Brief Literature Review. The mental health component of comprehensive treatment programs includes at least several of the following elements: individual therapy, anger management, cognitive behavioral treatment and problem solving, behavior modification, group therapy, multimodal treatments, and multisystemic therapy.The mental health component generally adheres to behaviorism, social learning, or cognitive behavioral models designed to reinforce prosocial behavior. The behaviorism model emphasizes objectively observable behavior (rather than inner experiences) and holds that behavior is learned and therefore can be unlearned or replaced by new behaviors. Behavioral modification components typically include reinforcing desired behaviors through rewards, discipline, role-playing, and anger management (Center for Evaluation Research and Methodology, 2002; Martin and Pear, 2002). The social learning model emphasizes the effect of perceived rewards and punishments (or costs) associated with a particular pattern of behavior or interaction, as well as the skills required for prosocial behavior (Battin–Pearson et al., 1998; Greenwood, 1996). The premise of cognitive–behavioral approaches is that thoughts, beliefs, and attitudes regarding a situation drive a youth’s emotional and behavioral responses. These approaches attempt to alter irrational thinking and behavior by changing attitudes. They typically use moral reasoning, empathy and victim impact, acceptance of authority and rules, and other methods that address triggers for disruptive or aggressive behavior (National Mental Health Association, 2004; Center for Evaluation Research and Methodology, 2002).  Cognitive–behavioral therapy (CBT) is considered the most evidence-based form of psychotherapy. There is consistent empirical evidence that CBT is associated with significant and clinically meaningful positive changes, particularly when therapy is provided by experienced practitioners (Waldron and Kaminer, 2004).

Many comprehensive treatment programs deliver services using a "wraparound" approach.  Wraparound refers to "a team-based planning process intended to provide individualized, coordinated, family-driven care to meet the complex needs of children who are involved with several child- and family-serving systems (e.g., mental health, child welfare, juvenile justice, special education), who are at risk of placement in institutional settings, and who experience emotional, behavioral, or mental health difficulties. The wraparound process requires that families, providers, and key members of the family's social support network collaborate to build a creative plan that responds to the particular needs of the child and family. Team members then implement the plan and continue to meet regularly to monitor progress and make adjustments to the plan as necessary. The team continues its work until members reach a consensus that a formal wraparound process is no longer needed" (Walker and Bruns, 2007:1).

According to the results of the 2007 State Wraparound Survey, an estimated 98,293 children received wraparound services in 2007 through 819 different programs in 43 responding States (Bruns, Sather, and Stambaugh, 2008:2–3). Bruns and Suter (2008:1) indicate that “[t]he wraparound process has been described as having a promising base of evidence (Burns,  et al., Goldman, Faw, and Burchard, 1999); National Advisory Mental Health Council, 2001; New Freedom Commission on Mental Health, 2003), to the point [that] it has been included in two Surgeon General reports (USDHHS, 1999, 2000), recommended for use in federal grant programs (USDHHS,  2005), and presented as a mechanism for improving the delivery of evidence-based practices for children and adolescents with serious emotional and behavioral disorders ([SEBD]" Friedman and Drews, 2005; Tolan and Dodge, 2005; Weisz, Sandler, Durlak, and Anton, 2006). Suter and Bruns (2008:26) note that many published wraparound studies have been marred by serious methodological limitations, but “there is a growing body of more rigorous research” and the evidence base is “encouraging.”

For more information, see Literature Review: Cognitive–Behavioral Treatment.