Left to right: Rob Abrams, Wraparound Oregon Project Director; Martha McCormack, Clinical Supervisor; Elaine Wallick, Child Welfare Liaison; Ally Linfoot, Family Coordinator; Sandy Bumpus, Training Coordinator
Wraparound Oregon: Treating Very Young Children
By Rebecca A. Clay
Can very young children have mental health issues? “Absolutely,” says Rob Abrams, M.S.W., Project Director of Wraparound Oregon: Early Childhood at the Multnomah Education Service District in Portland, OR. But many people still don’t believe that’s true.
“When people hear that we have 2-year-olds with severe depression in our program, they ask, ‘How can that be?’ ” said Mr. Abrams. “We hear that not only from the public, but also from professionals.”
Darcy Wilde, Family Team Facilitator, leads a group discussion.
Wraparound Oregon is one of nine current grantees in SAMHSA’s Comprehensive Community Mental Health Services Program for Children and Their Families that focus on building systems of care for children age 8 and under. (See Coordinating Care for Children with Serious Mental Health Challenges.)
The Agency expanded the program to include this population in 2005 in response to reports from the field. “SAMHSA recognized that you can get much stronger and long-lasting results if you intervene early in a child’s development,” said Mr. Abrams.
With this age group, he explained, the emphasis is less on making formal diagnoses and more on identifying risk and protective factors. “When children are really young—birth to age 3, for instance—we look at the interaction between the child and primary caregiver,” he said. “If there isn’t bonding going on, that’s what we begin to work on. We also look at the whole family, not just the child.”
How do you treat very young children? “We’re not going to take a 3-year-old to a therapist’s office for 50 minutes of talk therapy,” Mr. Abrams smiled.
Instead, the process begins with a family being assigned a facilitator and a “parent partner,” parents and grandparents who can make a strong connection to new participants because they have gone through the process themselves.
Next, the family works with an interdisciplinary team to uncover its strengths and needs. “Families come back and say, ‘We never knew we had these strengths,’ ” said Mr. Abrams. “That in and of itself is healing.”
The child, family, and team all work together to craft a mission statement and a plan for achieving their goals. That plan might include vocational training for parents, drug-free housing, or extra support for teachers—whatever the child and family need.
Now in the fourth year of its 6-year grant, Wraparound Oregon: Early Childhood has data showing the program’s effectiveness.
- 78 percent of families said they got the help they wanted for their families and reported their families were doing better thanks to the program.
- 70 percent of children are doing better in childcare settings or school.
- 69 percent of children now get along better with their families.
In fact, the program has been such a success that the state recently passed legislation to bring this “wraparound” approach to the state level.
Mr. Abrams doesn’t have to look at the numbers to see success—he hears it from the families themselves. “One mom said, ‘Wraparound Oregon allowed me to see that I had the power within myself to make the changes needed,’ ” Mr. Abrams remembered. “That’s family-driven care, and it works,” he added.
SAMHSA’s Web site offers more information on Systems of Care.