the model of ISP team effectiveness outlined in figure 1 and described in section 7.1. Additionally, the coding of the interviews with expert team members provided evidence that the model was consistent with expert views regarding effective practice. The model highlights the need for teams to focus on practices that simultaneously contribute to team cohesiveness and to high quality planning carried out in a manner consistent with the values of ISP/Wraparound.
• Model of effectiveness appears to be a useful tool for translating research-based strategies for effective teamwork to the ISP/Wraparound context. The literature on team and group effectiveness provides examples of many concrete practices that have been shown to stimulate high quality planning and/or team cohesiveness, and which are also consistent with the value base of ISP/Wraparound. Staff have compiled a number of these practices, and have described how they fit within the model of effectiveness, and how they can be used in the context of ISP teamwork.
• Expert team members endorse the values of ISP but cite many barriers to operationalizing them. Expert team members interviewed in our study spontaneously endorsed several of the core values of ISP/Wraparound (services should be family centered, strengths based, community based—endorsed by <80% of the interviewees), as well as the ISP/Wraparound approach as an overall paradigm for service delivery (93% spontaneous endorsement during the interview). Experts also spontaneously cited many barriers to operationalization of the value base (ranging from 57% for community based to 87% for the paradigm as a whole).
• Expert team members point to lack of specific strategies for operationalizing the ISP/Wraparound paradigm. When specifically asked to talk about strategies and skills that were necessary to operationalize the value base in practice, relatively few of the expert interviewees provided examples of practices that could be used within meetings or face to face with families and youth. There were two values for which just over half the interviewees described specific practices: being family centered and being strengths based. All but two of the interviewees pointed spontaneously to the lack of specific strategies for operationalizing the values/paradigm, and many mentioned that their peers were frequently demoralized by the challenges associated with trying work within a new paradigm but without specific, concrete guidance about how to do so.
• Expert team members reported high levels of stress and burnout among their peers. Lack of concrete guidance for practice, as well as lack of support from team members from partner agencies (education, juvenile justice, child welfare) are major obstacles. Expert review supported this contention.
• Expert team members do not appear to focus on high quality planning. Expert facilitators rarely mentioned specific strategies to use in meetings to move the planning process forward—e.g. fewer than a third of them mentioned strategies related to devising or prioritizing goals, linking services/strategies to goals, promoting accountability, or revising or updating the plan. We hypothesized that facilitators often are so preoccupied with the value base (and with the obstacles to implementing the paradigm) that planning becomes obscured. This possibility received support our observations of teams (phase 2).
• Expert team members reported that their supervisors often (>80%) had no experience with team facilitation or planning.

• Attributes of high quality planning appear rare in ISP/Wraparound meetings. Few ISP/Wraparound teams among those we observed maintained a planning process characterized by attributes most robustly linked to team effectiveness across a variety of team contexts. For example:
  • Fewer than a quarter of teams observed maintained a team plan that included team goals.
  • Fewer than one fifth of teams specifically linked services, supports or strategies to team goals or larger needs.
  • Fewer than one fifth of teams monitored progress on goals or evaluated strategies using any type of performance indicator or measure of success.
  • Fewer than one fifth of teams systematically checked to see if team members had accomplished assigned tasks.
  • Only about 15% of teams considered more than one option (during any decision making during any time during the meeting) before selecting a strategy or service.
• Teams make efforts to include strengths in the planning process. Almost one third of teams discussed strengths during the meeting, and about 20% engaged in a strengths activity.
• Teams tended to be responsive to family’s wishes to alter formal services, but were not particularly successful in developing community or informal services and supports:
  • During more than 80% of observed meetings, teams made small adjustments to formal services (time or place of meeting, frequency) in response to family preference.
  • About one third of teams discussed purchasing or providing a regular community service (health club membership, sports team, art class), but less than 10% of teams were actually facilitating family access to such services.
  • Less than 10% of teams were facilitating access to a community support (church youth group, volunteer mentoring).
  • Only about 10% of teams had more than one natural support, including paid natural supports (parent advocate or partner) or extended family.
• Analyses currently underway examine the extent to which team member overall satisfaction with meetings varies as a function of the number of attributes of high quality planning and cohesiveness observed (according to the ChIPP).

(All results in this phase are preliminary; however we anticipate that much of what we find will be worthy of dissemination and will, in fact, be disseminated. More results and greater detail will be forthcoming.)

• In meetings that are rated most unsatisfactory by all participants, family members tend to be significantly less satisfied than professionals.
• Team members across all roles are highly concerned with maintaining a sense of psychological safety (trust and mutual respect, non-attacking interpersonal style) within the team, citing psychological safety as an important determinant in both positive and negative evaluations of meeting segments.
• Team members’ ratings of satisfaction with the planning process and satisfaction with team cohesiveness tend to rise and fall together throughout the course of meetings.
• Team members’ ratings of satisfaction with the planning process and satisfaction with team cohesiveness tend to vary quite a bit during meetings, with middle sections being perceived relatively unfavorably by participants.
• Meeting segments judged most unfavorably tend to be those in which talk is least evenly distributed across team members (i.e. a small number of people talk most of the time).

• National convening of experts supports ISP model as part of framework for high quality implementation. A significant accomplishment of the early work in this phase of the project is having obtained formal agreement from a group of national experts regarding a framework for understanding the necessary conditions for high quality ISP/Wraparound practice. Members of the group have also agreed to donate substantial time and resources to participating in the Delphi consensus-building process with the goal of producing a) a compendium of specific practices consistent with high quality ISP/Wraparound team process and b) practice parameters for ISP/Wraparound.

Outputs

• Koroloff, N., Schutte, K., & Walker, J. S. (2003). The context of services: The importance of agency and system support to effective ISP/Wraparound. Focal Point: A National Bulletin on Family Support and Children's Mental Health, 17(1), 8-11.
• Schutte, K. (2003). Cody's experience of wraparound. Focal Point: A National Bulletin on Family Support and Children's Mental Health, 17(1), 16.
• Walker, J. S. (2003). Practices to promote effective teamwork in ISP/Wraparound. Focal Point: A National Bulletin on Family Support and Children's Mental Health, 17(1), 12-14.
• VanWormer, R., & Schutte, K. (2003). Wearing two hats: The challenges and strengths of being a parent and a wraparound facilitator. Focal Point: A National Bulletin on Family Support and Children's Mental Health, 17(1), 29.

Together with staff from the Context of Services project, staff have published a monograph describing the necessary conditions to support high quality ISP/Wraparound at the team, organization and system levels. You can download this monograph by going to the publications page and searching by using the author field and entering “Walker.” The citation for this monograph is:

• Walker, J.S., Koroloff, N. & Schutte, K. (2003). Implementing high-quality collaborative Individualized Service/Support Planning: Necessary conditions. Portland, OR: Research and Training Center on Family Support and Children's Mental Health, Portland State University.

Lastly, project staff have developed an assessment tool, Checklist for Indicators of Practice and Planning (ChIPP), and supporting documentation. The ChIPP provides a list of indicators for the team level conditions necessary for the implementation of high quality ISP/Wraparound. This assessment can be found in the monograph.

Staff are readying two further journal articles for submission, one reporting on the major findings from the observations of teams, and one reporting on analysis of qualitative data about the challenges related to ISP teamwork. At least one journal article will be written reporting on the results of the videotape study. Staff have been invited to contribute a chapter on ISP/Wraparound and our current research to a book on community-based mental health. Staff also anticipate publication of at least two more chapters in proceedings from national conferences, and pamphlets and short reports of findings presented in non-technical language. Finally, as a result of collaboration in the Wraparound Strategies Initiative, we anticipate producing several publications as well as the creation of tools to be used in setting and monitoring practice parameters.

Project staff have presented results from our research at nine national conferences. Two of these presentations were invited plenary presentations. Staff have also presented trainings to PhD students in the Social Work Program at Portland State University as well as graduate students in Portland State’s Special Education program. The majority of these trainings/presentations were done in collaboration with a parent with a child with a serious emotional/behavioral challenge. Staff have responded to close to 250 requests for technical assistance with individualized responses that include offering resources and referrals (usually via email and telephone) as well as on-site consultation.

Project staff plan to present to at least two more national conferences, and at a national training institute. In conjunction with the Context of Services project, we are pilot testing the assessments of ISP/Wraparound implementation as part of capacity-building efforts in at least three sites. We anticipate offering substantial technical assistance in conjunction with the pilot testing.

References

Bruns, E. J., Suter, J. C., & Burchard, J. D. (2002). Pilot test of the Wraparound Fidelity Index 2.0. In R. M. Friedman (Ed.), The 14th annual research conference proceedings. A system of care for children's mental health: Expanding the research base. February 25 - 28, 2001. (pp. 235-238). Tampa, FL: University of South Florida, The Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health.

Burchard, J. D., Bruns, E. J., & Burchard, S. N. (2002). The wraparound approach. In K. Hoagwood (Ed.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders (pp. 69-90). New York: Oxford University Press.

DeChillo, N. (1993). Collaboration between social workers and families of patients with mental illness. Families in Society, 104-115.

Farmer, E. M. Z. (2000). Issues confronting effective services in systems of care. Children and Youth Services Review, 22, 627-650.

Faw, L. (1999). The state wraparound survey. In S. K. Goldman (Ed.), Systems of care: Promising practices in children's mental health, 1998 series: Volume IV. Promising practices in wraparound for children with severe emotional disorders and their families (pp. 79-83). Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.

Hackman, J. R., & Morris, C. G. (1975). Group task, group interaction process, and group performance effectiveness: A review and proposed integration. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 8). New York: Academic Press.

Kimsey, W. D., Fuller, R. M., Bell, A. J., & McKinney, B. C. (1994). The impact of mediator strategic choices: An experimental study. Mediation Quarterly, 12, 89-97.

Pearson, J., & Thoennes, N. (1989). Divorce mediation: Reflections on a decade of research. In Associates (Ed.), Mediation research: The process and effectiveness of third-party intervention (pp. 9-30). San Francisco: Jossey-Bass.

Simpson, J., Koroloff, N., Friesen, B. J., & Gac, J. (Eds.). (1999). Systems of care: Promising practices in children's mental health, 1998 series: Volume II. Promising practices in family-provider collaboration. Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.

Walker, J. S., Koroloff, N., & Schutte, K. (2003). Implementing high-quality collaborative individualized service/support planning: Necessary conditions. Portland OR: Research and Training Center on Family Support and Children's Mental Health.

Webler, T., Levine, D., Rakel, H., & Renn, O. (1991). A Novel Approach to Reducing Uncertainty: The Group Delphi. Technological Forecasting and Social Change, 39, 253-263.

Woudenberg, F. (1991). An Evaluation of Delphi. Technological Forecasting and Social Change, 40, 131-150.

Latest Updates

This project has completed all activities except the final products from the final phase (videotape study). Reports are published or forthcoming, and can be found by accessing the Publications page and searching by author under Walker (link is provided below).

People interested in wraparound more generally may wish to review the Fall, 2003 issue of Focal Point, devoted to that topic.

http://www.rtc.pdx.edu/pgFocalPoint.shtml

The web page of the National Wraparound Initiative also provides resources about wraparound practice, fidelity, and research.

http://www.rtc.pdx.edu/nwi

Or use the link below.

• Wraparound Fidelity in Systems of Care and its Association with Outcomes - March 2007

• Wraparound Oregon: Integrating community support one child at a time. Presentation at the annual meeting of the Children’s Array of Psycniatric Programs (CHARPP), Portland, Oregon, September 11, 2007