"No More Clarences"

Abstract

This article discusses the challenges communities face when trying to help children whose complex needs place them outside the operational boundaries of existing service disciplines. Various strategies for creating more integrated and flexible systems of care have been attempted, but most have not produced reliable outcomes. A model that builds on what has been learned through these efforts and that integrates change at the practice, administrative, system, and community levels is proposed as a way of ensuring the availability of an effective response for these children.