The Children’s Bureau in the Office of Mental Health and Substance Abuse Services (OMHSAS) works with the University of Pittsburgh and its community partners to manage the Pennsylvania Youth and Family Training Institute (YFTI). The Institute has an Advisory Board composed of equal representation of youth, families, and professionals. Shannon Fagan, former Westmoreland County CASSP Coordinator, is the Director. More information is available on the Institute’s website.
The Youth and Family Training Institute was given the responsibility by the State of Pennsylvania to train, coach and credential the PA High Fidelity Wraparound (HFW) workforce. HFW is not a specific service or intervention, but rather a process for youth with multifaceted behavioral health needs and their families that follows a series of steps to help youth and their families realize their hopes and dreams. It is a process that allows more youth to grow up in their homes and communities. It is a planning process that brings people together (natural supports and providers) from various parts of the youth's and family’s life. High Fidelity Wraparound must involve family voice and choice, be a team-based approach, use natural supports, facilitate collaboration and integration, be community based, be carried out in a culturally competent manner, be individualized, strengths based and persistent, and be based on outcome measures and cost effectiveness. The model was formally defined by the U.S. National Wraparound Initiative (NWI). Members of this initiative have identified standards for conducting wraparound and the means for measuring successful outcomes.
Check out the Youth and Family Training Institute Website
The Youth and Family Training Institute (YFTI) has now been operating for five years. YFTI is the agency that has the responsibility of training, coaching and credentialing the High Fidelity Wraparound (HFW) workforce for the state of Pennsylvania.
The YFTI website explains what the Youth and Family Training Institute is, and more importantly, what High Fidelity Wraparound is. Included on the site are pages specifically for our workforce, information about the counties involved, pages for youth and family members, training information, current news, and YFTI’s Advisory Board and PA System of Care Partnership updates.
Yftipa.org is helpful for many reasons. Besides being useful for accessing information on current behavioral health news impacting youth and families in Pennsylvania, the site also shares uplifting and poignant stories of youth and families who have been successful in High Fidelity Wraparound. We urge readers to check us out to learn more!
How High Fidelity Wraparound differs from Pennsylvania’s Behavioral Health Rehabilitation Services (often commonly called wraparound):
Although the process is referred to as ‘wraparound’ by NWI and Vroon VanDenBerg, it is called High Fidelity Wraparound in Pennsylvania. This was, in part, a way to form a distinction between the HFW process and wraparound services. Wraparound services are for youth under the age of 21 who have mental health diagnoses. They are usually rendered necessary when the youth’s mental health needs exceed what is typically able to be accomplished in standard outpatient therapy. Behavioral Staff Consultant (BSC), Therapeutic Staff Support (TSS), and Mobile Therapy (MT) services were added to the Medical Assistance fee schedule in 1994 and are intended to accomplish the following: provide one-to-one services in a youth’s home, school or other community setting; prevent the youth’s need for a more restrictive treatment setting; assist primary caregivers and school personnel in learning and providing direct behavioral support; be carried out in a culturally competent manner; and be individualized to meet the social, emotional and/or behavioral needs of the child. These services have been and continue to be commonly referred to as “wraparound” services in Pennsylvania, although the state now refers to these positions as Behavioral Health Rehabilitative Services (BHRS).
Behavioral Health Rehabilitative Services are intended to be carried out according the principles set forth by the Pennsylvania Child and Adolescent Service System Program (CASSP). CASSP stipulates that BHRS provided to children and families be child-centered, family focused, community-based, multi-systemic, culturally competent, and least restrictive/least intrusive. BHRS and the HFW process can work together, but they are not the same. YFTI has adapted the HFW model to the needs of Pennsylvania, and includes Youth Support Partners as part of the HFW workforce.
High Fidelity Wraparound in Pennsylvania, PA CASSP Newsletter, December 2009
Resources on High Fidelity Wraparound for counties, agencies, providers, families and youth.
This information is intended to clarify the process involved in carrying out High Fidelity Wraparound for all parties who would potentially be involved.
- General overview of the wraparound process, principles, and steps
- Description of how and why wraparound works, provided by the National Wraparound Initiative and excerpted from their resource guide. A link to the full guide is provided below.
- Ensuring fidelity to the wraparound process: methods and results of three states’ efforts to make wraparound all that it should be
- NWI’s overview of the four phases: Phases and Activities of the Wraparound Process: Building Agreement About a Practice Model, by Janet Walker and Eric Bruns, National Wraparound Initiative Advisory Group
- http://wrapinfo.org/: This is a central site with links to four valuable resources:
- National Wraparound Initiative (NWI): information related to how this advisory group came to be; how they have come to a standard definition for the process of wraparound; how it is implemented; and how successful outcomes are assessed
- Resource Guide to Wraparound: compilation of all of the work that has been accomplished by the NWI, including a definition of the process and principles; pilot studies that have been completed; success stories from youth and families. It serves as a working manual for implementation.
- Wraparound Evaluation and Research Team (WERT): a research team that has completed extensive investigations on the implementation and outcomes of the wraparound process. Members of this team are also part of the NWI. This group of researchers also collaborated to create the Wraparound Fidelity Assessment System, a multi-faceted evaluation tool for evaluating the process of and outcomes of wraparound. The WERT site includes research and presentations associated with the Wraparound Fidelity Index.
- Wraparound Online Data Entry System (requires registration and log-in)
- Vroon VandenBerg, LLP, a national consulting agency that provides information, training, consultation and coaching for the implementation of High Fidelity Wraparound.
- High Fidelity Wraparound and Systems of Care, December 2009 edition of the PA CASSP Newsletter, reporting on the early implementation of high fidelity wraparound in Pennsylvania through the Youth and Family Training Institute.
The HFW Workforce:
The HFW Team:
HFW Coaches, Facilitators, Family Support Partners and Youth Support Partners are considered the HFW workforce. They make up just a part of the HFW team. The HFW team can be comprised of the HFW workforce members, the youth and family, family and community natural supports that the youth and family have chosen, and professional providers involved with the youth and family. Professionals can include those involved with the youth and/or family on a regular basis such as
counselors/therapists, doctors, speech therapists, occupational therapists, etc. These professionals should count for no more than 50% of the entire team composition.
User guides for youth and families:
More information related to BHRS services in Pennsylvania, the ISPT process, and CASSP principles:
Youth and Family Training Institute
Outcome and Cost-Effectiveness Analysis of High Fidelity Wraparound in Pennsylvania, March 2012