Locating the system in a system of care

While systems of care are recognized as a systems-level intervention, a gap remains between systems theory and practice that challenges the effectiveness of future system of care efforts. This article explores the extent to which the expanded system of care definition proposed by Hodges et al. [Hodges, S. Ferreira, K., Israel, N., & Mazza, J. (this issue). Systems of care, featherless bipeds, and the measure of all things. Evaluation and Program Planning] addresses this gap and suggests ideas for strengthening its systemic focus. Specifically, recommendations address considerations for assigning and adapting appropriate boundaries around intervention efforts and leveraging critical system characteristics and interactions to promote systems change. Implications for system of care practice and theory are discussed. (C) 2009 Elsevier Ltd. All rights reserved.