2022 California Council of Community Behavioral Health Agencies (CBHA) Conference

Wraparound and Wellness: A Catalyst for Recovery

Grappling with the ever-growing population of youth experiencing opioid abuse in New Jersey necessitates bold action. Is getting back to the basics of wellness and community connectedness too basic for this complex dilemma? Wellness and community connectedness are essential components for a successful recovery process in this population. The theoretical constructs of the Wraparound Model of Care while using the 8 Dimensions of Wellness from The Substance Abuse and Mental Health Services Administration (SAMSHA) can be foundational to this approach. The Wraparound Model of Care “is an intensive, holistic method of engaging with individuals with complex needs so that they can live in their homes and communities and realize their hopes and dreams” (National Wraparound Initiative, 2017). The Wraparound Model of Care is a process that involves strength, community and team-based principles to support individuals in meeting their goals. SAMSHA promotes the utilization of the 8 Dimensions of Wellness for substance use treatment. The 8 Dimensions of Wellness are not bound to the notion that “wellness [is the] absence of illness or stress”, but the idea that an individual can have wellness in various aspects of their life including physical, emotional, environmental, social, intellectual, occupational, financial, and spiritual wellness (SAMSHA, 2017).

The Wraparound Model of Care, which is utilized by the Children’s System of Care in New Jersey, is a process of wrapping supports around a youth and their family so they have sustainable connections and coping skills to manage the inevitable stressors of life. The process includes building a Child and Family Team which may include formal, informal and natural supports to assist the youth and family with the challenges they are facing. The wraparound model of care promotes prevention, treatment and recovery from substance use. Regarding prevention, the process provides the opportunity for caregivers to obtain support and education, which may include parenting coaching, peer support partners, or other services for the caregivers. By supporting the caregivers in developing the skills they need, the goal is to increase the likelihood of developing appropriate bonds with their children. These bonds assist children in developing adaptive, as opposed to maladaptive, coping skills. Should there warning signs or substance use in the home- there is a team of people to go to for support and assistance to handle the situation.

An issue with substance use treatment is that it is time limited and restrictive in nature. Regardless of the fact that treatment intensity varies, in all cases treatment ends at some point. Too often, a youth goes away to treatment and gets clean, only to return home and relapse in a short period of time. The environment is not always conducive of recovery. The underlying community-based principal of wraparound encourages the youth’s relationship with his or her environment as a critical part of the treatment process. The youth and the team develop sustainable resources and strategies that can be used when there are stressors in the environment promoting long term recovery. Wraparound services compliment the treatment process well. The Child and Family Team includes the clinicians or other professionals while treatment is occurring; however, the whole team includes caregivers and natural supports that reinforce long term recovery.

To further enhance this team process and integrated care, the New Jersey’s Children’s System of Care tasked Bergen’s Promise, the Care Management Organization (CMO) of Bergen County, to initiate the nation’s first pediatric Behavioral Health Home utilizing the wraparound model. As a result of this significant organizational change, Bergen’s Promise committed to the integration of physical and mental health needs influenced by the SAMSHA 8 Dimensions of Wellness. Through the adaptation of integrated care, all youth and families are supported in using the various dimensions of wellness to create individualized wellness goals supported by their Child and Family Team. These wellness goals include, but are not limited to improving diet and maintaining physician visits, in fact, they address topics such as social media, healthy relationships and sleep, to name a few. Youth struggling with opioid use are unique in that many wellness goals revolve around independent living skills such as healthy food preparation, money management and attainment of a High School diploma or equivalent. By building on their strengths, youth are given the opportunity to focus on positive aspects of their recovery. Why is this relevant?  This strength-based approach fosters increased self-efficacy and motivation in youth necessary to the recovery process. Through engagement, high quality team work and inclusion of natural supports, positive preliminary outcomes have been reported regarding our youth struggling with opioid use including reduction of use and increased engagement in their recovery process. These promising preliminary findings support the notion that the principles embodied in the wraparound model of care and the 8 dimensions of wellness can be catalysts for recovery for youth struggling with opioid use disorders.

For more information about Bergen’s Promise and the Wraparound Model of Care, please see our website at www.bergenspromise.org.

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