Alexandra Giatrelis, Psy.D., is a 2017 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Martha Straus, PhD, Committee Chair
  • George Tremblay, PhD, Committee Member
  • Gina Pasquale, PsyD, Committee Member


wraparound, serious emotional disturbance

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This study investigated the usefulness of session and outcome rating scales within a wraparound program in New England. The extensive needs of youth with serious emotional disturbance (SED) categorizations and their families require highly coordinated systems of care that not only deliver adequate services, but contend with the momentum of often contentious and unsuccessful relationships these families have typically experienced with social service systems. Outcome and session rating scales, along with measures of fidelity, hold the potential to provide rapid feedback on both outcome (outside of sessions) and working alliance (within sessions), as well as the consumers’ perspective on the quality of the services being provided. I first review current literature illuminating the gravity of receiving an SED diagnosis, the consequences for those that it affects, and the inadequate current levels of practice for this population. I then review literature related to the wraparound model, its effectiveness with treating this population, and the development and utility of session and outcome rating scales, as well as fidelity measures, within this model of care. I then describe research questions addressing relationships between (a) consumer perceptions of their working alliance with wraparound coordinators and child outcomes, (b) consumer perceptions of their working alliance with wraparound coordinators and observer-rated fidelity to the Wraparound model, and (c) the use of a session rating scale with wraparound coordinators’ perceptions and responses to their use in session. Methods for answering these questions are then outlined through both the use of data collected from 44 families participating in the wraparound program in New England, as well as interviews that were conducted with the three wraparound coordinators and the one wraparound coach who are involved in the project. Findings were discussed in terms of their usefulness for improvement of service delivery to this high-risk population in a wraparound setting.


Alexandra Giatrelis

ORCID Scholar ID# 0000-0002-0938-0711