RESUMEN
Wraparound is a widely-implemented team-based care coordination process for youth with serious emotional and behavioral needs. Wraparound has a positive evidence base; however, research has shown inconsistency in the quality of its implementation that can reduce its effectiveness. The current paper presents results of three studies used to examine psychometrics, reliability, and validity of a measure of wraparound fidelity as assessed during team meetings called the Team Observation Measure (TOM). Analysis of TOM results from 1,078 team observations across 59 sites found good overall internal consistency (alpha = .80), but constrained variability, with the average team rated as having 78% of indicators of model adherent wraparound present, 11% absent, and 11% not applicable. A study of N=23 pairs of raters found a pooled Kappa statistic of .733, indicating substantial inter-rater reliability. Higher agreement was found between external evaluators than for pairs of raters that included an external evaluator and an internal rater (e.g., supervisor or coach). A validity study found no correlation between the TOM and an alternate fidelity instrument, the Wraparound Fidelity Index (WFI), at the team level. However, positive correlations between mean program-level TOM and WFI scores provide support for TOM validity as a summative assessment of site- or program-level fidelity. Implications for TOM users, measure refinement, and future research are discussed.
RESUMEN
Family treatment drug courts (FTDCs) are an increasingly common approach for serving families involved in child welfare due to parental substance abuse; however, the evidence base for FTDCs remains emergent. This quasi-experimental study replicates previous research on FTDCs by comparing parental substance abuse treatment and child welfare outcomes for 76 FTDC participants to outcomes for 76 parents in the same system who did not participate in the FTDC, using propensity score matching. Data were obtained from the Superior court, FTDC, child welfare, and public substance use treatment service administrative databases. The follow-up window for participants ranged from 1 to 3 years. Results showed FTDC parents had significantly more review and motion hearings, were significantly more likely to enter treatment, entered treatment faster, received more treatment, and were more likely to successfully complete treatment. FTDC children spent significantly less time placed out of home, ended child welfare system involvement sooner, were more likely to be permanently placed and discharged from child welfare, and were more likely to return to parental care. Results demonstrate that FTDCs promote positive treatment and child welfare outcomes without deepening participants' involvement in justice systems.