OVER THE COUNTER SERVICE VERSUS TRAINING AND TREATMENT EFFICACY: WHAT WILL BEHAVIORAL HEALTH REHABILITATION (WRAP-AROUND) PROGRAMS STRIVE TO BE?

This article is a part of the on-going series of operational, management and consulting issues that appear in developing and running a behavioral health rehabilitation (wrap-around) program. It is recommended that readers begin this series with reading the first article in the first issue of the behavior analyst today (e.g., Cautilli & Clarke, 2000) and work through all of the articles. These articles draw on an organizational behavior management perspective to structure what many have come to see as unstructured at best. Services rendered in the child's home, school and community. Since the first article, we have set out to cover three major objectives: keeping costs low, scheduling in an efficient manner (Cautilli, Rosenwasser, & Clarke, 2000), and enhancing performance of the key players (Cautilli & Santilli-Connor, 2000; Hancock, Cautilli, Clarke, & Rosenwasser, 2000; Thomas & Cautilli, 2000). These objectives often lead to trade-offs between components. For example, the cost of a new supervisor is often a trade-off against the increased performance to the teams under the supervisor's care. It becomes important to recognize that tradeoffs in training, education of key personnel, and a process of developing a continuum of care through expertise and specialization instead of simply developing new programs to provide a continuum of care will ultimately prove more efficacious. Additionally "forms" compliance should never replace sound clinical decision-making. Also, the way that BHRP programs build partnerships is important to the smooth functioning of such programs. This paper discusses these issues while examining the direction that BHRP's should not but unfortunately seem to have taken.