Wrap around and coordinated support

Flexible activity

In this activity, families are provided with practical, emotional and material support to address their complex and evolving needs. 

Wrap around support ensures families receive integrated and coordinated services that work together to meet their needs. It also acknowledges that clients have complex and diverse needs that are ever changing. Wrap around support ensures practitioners are flexible and the support provided is tailored to client’s circumstances, needs and wants. 

How can it be implemented?

This activity should be embedded into home visits with a case manager. The frequency of visits will depend on the needs of the family. However, they will typically start out weekly and reduce to fortnightly or monthly as the family’s needs lessen. Face-to-face visits can be supplemented with telephone calls where appropriate. 

Home visits can be 20mins to 2hrs in length. The length of the session will depend on the family’s needs. 

During the home visits, the case manager will work with the family to identify what support they need. This support could include:

• purchasing basic necessities (e.g. car seat, food, bills)
• providing transport to appointments
• support to apply for welfare or social housing
• support to navigate the service system
• advocating on behalf of the client
• therapy or counselling
• respite care or helping with childcare
• support to build social networks

The case manager should ensure any immediate needs are met as soon as possible.

Case managers will also organise and coordinate other needed supports. 

The case manager will bring together different practitioners and services to support the family. This ensures families work with skilled practitioners to address more complex issues they may have. The practitioners involved will depend on the family’s needs. For example:

• mental health clinician for therapy and intensive interventions with children and parents
• health care providers (e.g. obstetrician, paediatrician and dietician)
• social worker to deliver interventions for additional risk factors (e.g. trauma).
• public health nurse
• early childhood educator
• parent aides 

Involving different practitioners can be achieved a number of different ways:

• practitioners can attend and be involved in existing home visits
• the case manager can attend appointments with the client
• the case manager can transport the client to and from other appointments
• the case manager can coordinate referrals to other services

The approach taken will depend on the needs of the client. You should use your professional judgement to determine what is most appropriate for your client/s.

What should I consider when working with Aboriginal people and communities?

• Case management with Aboriginal and Torres Strait Islander families should be undertaken by Aboriginal practitioners where possible, or Aboriginal practitioners should be engaged and valued to provide information about community, cultural protocols and world views.
• Be aware and respectful of relevant extended family and kinship structures when working with Aboriginal people. Ensure that extended family is included in important meetings and in making important decisions (DCJ Practice Resource: Working with Aboriginal People).
• See the Cultural Safety and Wellbeing Evidence Review for more information.

Who is the target group?

This flexible activity has been implemented with a number of target groups. Key characteristics include:

• families with children, prenatal to 6 years of age, demonstrating emotional/behavioural or developmental/learning problems
• families experiencing significant psychosocial risk
• families living in extreme poverty, unemployment and general economic distress
• families at risk of child abuse and neglect
• families with parental risk factors (e.g. substance abuse, mental health)
• Families with children under 4 years old
• Teenage mothers at risk of maltreating their children

What programs conduct this activity?

• The Child FIRST program adopts a system of care approach to provide comprehensive, integrated services and supports to families and their children. A mental health clinician and care manager work together to conduct a comprehensive assessment of the child and family. This assessment identifies and, when appropriate, involves other service providers. 
• In the Colorado Adolescent Maternity Program, teenage parents are provided with an array of supports, as needed. The program integrates the support of various health care providers, including obstetrician, paediatrician, social worker, and dietician. 
• The Hawaii Healthy Start Program supports families to access needed services, e.g. obtaining quality health care, education, income and managing money matters and services to reduce parenting risk factors like substance abuse and poor mental health. 
• In the Linkages for Prevention project, home visits were conducted by a public health nurse and an early childhood educator. The early childhood educator was added to the nurse visitor to enhance the emphasis on early childhood development.
• The Home visiting program has child health nurses, social workers and parent aides support families as needed. Child health nurses conduct regular home visits. Social workers provide interventions for additional risk factors (e.g. intergenerational abuse/trauma, parental conflict, maternal ambivalence). Parent aides work with families requiring intensive assistance with parenting.   
• The Parent Support Outreach program provides a wide range of services:
  • financial (e.g. helping pay for basic necessities, connecting to emergency food banks, welfare assistance, employment and job training services),
  • therapeutic (e.g. mental health, substance abuse)
  • help with parenting and childcare
  • others (e.g., legal, child developmental services or recreational activities). 
• In the Relief Nursery Prevention Program, teachers specialists and parents work together to establish individual goals for each child. Other services are provided as needed, including: respite care, provision of child nutrition, transportation to and from services, individual and family counselling.

Further resources