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Journal of Emotional and Behavioral Disorders
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Outcomes From Wraparound and Multisystemic Therapy in a Center for Mental Health Services System-of-Care Demonstration Site

Leyla Faw Stambaugh

Duke University School of Medicine, lstambaugh{at}psych.duhs.duke.edu

Sarah A. Mustillo

Duke University School of Medicine

Barbara J. Burns

Duke University School of Medicine

Robert L. Stephens

Macro International, Inc.

Beth Baxter

Region 3 Behavioral Health Services in Kearney, NE

Dan Edwards

Medical University of South Carolina

Mark Dekraai

University of Nebraska Public Policy Center

This study examined outcomes for 320 youth in a Center for Mental Health Services system-of-care demonstration site. Youth received wraparound-only (n = 213), MST-only (n = 54), or wraparound + MST (n = 53). Participants were 12 years old on average and mostly White (90%), and 75% were Medicaid-eligible. Service use and functional and clinical outcomes were examined at 6-month intervals out to 18 months.All three groups improved over the study period. The MST-only group demonstrated more clinical improvement than the other groups. Functional outcomes did not differ significantly across groups.Youth in wrap + MST had higher baseline severity and experienced less clinical and functional change than the other two groups, despite more mental health service use. Targeted, evidence-based treatment may be more effective than system-level intervention alone for improving clinical symptoms among youth with serious emotional disorders served in community-based settings. New or amended approaches may be needed for youth with the most severe disorders.

Journal of Emotional and Behavioral Disorders, Vol. 15, No. 3, 143-155 (2007)
DOI: 10.1177/10634266070150030201
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