Guide to Developing a WRAP – Wellness Recovery Action Plan
The following [article] will serve as a guide to developing Wellness Recovery Action Plans. It can be used by people who are experiencing psychiatric symptoms to develop their own guide, or by health care professionals who are helping others to develop Wellness Recovery Action Plans.
This [article] may be copied for use in working with individuals or groups.
The following supplies will be needed to develop a Wellness Recovery Action Plan:
- a three ring binder, one inch thick
- a set of five dividers or tabs
- a package of three ring filler paper (most people preferred lined)
- a writing instrument of some kind
- (optional) a friend or other supporter to give you assistance and feedback
Section 1 – Daily Maintenance List
On the first tab, write Daily Maintenance List. Insert it in the binder followed by several sheets of filler paper.
On the first page, describe, in list form, yourself when you are feeling all right.
On the next page, make a list of things you need to do for yourself every day to keep yourself feeling all right.
On the next page, make a reminder list for things you might need to do. Reading through this list daily helps keep us on track.
Section 2 – Triggers
External events or circumstances that, if they happen, may produce serious symptoms that make you feel like you are getting ill. These are normal reactions to events in our lives, but if we don't respond to them and deal with them in some way, they may actually cause a worsening in our symptoms.
On the next tab, write "Triggers" and put in several sheets of binder paper.
On the first page, write down those things that, if they happened, might cause an increase in your symptoms. They may have triggered or increased symptoms in the past.
On the next page, write an action plan to use if triggers come up, using the Wellness Toolbox [see article entitled, “Developing a Wellness Toolbox”] as a guide.
Section 3 – Early Warning Signs
Early warning signs are internal and may be unrelated to reactions to stressful situations. In spite of our best efforts at reducing symptoms, we may begin to experience early warning signs, subtle signs of change that indicate we may need to take some further action.
On the next tab, write "Early Warning Signs." On the first page of this section, make a list of early warning signs you have noticed.
On the next page, write an action plan to use if early warning signs come up, using the Wellness Toolbox [see article entitled, “Developing a Wellness Toolbox”] as a guide.
Section 4 – Things Are Breaking Down or Getting Worse
In spite of our best efforts, our symptoms may progress to the point where they are very uncomfortable, serious and even dangerous, but we are still able to take some action on our own behalf. This is a very important time. It is necessary to take immediate action to prevent a crisis.
On the next tab write, "When Things Are Breaking Down." Then make a list of the symptoms that, for you, mean that things have worsened and are close to the crisis stage.
On the next page, write an action plan to use "When Things Are Breaking Down," using the Wellness Toolbox [see article entitled, “Developing a Wellness Toolbox”] as a guide.
Section 5 – Crisis Planning
In spite of our best planning and assertive action, we may find ourselves in a crisis situation where others will need to take over responsibility for our care. We may feel like we are totally out of control.
Writing a crisis plan when you are well to instruct others about how to care for you when you are not well keeps you in control even when it seems like things are out of control. Others will know what to do, saving everyone time and frustration, while insuring that your needs will be met. Develop this plan slowly when you are feeling well. The crisis planning form includes space to write:
- those symptoms that would indicate to others they need to take action on your behalf
- who you would want to take this action
- medications you are currently taking, those that might help in a crisis, and those that should be avoided
- treatments that you prefer and those that should be avoided
- a workable plan for at-home care
- acceptable and unacceptable treatment facilities
- actions that others can take that would be helpful
- actions that should be avoided
- instructions on when the plan no longer needs to be used
For more information on developing a Wellness Recovery Action Plan, see the following books by Mary Ellen Copeland:
- Wellness Recovery Action Plan
- Winning Against Relapse
This article also appears on Mary Ellen Copeland’s Web site http://www.mentalhealthrecovery.com and is reprinted here with her permission.Date published: 8/18/00