Grounded theory and backward mapping: exploring the implementation context for wraparound

Abstract

Within children's mental health, there is an increasing demand for wider implementation of wraparound and other interventions that can provide comprehensive, individualized, family-driven care. Unfortunately, implementation has proven difficult because these approaches do not necessarily flourish within traditionally organized agencies and systems. This has highlighted the need for information about how mental health agencies and systems must evolve if they are to provide a hospitable implementation environment for these interventions. A first step in developing this information is through research that advances conceptual and theoretical understanding of the impact of contextual factors on implementation. At the same time, there is an immediate need for practical information to guide decision making and policy development in settings where implementation is being undertaken. This article describes a study of wraparound implementation that used a combination of qualitative strategies to meet both of these needs simultaneously. It is argued that these strategies are particularly well suited to the study of emerging practices that reflect-and help drive-transformation in mental health systems.