How “High Fidelity Wraparound” Can Help Youth in Loudoun County

For families struggling to meet the needs of a child with a complex disability, High Fidelity Wraparound, or HFW, can be the missing ingredient. HFW streamlines and simplifies therapy services to single action steps that allow families to see real progress on their goals. It is a family-driven, youth-guided approach to navigating complex issues that often impact families in distress. This can be a game-changer for local adolescents and families facing mental health challenges. Grafton is now a provider of High Fidelity Wraparound for Loudoun County.

As a planning process guided by the youth themselves, HFW is designed to help families reach their goals while allowing children to stay within their homes. There is strong evidence that when Wraparound is done well—or done with “fidelity to the model”—young people are less likely to be placed in residential treatment. A study published this spring in the Journal of the American Academy of Child and Adolescent Psychiatry found that Wraparound successfully reduced out-of-home placements and improved mental health functioning, school attendance, and school achievement. The study also found significantly lower overall costs of care for youth in Wraparound, due to less spending on costly out-of-home placements. A growing number of behavioral health providers are using HFW because it not only yields better results, but it also reduces the trauma associated with a child being removed from their home.

HFW is not a typical treatment intervention. Wraparound is a collaborative approach that uses a facilitator and team to develop the self-efficacy of the adolescent and their family, allowing them to successfully meet their own needs. This could mean developing a crisis plan for everyone in the family to feel safe, helping parents figure out how to secure reliable transportation, or even coming up with a plan to address the behavior of a sibling, which could be having a negative impact on the child who is struggling. Using this individualized, streamlined approach can drastically improve outcomes for families that are coping with multiple issues, resulting in step-by-step plans that are more effective and more relevant to the child and family.

HFW also helps parents and guardians navigate state and local systems, which can be overwhelming and confusing, even for seasoned professionals. In any given month, a family may be trying to navigate Medicaid paperwork, juvenile justice hearings, or Child Protective Services requirements, all while seeking mental healthcare for their child in crisis. Additional support can be provided to each family and adolescent with a “support partner,” who has overcome similar challenges. In the case of the child, this is typically an older teen who is now stabilized. Another part of what makes HFW sustainable is the use of natural supports, such as grandparents or family friends, who

are willing to help a family meet their goals; this could mean offering childcare, picking a student up from school, or simply checking in every week

Most importantly, youth and families are given a voice and choice throughout the HFW process. That means that the team won’t have a conversation about the child’s needs without them in the room. Most kids aren’t struggling because they aren’t trying hard enough—they’re struggling because something is missing. And it’s our responsibility to listen for what that is. Engaging and empowering adolescents to be a core part of the decision-making process is key to the success of HFW.

In a perfect world, every family in crisis would receive timely HFW services to ensure their child gets the help they need at home. Unfortunately, many areas lack the resources to provide these services to everyone who needs them. Having Grafton as another provider of HFW in Loudoun County is a cause for celebration. I can’t wait to see what we accomplish.