Embracing the Wellness Recovery Action Plan, harnessing peer support and living your best life
"Blips and Dips in the Recovery Journey" issue of Visions Journal, 2019, 15 (2), pp. 40-44
Many of us have experienced mental health challenges and worry that we might experience them again. How can we better prepare ourselves for living our best life, despite these challenges?
The Wellness Recovery Action Plan® (or WRAP®) is a structured approach designed to help each of us develop our own personalized wellness toolbox. WRAP’s founder, Dr. Mary Ellen Copeland, developed the program with a group in Vermont in the 1990s to help her cope with mental health challenges. Since its creation, WRAP has been hailed as an effective relapse prevention tool.1,2
The WRAP program helps participants to create a document that lists the goals they would like to achieve for their wellness, and then to develop six wellness action plans. I think of this as “earthquake preparedness” for mental health. When we find ourselves facing a mental health challenge and sense that our foundations are starting to shake, we can pull out one of our action plans. WRAP helps us develop these plans when we are well so that we have something to hang onto when we are struggling. As our health ebbs and flows, we can update our WRAP to reflect our changing needs. The WRAP document is a living document, intended to be useful to us as we grow and change over time.
Although you can create your own WRAP with or without a WRAP-trained guide, participating in the program in a group setting can lead to shared wisdom and help build a supportive community. WRAP encourages us to identify five people as our key supports, including professional helpers, family and friends. Facilitated WRAP workshops are a great opportunity to expand your personal network.
How WRAP works
The first step in the WRAP program is to make a list of the activities that make you feel good—things that you, personally, need to do in order to feel healthy mentally, physically and emotionally. Some things on your list may be the same as the things on another person’s list, but ultimately, your list will be unique to you. Everyone needs different things to feel content, happy and well.
Once you have made this list, the next steps of WRAP will help you overcome a challenge and improve your well-being.
Meet Jessica.* Jessica is a 24-year-old single mother of two toddlers. She is finding it difficult to adjust to her role as a responsible, single mother. She frequently drinks a lot of alcohol at parties with her friends and occasionally smokes marijuana. But as a mother, Jessica is motivated to change. She wants to return to school to become a dental hygienist so she can support her young family and move out of her parents’ basement suite. She began writing a WRAP for herself and is working on implementing her preparedness kit to improve her life, achieve her goals and keep her well.
- Develop a daily maintenance plan.
Using the list of activities that make you feel content and happy and well, come up with a daily plan that maximizes the health benefits of these activities. The plan should include dedicated time and space to do at least one of these activities every day.
Jessica knows that every day she needs to get her kids up, feed them breakfast and get them dressed. She needs to do the same for herself. Jessica likes to go to the park most mornings so she can socialize with other parents and let the kids play with other children. If she doesn’t do this, she feels isolated. When the kids nap in the afternoons, Jessica likes to read, relax or do some light chores. Using these activities as a guide, Jessica develops a daily maintenance plan for a typical day—a list of all the things she needs to do to maintain a sense of balance in her life.
- Acknowledge your stressors.
The next step in the WRAP program is to write a list of your personal stressors. Take the time to think about the things in your life that can trigger unhealthy coping behaviours. Be as detailed as possible so that you can anticipate as many potential triggers as you can.
One of Jessica’s key stressors is loneliness. She gets frustrated when she is lonely, especially in the evenings after the kids have gone to sleep. Another stressor is financial instability. She knows that night classes at her local college would help with loneliness, but she doesn’t have enough savings to enrol. This makes her feel both frustrated and angry. She often has the urge to drink alcohol when she feels this way.
- Learn your early warning signs and generate ideas to address them.
Next in the WRAP program, write down a list of your “early warning signs”—what you feel when you haven’t successfully calmed your stressors. Think about the physical and emotional cues that tell you when you are about to engage in unhealthy behaviours.
For Jessica, the primary early warning sign is a strong urge to drink alcohol. By thinking about how this urge manifests itself in her body, Jessica had the opportunity to get to know herself a bit better. She also came up with ideas for addressing those early warning signs. She realized that if feelings of loneliness, frustration and isolation triggered her urge to drink, then it was important to minimize opportunities for those feelings to build. She decided that if she felt lonely, she would invite a friend over or ask her parents to babysit so she could go out for coffee. She decided that getting a part-time job in the evenings would keep her busy and help her earn money for school. She also decided to attend a support group for people facing alcohol challenges. She shared this wellness plan with her parents, two close friends and, eventually, the manager at her new part-time job at a coffee shop. These people are now Jessica’s support team.
- Learn how to recognize when things break down, and have a plan.
Having a wellness plan does not mean we are always successful in following it. It’s important to accept that there will be setbacks and to be forgiving of ourselves when they occur. Equally important is being able to recognize a setback and knowing what tools we have to deal with it.
Sometimes, despite her hard work, Jessica gives in to her addiction, goes out at night and drinks too much. The next day, she feels sick and she often misses work. She finds it very difficult to cope with her children when she is suffering the effects of a party night with friends. This situation can very quickly escalate. WRAP encourages us to delve into our toolkit when things are breaking down to help us get our wellness plan back on track. When this kind of situation happens, Jessica attends several support meetings over the next few days and then picks up a few extra shifts at the coffee shop. She limits her evening interactions with friends so as to not be enticed to drink, and focuses on making connections with other parents in the neighbourhood park.
- Make a crisis plan.
The WRAP program encourages us to put a plan in place in the event of a mental health crisis. The thought of making such a plan makes Jessica feel weary but she knows that relapse is part of the recovery process and that a crisis event could happen.
Jessica has asked her parents to take over the primary care of her children if a crisis happens. She has also asked them to take over her finances and to inform her employer that she will be away for a period of time. Jessica has decided that if such a crisis were to occur, she would check herself into rehab, where she would receive specialized care and services to help her remain sober and well enough to be responsible for her children.
- Make a post-crisis plan.
After our mental health is no longer in immediate danger, we still need to have in place a detailed plan for continued recovery—one that minimizes the chances for another crisis. Jessica’s post-crisis plan includes having her parents keep a close eye on her to encourage her to remain sober and be present for her kids. When they all feel she is ready, Jessica will resume control of her finances and return to work. Jessica will attend her support group as much as possible and try to socialize with people who support her sobriety.
People of all ages can use the WRAP program for recovery or management of a range of issues—from mental health challenges to trauma, weight loss, health management and building self-confidence and meaningful relationships. WRAP facilitators are not there as experts but rather to share, shoulder-to-shoulder, the experience of living in the WRAP recovery-oriented way. Many family members find it helpful to participate in the program themselves. We cannot create a WRAP for someone else, but we can benefit from our own WRAP program and then share the language and concepts with our loved ones
MHRP and peer support networks
Mental Health Recovery Partners (MHRP, previously the BC Schizophrenia Society (BCSS) Victoria, BCSS Nanaimo and BCSS Campbell River) recognizes the value of peer support within the framework of the WRAP program and mental health advocacy generally. A strong peer support relationship complements clinical care and can strengthen the positive outcomes of WRAP participation. At MHRP, we have made peer support a guiding principle of our work and service environment. Peer support includes support from family members and peers with lived experience of their own mental health challenges.
Since 2010, all MHRP employees have been able to opt in and develop their own WRAP. My colleagues and I share a common WRAP language and ethical outlook. Not only do we provide a support network for each other but we also exercise this deeper understanding in our work with clients.
In addition to having hosted over 35 WRAP programs since 2010, with over 420 participants, MHRP South Island has unveiled a comprehensive 40-hour peer support training module, authored by WRAP consultant and facilitator Jenn Cusick. The module has been successfully piloted locally and in Alberta. Over the next year, we hope to train more peer supporters locally and beyond.
To learn more about WRAP, recovery, peer support and our services at Mental Health Recovery Partners (MHRP) South Island, visit www.mhrp.ca and click on the South Island link, or like us on Facebook at facebook.com/MHRPSouthIsland/. You can also view information videos at youtu.be/ti6GU2il4hg and youtu.be/QLAqNO5Im3w.
About the author
Hazel is a WRAP facilitator dedicated to leadership and innovation in mental health care and substance use. In 2010, she helped spearhead the program’s development on Vancouver Island. Hazel has a bachelor’s degree in psychology and conflict resolution. Her master’s thesis (2017) focuses on early psychosis, peer support and health care transformation
Cook, J.A., Copeland, M.E., Jonikas, J.A., Hamilton, M.M., Razzano, L.A., Grey, D.D., Floyd, C.B., Hudson, W.B., Macfarlane, R.T., Carter, T.M. & Boyd, S. (2012). Results of a randomized controlled trial of mental illness self-management using wellness recovery action planning, Schizophrenia Bulletin 38(4), 881-891. https://doi.org/10.1093/schbul/sbr012.