High Fidelity Wraparound (HFW) and other related terms:
Statements in a HFW plan that describe the specific activities that will be undertaken, including who will do them and within what time frame.
Autism Spectrum Disorder (ASD)
Autism is a pervasive developmental disorder. Its symptoms include differences and disabilities in many areas including social communication skills, fine and gross motor skills, and sometimes intellectual skills. Autism is also a spectrum disorder and therefore it ranges in severity. At one end of the spectrum is the disorder which often includes profound developmental delays and challenges. On the other end is Asperger’s Syndrome, or High-Functioning Autism. Also included are a variety of pervasive developmental disorders including Rett Syndrome, Fragile X Syndrome, and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS). HFW is currently not available in PA for children and adolescents who have ASD as their primary diagnosis. In the Diagnostical Statistical Manual (DSM-5), the spectrum is only identified as Autism.
Behavioral Health Rehabilitation Services (BHRS)
Services that are typically rendered necessary when the youth’s mental health needs exceed what is able to be accomplished in standard outpatient therapy. In Pennsylvania, Behavioral Specialist Consultant (BSC), Therapeutic Staff Support (TSS), and Mobile Therapy (MT) are commonly prescribed Behavioral Health Rehabilitation Services (BHRS) for children and adolescents under the age of 21 who have mental health diagnoses (http://www.parecovery.org/services_teams.shtml#user).
Child and Family Teams
A Child and Family team is another name for a High Fidelity Wraparound team. In certain counties, these teams can also be called Joint Planning Teams (JPT). Regardless of which name is used, the HFW process is used and the process is consistent across counties.
A hands-on teacher of High Fidelity Wraparound. A Coach teaches the Facilitator and Youth and Family Support Partners how to do HFW by showing them the process, consulting with them on how to use the process and helping them discover the craft knowledge to do it well. Coaching is achieved through shadowing, training support, behavioral rehearsals, in process planning and consultation, live coaching and group coaching.
All child serving systems agree to work together and implement one plan, with everyone working as a single team. Collaboration is one of the ten Principles of High Fidelity Wraparound.
All treatment options operate inside the plan produced by the youth and family as part of the HFW team. Even when a residential treatment facility (RTF) or hospitalization is accessed, the services are regarded as stabilization resources and not placements. Keeping services community-based is one of the ten Principles of HFW.
The High Fidelity Wraparound workforce must complete tasks to be credentialed in the High Fidelity Wraparound process. This indicates that they fully understand, and are trained and competent in the HFW process.
Services and supports must be tailored to the unique culture of the youth and family. Family culture refers to family race and ethnicity as well as family habits, preferences, beliefs, language, rituals, and dress, and it is based on “one family at a time.” Culturally Competent is one of the ten Principles of HFW.
The first of the four phases of High Fidelity Wraparound. The Engagement Phase begins with initial contact with the youth and family members. During the Engagement Phase the Facilitator, Youth Support Partner and Family Support Partner begin to establish a relationship with the youth and family. The family will share information with the Facilitator that they are comfortable sharing; this includes the family’s beliefs, traditions and family member’s strengths. Family members will also describe what they believe they need help with – what their needs are. With permission of the youth and family the Facilitator will talk with other people in the family’s life to get their commitment to participate on the family’s HFW team and invite them to the first team meeting.
Evaluation is a systematic determination of a subject's merit, worth and significance using criteria governed by a set of standards. It can determine the degree of goal achievement and outcome. Regarding HFW, evaluation is used to ensure that the process is being done correctly and whether the outcomes are congruent with the goals of the process.
A person who is trained to coordinate the High Fidelity Wraparound process for a youth and/or family. The person in the Facilitator role may change over time depending what the family thinks is working best. A youth, parent, caregiver, or other team member may take over facilitating team meeting after a period of time.
The family is an integral part of the team and must have ownership of the plan. No planning sessions occur without the presence of the family.
Family Support Partner (FSP)
A Family Support Partner is a person who provides support to families to ensure individualized attention. This person may be a graduate of HFW or be a family member and/or parent to a person with severe emotional or behavioral health challenges. The FSP assists in ensuring that the HFW Phases and activities, HFW Principles and HFW Theory of Change are accomplished.
Adherence to the High Fidelity Wraparound process. Fidelity to the HFW model means being trained to do the process in the correct and in a consistent way.
Services and support provided by professionals or other individuals who are “paid to care” under a structure of requirements for which there is oversight by state or federal agencies, national professional association or the general public arena.
Guidelines the team develops that define how the team will function during a meeting. They may include how decisions are made, confidentiality, how conflict is handled during a meeting and other topics based on team composition and potential challenges.
High Fidelity Wraparound Activities
Specific tasks or actions (meetings, paperwork, crisis planning, brainstorming, etc.) that the team must do to help the youth, family and team move through the four phases of the HFW process.
High Fidelity Wraparound (HFW) Principles
A set of ten statements that define the HFW philosophy and guides the activities of the HFW process. The ten Principles are: family and youth driven, team-based, collaborative, community-based, culturally competent, individualized, strengths-based, natural supports, persistence, and outcome-based.
High Fidelity Wraparound (HFW) Team
The HFW team is comprised of the HFW workforce members, the youth and/or family, and a group of people chosen by the youth and family and connected to them through natural, community and formal support relationships. The HFW team helps the youth and family develop and implement the HFW plan, address unmet needs, and work toward the vision stated by the youth and family.
The third of the four phases of High Fidelity Wraparound. During the Implementation Phase the HFW Plan, Plan of Care or Individualized Care Plan developed by the team will be put into action. In ongoing team meetings, the youth, family and other team members will share which parts of the plan they believe are working. The Facilitator will lead the team in making changes to the plan if necessary. At this point meetings may occur every two to four weeks for one to two months as the team identifies the meetings that are needed.
Each youth and family has an Individualized HFW Plan. There is a mindfulness, and reason behind all elements of the HFW plan. The team always evaluates and understands why the service or effort is a precise match for the unique needs of the youth and/or family. Individualized is one of the ten Principles of HFW.
Joint Planning Team (JPT)
Administrative activities for developing and facilitating implementation of individualized care plans for children and youth. Joint Planning Team is another name for High Fidelity Wraparound team. Allegheny County HFW programs are known as Joint Planning Teams.
Least Restrictive Setting
Settings that are the most appropriate and natural for the child and family. These are the least intrusive settings possible that serve as the environment where the needs of the youth and family can still be met.
Life domains are areas of daily activity critical to healthy growth and development of a child or successful functioning of a family. Life domains can include such areas as safety, school/work, health, social/fun, a place to live, legal issues, culture, behaviors, emotions, transportation, and finances. A life domain is really any part of a youth and/or family's life that is important to them, and something they work into their lives.
Coaching done in the presence of client families with activities designed to develop skill building in the HFW team.
Measureable objectives are short-term goals that will be set for each of the prioritized needs. Measureable objectives may be referred to as “baby steps” and are generally things that can be accomplished in two to four weeks or less so the family and team can celebrate often.
Mental Health/Mental Retardation Administrator (MH/MR Administrator)
Combined administer for the Office of Mental Health and the Office of Developmental Programs. Supervises a comprehensive service delivery system in each county, or in combined counties which provides a full array of treatment and rehabilitation services in both institutional and community settings.
A statement crafted by the HFW team that provides a one to two sentence summary of what the team is working toward with the youth and family.
Involvement in several systems or on several levels, such as education and behavioral health; behavioral health, education and juvenile justice, etc.
Individuals or organizations in the family’s own community. Can include kinship, social, or spiritual networks such as friends, extended family members, religious leaders, sports coaches, and neighbors. A natural support can be anyone the family trusts and can depend on in time of need, outside of paid professionals. A natural support is someone who is willing to be a part of the family’s support network.
National Wraparound Initiative (NWI)
The National Wraparound Initiative is an attempt to engage experts nationally in a process of defining standards and compiling specific strategies for conducting high-quality High Fidelity Wraparound (www.rtc.pdx.edu/nwi).
Network of Care
Network of Care is an interactive, single information place where consumers, community-based organizations and municipal government workers all can go to easily access a wide variety of important information. The resources in this "virtual community" include a fast, comprehensive Service Directory; links to pertinent Web sites from across the nation; a comprehensive, easy-to-use Library; a political advocacy tool; community message boards; and many others. (http://networkofcare.org/index3.cfm?page=what&pageid=111)
Child, family or team goals stated in a way that can be observed and measured.
Organizations that fund services tend to focus on efforts like High Fidelity Wraparound which have shown to be effective in helping children with mental health and behavioral health issues. Outcome measures are identified and individual HFW plans are frequently evaluated.
The plan that the team creates is flexible and when problems arise, the team changes the individual services and supports to meet the unique needs of the youth and/or family. Persistence is one of the ten Principles of HFW. This is also known as “Unconditional Care”.
Plan of Care, High Fidelity Wraparound (HFW) Plan, or Individualized Care Plan
A dynamic document that describes the youth, family, the team, and the work to be undertaken to meet the youth and family’s needs and achieve the youth and family’s long-term vision.
The second of the four phases of HFW. During the Planning Phase the first planning meeting is held among team members. A mission statement is developed and the needs of the youth and family are identified. The Facilitator leads the youth, family and team in brainstorming strategies to meet those needs. Once the strategies are developed action steps will be developed to implement those strategies. The result will be a summarized HFW Plan, Plan of Care or Individualized Care Plan that will be distributed to the youth, family and all team members.
The demographics, or types of youth who are eligible for HFW. This group may differ from county to county, such as young children with behavioral health challenges, youth with juvenile justice involvement, youth in residential treatment facilities (RTF), youth of a certain age who are involved in multiple systems, youth who are involved in child welfare, or any combination of the above.
Needs are the things that must change for the family to achieve the long-range vision and team mission. Prioritized needs are the ones the team will address first through the HFW Plan. In HFW, identifying needs is very important. Needs are not things the youth/family want. And, needs do not always require services to address them.
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential (www.samhsa.gov).
The ability to recover quickly from illness, change, or misfortune. Being resilient is having the ability to manage adversity without negative repercussions.
Achieving self-efficacy is when the youth and family begin to believe in themselves. Self-efficacy is the measure of one's competence to complete tasks and reach goals. When achieved, it is evidenced by a youth and/or family member leading their team meetings, navigating the various systems, and having the confidence to know where to turn without a HFW team.
The High Fidelity Coach shows how to do a HFW activity by doing it in front of the HFW workforce member.
Individuals or organizations that are directly impacted by a system-wide decision, program, or intervention. Stakeholders in High Fidelity Wraparound are those who are part of the development of HFW in a county, HFW team members, or youth and families who may be involved in HFW.
Different things that team members or others might do to address the prioritized needs. These should be based on the youth and family’s strengths and culture. The youth and family will select which strategy is best for them.
Assets, skills, capacities, actions, talents, potentials and gifts in the youth, each family member, each team member, the family as a whole and the community. In HFW, strengths help family members and others to successfully navigate life situations. A goal for the HFW process is to promote these strengths and to use them to accomplish the goals in the HFW team’s Plan of Care.
The HFW plan is based on the vision of the youth and family and is structured based on the unique strengths, needs, values, norms, preferences, and culture of that youth and family. The HFW plan is focused on the typical needs in life domain areas that all persons (of like age, sex, culture) have. These life domains are: independence, family, living situation, financial, educational, social, recreational, behavioral, emotional, health, legal, cultural, safety, and others. Strength-based is one of the ten Principles of High Fidelity Wraparound.
Strengths, Needs and Cultural Discovery (SNCD) or 'Discovery'
A 'Discovery' is a document created by the youth, family, Facilitator and Family and Youth Support Partners (if chosen) that clearly identifies the youth and family's uniqueness. The Discovery identifies strengths, needs and culture that encompass life domains. After the youth and family approves the Discovery, this becomes the document for individualizing the HFW plan. It is updated on a regular basis to reflect the family's continued needs, progress and celebrations.
Systems of Care (SOC)
A System of Care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with serious mental health needs and their families. Families and youth work in partnership with public and private organizations to design mental health services and supports that are effective, that build on the strengths of individuals, and that address each person's cultural and linguistic needs. A system of care helps children, youth and families function better at home, in school, in the community and throughout life. System of Care is not a program — it is a philosophy of how care should be delivered. Systems of Care ensures that approaches to services recognize the importance of family, school and community. Systems of Care seeks to promote the full potential of every child and youth by addressing their physical, emotional, intellectual, cultural and social needs (http://www.systemsofcare.samhsa.gov and pages/the-pa-system-of-care-partnership). Pennsylvania has the PA System of Care Partnership, of which the Youth and Family Training Institute is a part.
The Individualized Care Plan/HFW Plan/Plan of Care is developed by the HFW team. The team consists of the youth, family, the HFW workforce members and the three to seven people who care and know the youth and family best. The team is selected by the youth and family and typically is comprised of no more than 50% professionals. Team-based is one of the ten Principles of HFW.
Theory of Change
Meeting the basic needs and strengthening the social networks of children with mental and behavioral health challenges and their families while enhancing their belief that they can create a successful future resulting in good or at least improved lives is the Theory of Change. This will be further enhanced by integrating their services and supports into a single plan of action. The Theory of Change is comprised of four components: Integrated Plans; Natural Support System; and the identification of Prioritized Needs. These lead to Self-Efficacy.
The fourth phase of High Fidelity Wraparound. The Transition Phase begins to occur when the family and the team find that action steps from the plan are being accomplished and the team’s mission has been met or is close to being met. Options are brainstormed to help and support the family outside of the formal HFW structure. These options are placed into a transition plan by the Facilitator that defines what type of support the team will continue to be to the youth and family and how regularly everyone will check in with the youth and family. The family and youth may choose to have a celebration of their accomplishments with their team. Transition is a phase. It doesn't happen in one meeting.
Prior to 2004, this was the HFW Principle that is now referred to as “Persistence”. There is currently a great deal of discussion at the National Wraparound Initiative about reverting “Persistence” back to “Unconditional Care”. Regardless of the name, this refers to the flexibility of the plan that the team has created. When problems arise, the team changes the individual services and supports to meet the unique needs of the youth and/or family.
A statement constructed by the youth and family (with help from their HFW Facilitator and possibly the HFW team), that describes how they wish things will be in the future, individually and as a family.
Vroon Vandenberg (VVDB)
The HFW Consulting Team which assisted the Youth and Family Training Institute in implementing High Fidelity Wraparound in PA (http://www.vroonvdb.com/).
The youth is an integral part of the team and must have ownership of the plan. No planning sessions occur without the youth present.
Youth Support Partner (YSP)
The YSP is a person who provides support to youth of the family to ensure individualized attention. The Youth Support Partners are ages 18 to 26. Pennsylvania is currently the only state that has YSP as part of the HFW team. Youth Support Partners should have had similar life experiences with complex emotional and behavioral health challenges and should be able to share lessons learned with the youth. The YSP assists in ensuring that the HFW Phases and activities, HFW Principles and HFW Theory of Change are accomplished.