Wraparound New Zealand : an evaluation of fidelity and experiences : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand

Abstract

Serious mental health disorders are complex clinical problems which interfere with a youth‟s ability to live functionally within their family and community. The wraparound process is an intensive individualised coordination and care planning process for youth with serious mental health disorders and their families who present with multiple, complex, and expansive needs. Originating from the United States of America the wraparound process was introduced on a limited basis in one District Health Board in New Zealand in 2004. Although deemed a promising practice internationally, no independent research, to our knowledge, had been conducted on this process within a New Zealand context. Therefore, the studies in this thesis aimed to evaluate the wraparound process in New Zealand. Study one reviewed the needs of youth with serious mental health disorders in New Zealand, the interventions currently available, and introduced the wraparound practice model as a potential solution to the service gaps and limitations. Study two and three investigated the fidelity to, and the experiences of, the wraparound process from the perspectives of wraparound facilitators, caregivers, youth, and team members who made up 16 wraparound teams. Overall the results from these studies indicated that the wraparound process in New Zealand was experienced as positive and helpful and was being implemented as it was intended with an overall fidelity score in the above average range. The positive experience was related to four interconnected themes: the role of the wraparound facilitator; support; wraparound‟s philosophies and principles; and the outcomes achieved. Importantly, a degree of consistency was also found across studies between the level of adherence to wraparound principles and phases in the fidelity study and those which were perceived as important or in need of improvement in the qualitative study. Taken together the results of this research project confirmed that the wraparound process was a viable and useful intervention for New Zealand youth and families with high and complex needs. However, future research is recommended using larger more representative sample sizes which include quantitative outcome measurement to establish the effectiveness of the process.