Date of Award

Summer 2001

Document Type

Dissertation - Restricted

Degree Name

Doctor of Philosophy (PhD)




Community-based, continuum-of-care programs for youth arose from dissatisfaction with traditional treatment options. Traditional interventions for youth with behavioral disorders frequently consisted of long-term residential treatment or placement in correctional facilities. These interventions yielded few positive outcomes, were considered inordinately restrictive, and cost an exorbitant amount of money. The purpose of this study was to determine how youth with externalizing behavior disorders (EBD) responded while enrolled in a community based, continuum-of-care program. The Wraparound Milwaukee program was established with federal grant money in 1995. The program was designed to offer a case managed, community-based, continuum-of-care to youth at risk of being placed in residential treatment. Presently, it is one of the largest self-sustained program of its type in the country. The Wraparound Milwaukee program serves youth living in Milwaukee County and identified as seriously emotionally disturbed (SED). Over 600 youth are enrolled in the program at one time, with over two-thirds being court ordered on delinquency petitions. This research project was designed to specifically focus on youth that had elevated externalizing behavior problems and met the DSM-IV criterion for either conduct disorder or oppositional defiant disorder. Previous research has either not specified this population in continuum-of-care studies, or has focused only on an individual treatment for these youth. A second goal of the research project was to determine if certain youth and family characteristics were related to change in the program. Youth and family variables were selected based on previous studies of etiology and treatment response of EBD youth. This investigation was conducted to determine if one could predict response to the program based on youth and family characteristics. The Wraparound Milwaukee program offers multiple services to youth. These services include traditional interventions such as individual and family outpatient therapy, community-based services such as mentoring and in-home therapy, and living alternatives including foster care, group homes, and short-term residential care. The third question of investigation in this study was if any of the treatment components were predictive of improvement. This study posed three questions regarding the efficacy of the program with EBD youth, the amenability of youth to the program, and to determine if there was a relationship between service components used, and improvement in the program.



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