Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Social Work


Social Work

First Advisor

Dr. Carlton Craig


Despite the federal government’s $1.5 billion investment between 1993 and 2010 to fund 164 separate community-based systems of care, there has been an extremely limited attempt to measure the impact of system of care. The impetus for this research is the struggle for how the value based concept of system of care is communicated within a community. While child mental health services researchers have published a number of randomized control trials to explore individual level supports for youth served in a system of care community, researchers have struggled to devise a way to measure system of care philosophy diffusion.

While system of care is a system level intervention, this study explored the role of the system of care value: family voice as it pertains to direct practice for children and families. The goal was to assess whether specific direct practices regularly associated with system of care (i.e., wraparound or home-based services) lead to greater family voice or if the mere presence of a high-functioning system of care community leads to equal family voice for all receiving community-based services.

The primary finding was a relationship between the perception of family functioning and perceived empowerment/self-efficacy. This finding suggests that as functioning improves, so does a caregiver’s perception of their personal empowerment/ self-efficacy. While the framing of this study was to “unpack” the system of care value of family voice, the findings do not support any clear cut explanation for how family voice is promoted or communicated to families. Based on the findings, it appears as if families feel more empowered as their child improves. Additional research needs to be done on the application of family voice within the practice setting to better understand how to best instruct staff to infuse family voice in their daily practice.