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Eric J Bruns

Publications and source records attributed to Eric J Bruns.

5 recordsLinked to original sources

Spreadsheets, service providers, and the Statehouse: using data and the wraparound process to reform systems for children and families.

Evaluation descriptions in the research literature tend to ignore the full context of the community change efforts from which they emerged. In this paper, we describe a range of evaluation studies and data collection activities conducted over the course of one state's effort to reform its child welfare system on behalf of families with children experiencing serious mental health problems. Initial activities included studies of the prevalence of unmet mental health need in children and youth in the state. As these needs were addressed, evaluation activities examined the impact of a pilot wraparound program that became a major part of systems reform. Later efforts included implementation analysis of wraparound programs and assessment of priorities for continued systems reform. As we describe this set of evaluation activities, we discuss how data collection evolved to meet the needs of stakeholders over time and consider lessons learned about the roles of research and information sharing in shaping community change efforts.

Child↗

Building on practice-based evidence: using expert perspectives to define the wraparound process.

OBJECTIVE: In order to expand the research base on effective community-based mental health treatments, methods are needed to define and evaluate promising interventions that have not been systematically developed and tested. In this report, the authors describe the results of an effort to better define the wraparound process for children and adolescents with serious emotional and behavioral problems. METHODS: A broad review of wraparound treatment manuals and model descriptions was conducted. With the help of a small group of experts, this review was synthesized into an initial description of the phases and activities of the wraparound process. This model was then presented to a multidisciplinary advisory panel of 31 experts on the wraparound process who provided structured and semistructured feedback. RESULTS: Overall, respondents expressed a high level of agreement with the proposed set of activities. For 23 of the 31 activities presented, there was unanimous or near-unanimous agreement (that is, one dissenter) that the activity was an essential component of the wraparound process. For 20 of the 31 activities, there was unanimous agreement that the description was phrased acceptably. A final model was created on the basis of feedback from reviewers. CONCLUSIONS: Results indicate that using the experience of a wide base of stakeholders to operationalize a complex model such as wraparound is feasible and holds many potential benefits, including building consensus in the field, improving service quality, and accelerating the incorporation of evaluation results into real-world practice.

Adolescent↗

Relations between program and system variables and fidelity to the wraparound process for children and families.

OBJECTIVE: Past research and experience have indicated that characteristics of organizations and service systems influence the quality of mental health services delivery. The study aimed to illuminate such associations by examining the relationship between a set of program- and system-level variables and fidelity to the wraparound model for children and families. METHODS: A measure of fidelity to the wraparound process for children and families (the Wraparound Fidelity Index) was administered to families receiving services in eight mental health agencies across the United States. Program administrators at each agency also completed by telephone a standardized interview for assessing program and system conditions hypothesized to influence quality of implementation (Program Administrator version of the Wraparound Fidelity Index). Regression analyses were used to assess the relationship between program and system variables and fidelity. RESULTS: Results of interviews with program administrators revealed substantial variation across programs in the number and type of program and system supports for wraparound implementation. Regression analyses found a significant association between the number of organizational and system supports and Wraparound Fidelity Index scores. CONCLUSIONS: Results support the hypothesized relationship between program and system conditions and the quality of service delivery. Results also highlight the importance of engineering the system and organizational context (maintaining low caseload sizes, establishing interagency partnerships, and implementing accountability mechanisms) in order to provide a solid foundation for high-quality wraparound to children and families.

Child↗

Understanding expanded school mental health services in Baltimore City.

This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city's public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed.

Adolescent↗

School-based mental health services in Baltimore: association with school climate and special education referrals.

This study investigated the association between school-based mental health services and two proposed but untested outcomes of these services: (a) school climate and (b) patterns of referrals to special education. Results from a climate survey found that teachers and staff in eight elementary schools with expanded school mental health (ESMH) services gave higher ratings on the survey's mental health climate subscale than respondents from schools in a matched comparison group. No differences were found for the General Climate subscale of the survey. Results also indicated that teachers in ESMH schools referred fewer students to the special education eligibility process because of emotional and behavioral issues and that fewer students in ESMH schools were found eligible for special education for emotional and behavioral disabilities. Results of this study provide beginning evidence for the positive impact of ESMH programs on these two schoolwide indicators of functioning.

Adolescent↗