Wellness Recovery Action Plan (WRAP)

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Wellness Recovery Action Plan
(WRAP)
By Mary Ellen Copeland PhD
      Adapted from the review by the National Registry of
      Evidence Based Programs and Practices Date of
      Review: September 2010

Wellness Recovery Action Plan (WRAP) is a manualized
group intervention for adults. It has been modified to be
used with teens and children. WRAP guides participants
through the process of identifying and understanding their
personal wellness resources ("wellness tools") and then
helps them develop an individualized plan to use these
resources on a daily basis to manage their lives so that they
can get well and stay well.

WRAP has the following goals:

 Teach participants how to implement the key concepts of
     recovery (hope, personal responsibility, education, self-
     advocacy, and support) in their day-to-day lives;
 Help participants organize a list of their wellness tools
     (Wellness Toolbox)--activities they can use to help
     themselves feel better when they are experiencing
     mental health difficulties and to prevent these
     difficulties from arising, and organizing those tools into
     a daily maintenance plan, identification of triggers and
     an action plan, identification of early warning signs and
     an action plan, identification of signs that things are
     breaking down and an action plan.
 Assist each participant in creating an advance directive
     that guides the involvement of family members or
     supporters when he or she can no longer take action on
     his or her own behalf;
 Help each participant develop an individualized post crisis
     plan for use as the mental health difficulty subsides, to
     promote a return to wellness, that time when they can
     again use their Daily Maintenance Plan.
 Groups often include intensive study of the most popular
     Wellness Tools, things like support, diet, exercise,
     journaling and creative activities.


While a person can develop a WRAP on their own, or while
working with a health care provider or other supporter of
their choice, people seem to benefit most from attending a
WRAP group where they can share ideas and learn from the
experience of others. The group process has been studied
extensively and its effectiveness has been proven over time.

WRAP groups typically range in size from 8 to 12
participants and are led by two trained facilitators.
Information is imparted through lectures, discussion, and
individual and group exercises, and illustrated through
examples from the lives of the facilitators and the
participants. The intervention is typically delivered over
eight weekly 2-hour sessions, but it can be adapted for
shorter or longer times to more effectively meet the needs
of participants. Participants often choose to continue
meeting after the formal 8-week period to support each
other in using and revising their WRAP plans.

Although a sponsoring agency or organization may have its
own criteria for an individual's entry into WRAP, the
intervention's only formal criterion is that the person must
want to participate. WRAP is generally offered in mental
health outpatient programs, residential facilities, and peer-
run programs. Mental health care providers, self-help
organizations, and other WRAP participants usually make
referrals to WRAP. Although the intervention is used
primarily by and for people with mental health difficulties of
varying severity, WRAP also has been used with people who
are coping with other health issues (e.g., arthritis, diabetes)
and life issues (e.g., decision-making, interpersonal
relationships) as well as with military personnel and
veterans.

All aspects of WRAP are totally voluntary and are not
diagnosis based. Development or use of a WRAP cannot be
mandated. Mandating WRAP violates the fidelity of the
model. As this intervention developed, program developers
and participants became convinced that adherence to a
strong body of Values and Ethics that had evolved with this
intervention was essential to its implementation and
assured the most positive effect on the participants. These
values and ethics can be reviewed at
http://mentalhealthrecovery.com/about/values.php

Implementation History

WRAP was developed in 1997. The first WRAP groups were
held that year, and the first edition of the book "Wellness
Recovery Action Plan" was also published in that year. Since
then, millions of WRAP books and related resources have
been distributed worldwide, and millions of people have
benefited from the WRAP intervention. Formal training for
WRAP facilitators was first offered in 1997, and the first
edition of the structured WRAP facilitator-training manual,
"Mental Health Recovery Including Wellness Recovery Action
Plan Curriculum," was published in 1998. There have been
five revisions of the manual since that time, including the
most recent in 2012.

The not-for-profit Copeland Center for Wellness and
Recovery was established in 2005 with a mission to
implement and network the WRAP training model both
nationally and internationally. As of March 2012, more than
3,000 people had been trained as WRAP facilitators by the
Copeland Center, and 250 of these individuals had been
trained as advanced-level facilitators. Trainings have been
conducted in Australia, Canada, England, Hong Kong,
Ireland, Japan, New Zealand, Scotland, and the United
States, and WRAP groups, which are conducted by trained
facilitators, are being held in these countries.

In the United States, local and regional WRAP programs
sponsored by mental health agencies and peer-run centers
exist in every State, and over 25 States have integrated
statewide WRAP initiatives. There have been at least six
evaluations of this intervention in the United States, as well
as one in New Zealand and one in Scotland. There is
currently a major study of WRAP in Illinois by Judith Cook
and other highly respected researchers at the University of
Illinois at Chicago.

The book "Wellness Recovery Action Plan" and other WRAP
implementation materials have been translated into many
languages, including Chinese, French, Japanese, Polish,
Korean and Spanish. In addition, international trainings and
presentations have been adapted to accommodate unique
cultural perspectives on mental health, language differences,
and cultural norms.


Dissemination

The Copeland Center for Wellness and Recovery offers a
wide variety of training opportunities including basic mental
health recovery and WRAP, facilitator training, advance
Level facilitator training, facilitator refreshers and special
interest training such as "WRAP for Children", "WRAP for
Dealing with the Effects of Trauma", "WRAP for Youth" and
"Using WRAP to Avoid the Use of Seclusion and Restraints".

The facilitator training covers all aspects of organizing,
preparing, and conducting group sessions, with training
activities and discussions closely following the content of the
manuals. The facilitator training manual includes a
comprehensive curriculum. Extensive support materials
(e.g., handouts, worksheets) are available for participants
and facilitators, and many of these materials are accessible
at the participant and facilitator resource web site
http://www.WRAPandRecoveryBooks.com.

The Copeland Center is the only organization qualified to
train Advance Level WRAP facilitators, people who can teach
others to be WRAP facilitators. There is a certification
program for WRAP facilitators as well. The certification
program helps to ensure fidelity to the model.

An extensive array of well-developed implementation
materials is available. All materials are consistent in content
and approach, and they include guidance for adapting the
program for use with specific populations.

Program dissemination materials include but are not limited
to:


Copeland, M.E. WRAP for dealing with the effects of trauma.
Dummerston, VT: Peach Press.
Copeland, M.E. (2010) WRAP plus. Dummerston, VT: Peach
Press.
Copeland, M. E. (1999). Winning against relapse: A
workbook of action plans for recurring health and emotional
problems. Dummerston, VT: Peach Press.

Copeland, M. E. (2001). The depression workbook: A guide
for living with depression and manic depression (2nd ed.).
Oakland, CA: New Harbinger Publications.

Copeland, M. E. (rev. 2011). Facilitator training manual:
Mental health recovery including Wellness Recovery Action
Plan curriculum. Dummerston, VT: Peach Press.
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