Yale School of Medicine, New Haven, CT, USA.
Westfield State University, Westfield, MA, USA.
Am J Community Psychol. 2019 Jun;63(3-4):487-498. doi: 10.1002/ajcp.12323. Epub 2019 Mar 8.
Systems of care (SOC) have relied on the wraparound care process to individualize community-based services for children and youth with serious emotional and behavioral difficulties. A core element of wraparound care is Child and Family Team meetings (CFTs), which are designed to give youth and families a leadership role in developing and guiding their plan of care. The National Wraparound Initiative (NWI) has identified Practice Standards regarding CFT implementation. This study examined CFT characteristics and the association between those characteristics and youth and family outcomes in a statewide SOC. Participants were 363 youth (M = 10.89, SD = 3.72) and their caregivers. Families completed measures of youth and caregiver functioning and symptoms at enrollment and 6-month follow-up. Care coordinators completed a survey assessing CFT implementation and characteristics following each meeting. Multiple regression analyses were used to examine the relationship between CFT characteristics and youth and caregiver outcomes. Results indicated that a higher number of CFTs was associated with poorer outcomes, while a higher percentage of natural supports at meetings was associated with better youth outcomes. Number of days to the first CFT was associated with greater caregiver strain. Implications for CFT implementation within wraparound are discussed.
照护系统(SOC)依赖于全面关怀护理过程,以针对有严重情绪和行为障碍的儿童和青少年提供个性化的社区服务。全面关怀护理的一个核心要素是儿童和家庭团队会议(CFT),旨在让青年和家庭在制定和指导他们的护理计划方面发挥领导作用。国家全面关怀倡议(NWI)已经确定了有关 CFT 实施的实践标准。本研究考察了在全州 SOC 中 CFT 特征以及这些特征与青年和家庭结果之间的关联。参与者是 363 名青少年(M=10.89,SD=3.72)及其照顾者。家庭在入组时和 6 个月随访时完成了关于青少年和照顾者功能以及症状的测量。护理协调员在每次会议后完成了一项评估 CFT 实施和特征的调查。多元回归分析用于检验 CFT 特征与青年和照顾者结果之间的关系。结果表明,CFT 的数量与较差的结果相关,而会议上的自然支持比例与更好的青年结果相关。第一次 CFT 的天数与照顾者压力的增加有关。讨论了在全面关怀中实施 CFT 的影响。