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The Theory of Change is what makes High Fidelity Wraparound work, and what makes it different from any other program for youth and families. It sets expectations for what youth and families can accomplish. These accomplishments are possible because within the Theory of Change, youth and families have their basic needs met. Youth with severe mental health challenges and their families are able to strengthen their social network of support. The Theory of Change enhances the beliefs of the youth and family that they can create a better life and an improved future.

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The Theory of Change has four key aspects:

1. A focus on the youth and family's Prioritized Needs is the first component of the Theory of Change. The issues that the youth and family consider most important are addressed first. This is why the engagement with the youth and family is so important. It is through this relationship that immediate needs are identified, along with identifying other needs that can be addressed in the future.

2. Prioritizing youth and family needs helps to promote the second Theory of Change component, Self-Efficacy. Self-efficacy is when the youth and family begin to believe in themselves. Self-efficacy will impact how hard they work towards accomplishing their goals. Self-efficacy will also build the skills necessary to achieve the current goals, and creates the knowledge, confidence and motivation that are important in the process of achieving future goals.

3. The third component of the Theory of Change is the identification and development of a Natural Support System. A more reliable, healthy and supportive social network outside the family can help create an environment where self-efficacy or self-confidence can develop and strengthen for youth and families. Supportive relationships outside the home can also help facilitate stronger relationships within the family.

4. The fourth component of the Theory of Change is the Integration of Plans. Families who are dealing with children who are involved in many systems because of complex problems often find working to meet the goals from each separate organization difficult. The Integration of Plans seeks a way to simplify multiple issues and needs. It is not an effort to combine separate plans together, but instead to create one plan that brings together all the goals already established. High Fidelity Wraparound is a process that is designed to work with all plans.