An incredibly useful tool for someone who is coping with a mental illness or other significant health challenges is the WRAP, or Wellness Recovery Action Plan. If you’re not already familiar with WRAP, you’re really missing out on a wonderful resource. Let’s review some of the basics about this very helpful approach.
What is WRAP?
The Wellness Recovery Action Plan (WRAP) is an effective, structured intervention created by educator and mental health advocate Mary Ellen Copeland. It was designed as a self-management and recovery system for persons coping with various physical and mental health challenges.
WRAP can help people decrease and prevent troubling feelings and behaviors, increase personal empowerment, improve overall quality of life, and achieve their personal life goals and dreams.
WRAP was first formally implemented in 1997, when Copeland’s first edition of the “Wellness Recovery Action Plan” book was published. In 1998, a companion training manual for WRAP group leaders was introduced.
Since then, over a million WRAP books and related resources have been distributed worldwide, and millions of people have benefited from the WRAP intervention. The Copeland Center for Wellness and Recovery was established in 2003, whose mission is to implement the WRAP training model around the world.
In the US, WRAP programs now exist in every state, and the model has spread to numerous other countries, with translations of the WRAP book and other related materials into many different languages. More recent applications of the WRAP model address various health issues such as diabetes, smoking cessation, weight loss, and suicide prevention.
What are the goals and structure of WRAP?
WRAP empowers individuals to identify and understand their personal wellness resources and then helps them develop a personalized plan to use these resources on a daily basis to manage their health concerns.
The goals of WRAP include learning how to:
- Incorporate five key concepts of recovery (hope, personal responsibility, education, self-advocacy, and support) into one’s daily life.
- Create and organize a list of wellness tools, including activities to use to help the person feel better when they are experiencing health difficulties and to prevent such difficulties from occurring.
- Develop an advance directive that allows for family members or other supporters to help when the person cannot appropriately take care of themselves due to an increase in symptoms and decreased self-care abilities.
- Formulate an individualized post-crisis plan to use as the health challenges subside, to promote a return to overall health and wellness.
The seven sections of a WRAP include:
- Wellness Toolbox – This is a list of resources which are used to develop your WRAP. Examples of resources include contacting friends and family, therapy, peer support, coping and stress management skills, rest, nutrition, and physical activity.
- Daily Maintenance Plan – Describe yourself when you are feeling well, and list the things you need to do every day to maintain your health and wellness.
- Identifying Triggers – List triggers, which are external events that can make you feel uncomfortable. An action plan is developed to deal with such triggers.
- Identifying Early Warning Signs – Understand your early warning signs, which are internal, often subtle signs that let you know you are starting to feel worse. Having a plan to review these early warning signs regularly helps increase awareness and allows for action before they get worse.
- When Things are Breaking Down – List the signs that let you know you when are feeling much worse. Using your Wellness Toolbox, develop an effective action plan to help you feel better and prevent things from getting out of control.
- Crisis Planning – Identify the signs and symptoms that let others know when they need to take step in and take over responsibility for your care and decision making. Outline a plan for who you want to support you and make decisions for you, outlining specific things they can do to help and what you would not find helpful. This step can include developing a legally authorized medical or psychiatric advance directive.
- Post-Crisis Planning – This part of your WRAP can be developed in advance to outline what you need to do after a crisis to regain stability. It can also be helpful to modify this section as you actually begin to recover from a crisis, when you may have a better sense of what helps during this difficult time.
What’s a WRAP group like?
The WRAP approach is most commonly learned in a small group format with about 10 to 15 members. Groups are led by two trained peer co-facilitators, and are often held in a health care mental health setting. Group participation should always be voluntary.
The group format includes lectures, discussions, and individual and group exercises. Important WRAP concepts are illustrated through examples from the lives of the group members and facilitators.
WRAP groups typically include eight weekly 2-hour sessions, but may be adapted as needed to meet the needs of the particular group. Often, group members will decide to meet for additional sessions for further refinement of their individual WRAP and to offer additional support to one another.
Is WRAP effective?
WRAP was recognized in 2010 by the US Substance Abuse and Mental Health Services Administration (SAMHSA) as an evidence-based practice and is listed in its National Registry of Evidence-Based Programs and Practices.
Numerous research studies have shown the effectiveness of the WRAP approach. Compared to people not receiving WRAP instruction, WRAP participants have shown significant improvements in several important areas:
- Reduction in severity and number of symptoms of mental illness
- Increased feelings of hopefulness
- Increased personal confidence
- Greater willingness to ask for help
- Better goal orientation
- More able to rely on others for help
- Greater freedom from symptom domination
- Improved self-advocacy
- Improvement toward overall recovery
- Better overall physical and mental health
Although the WRAP approach was initially developed and used primarily for people with mental illnesses, it has been adapted for use with people coping with other chronic health issues (e.g., arthritis, diabetes), life issues (e.g., decision making, relationships) and with military personnel and veterans.
Where can you find WRAP resources?
Here’s a question: Do you know someone who could benefit from developing a WRAP (Wellness Recovery Action Plan)? Please leave a comment. Also, please subscribe to my blog and feel free to follow me on Twitter, “like” my Facebook page, or connect on LinkedIn. Thanks!