RESUMO
OBJECTIVE: Wraparound is a common method for coordinating care for children and adolescents with serious emotional disorders (SED), with nearly 100,000 youths served annually in the United States. The current systematic review and meta-analysis estimated effects on youth outcomes (symptoms, functioning, school, juvenile justice, and residential placement) and costs. METHOD: A literature search identified 17 peer-reviewed and gray literature studies meeting criteria, which were coded on characteristics of sample, design, implementation, and outcomes. Random effects modeling was conducted using Comprehensive Meta-Analysis Version 3.0. Effect sizes were calculated using Hedges g. Homogeneity of effects were assessed using Q statistics. RESULTS: Medium-sized effects favored Wraparound-enrolled youths for costs (gâ¯=â¯0.391, CIâ¯=â¯0.282-0.500, p < .001), residential outcomes (gâ¯=â¯0.413, CIâ¯=â¯0.176-0.650, pâ¯=â¯.001), and school functioning (gâ¯=â¯0.397, CIâ¯=â¯0.106-0.688, pâ¯=â¯.007); small effects were found for mental health symptoms (gâ¯=â¯0.358, CIâ¯=â¯0.030-0.687, pâ¯=â¯.033) and functioning (gâ¯=â¯0.315, CIâ¯=â¯0.086-0.545, pâ¯=â¯.007). Larger effects were found for peer-reviewed studies, quasi-experimental designs, samples with a larger percentage of youths of color, and Wraparound conditions with higher fidelity. CONCLUSION: Results indicate positive effects for Wraparound, especially for maintaining youths with SED in the home and community. However, many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research. Nonetheless, the results should aid decisions around resource allocation, referral practices, and system partnerships among child psychiatrists and other behavioral health professionals.