Wellness Recovery Action Plan

WRAP Personal Workbook

GR/LD April 2004

The Wellness Recovery Action Plan is a framework with which you can
develop an effective approach to overcoming distressing symptoms, and unhelpful behaviour patterns. It is a tool with which you can get more control over your problems. WRAP was originally developed by Mary Ellen Copleand and a group of mental health service users who wanted to work on their own recovery – this is what they found worked for them. Developing your own WRAP will take time, it can be done alone, but many find it very valuable to have a supporter – someone they trust, and work on it together.

As you develop your WRAP it can become a practical support for your recovery which you refer to daily, as a reminder and guide, and also turn to at times of difficulty. It is designed as an aid for learning about yourself, what helps and what doesn’t, and how to get progressively more in control of your life and your experience. It also includes instructions on developing a crisis plan, as a means of guiding others on how best to make decisions for you and to take care of you, for those times when your problems and symptoms have made it very difficult for you to do this for yourself. Once you are committed to your own recovery, however things work out, they can be an opportunity for learning more about yourself, and improving your WRAP.

A WRAP includes: developing a Wellness Toolbox, and then

1. Evolving a daily maintenance plan

2. Understanding triggers and what I can do about them

3. Identifying early warning signs and an action plan

4. Signs that things are breaking down and an action plan

5. Crisis planning

6. Post crisis planning

The WRAP belongs to you and you decide how to use it. You decide who to show it to and you decide whether you want someone to work with you on it or not. You decide how much time to spend on it and when to do it. It becomes your guide to support your own wellness and recovery.
Developing a Wellness Toolbox – reminders and resources to call on

a. In my experience these are things that support my wellness – this works for me:

b. This is what carries a sense of meaning or significance for me, this is what inspires me and reminds me of my values

c. These are some things that I would like to try to see if they would support my wellness:

a. My baseline: What am I like when I am well ?
When I feel well, I am …………

I am well when I smile, smile, take a walk or socialize with friends. I am well when I agree to out with friends and complete all my chores both at home and school.

b. Daily maintenance Plan
This is what I need to do for myself every day to keep myself feeling as well as possible
I ensure I am feeling well by watching a movie, playing cards, and spending time with neighbors. I am safeguard my feelings by going to the gym for an hour a session.

c. This is what I need to do, less often than every day, to keep my overall wellness and sense of wellbeing

Some of the essential things I can do daily include going on a holiday or summer camp, and visiting a park or zoo. The activities will help me to safeguard the feelings and sense of wellbeing.

d. These are the things that I know I need to do to sustain my wellness, but for some reason do not do them

One of the major things is failure to exercise daily. I have been accumulating weight and the health fitness is deteriorating. Others include keeping in touch with friends as regular as possible.

2. Triggers
a. Recognition
Triggers are things that happen to us that are likely to set off a chain reaction of uncomfortable or unhelpful behaviours, thoughts or feelings – what triggers me?

Some of the issues that trigger me include going out with the wrong friends, theft, drinking, and lack of money.

b. Action Plan
What can I do about these triggers ?

I can ensure I avoid the negative company of friends who drink alcohol. I will also ensure I manage the finances well to avoid stealing. Practicing contentment is also a great gain.

Avoiding your triggers: What can I do to avoid or limit my exposure to things that trigger me?
I will avoid going out with friends who put me in the temptation of drinking and using all my money in the club. I will also find a new group of friends who can inspire me.

Coping with triggers when they occur: What can I do when I
am triggered to prevent things from getting worse?
I can always walk away and get some time off. The time will help rethink the issue and approach it effectively. I can also take time to go out and take a walk to relieve the mind.

3. Early warning signs are the subtle signs of changes in our thoughts or feelings or behaviour, which indicate that you may need to take action to avoid a worsening of your condition or situation.

a. Recognition
What changes for me; what are my early warning signs?
The early warning signs include feeling depressed and withdrawing from my friends and colleagues. I also decline to go to work, clean the room or spend most of the time in bed.

b. Action Plan
What can I do about this?
What action can I take when I recognise the early warning signs?

Some of the actions to take when the early warning signs occur include going out to visit a friend or take a walk. I will also call the counselor and my closest friend to discuss the issues. Another important step is being positive about situations such as lack of money.

4. When things start breaking down or getting worse
a. Recognition
This is how I think and feel, and how I behave when the situation has become uncomfortable, serious or even dangerous:

I have a low self-esteem about the hopeless situation. I also expect that others will offer a helping hand with a generous and kind heart.

b. Action Plan:
When things have progressed this far caring for myself is my top priority. What can I do to reduce these difficult and unpleasant experiences, and prevent things getting worse?

I can embrace a positive mindset by looking at situations differently. I will also hang out with positive friends who do not drink alcohol. The friends will help me manage finances well.

Wellness Recovery Action Plan

PERSONAL CRISIS PLAN

This plan was made on…6/9/2020.. date

And it takes over from any other plans with earlier dates.

This 10 point plan can be just for your own use and reference or can be shared with others involved in the plan. It will take time to set up, and can be changed whenever you have new ideas or information. When you change it, consider sending updated versions to those it involves

Part 1. Remembering What I am like when I’m feeling well

When I am well I am………..

I feel well when I have the money to spend with friends and go out to the bar with them. I also like to play the PlayStation, watch TV or listen to music.

Part 2. When it gets too bad
Describe how others would know that they need to take over some or full responsibility for your care and make decisions on your behalf, what are you like?
When it gets too bad I ………….

When it gets too bad I become depressed, withdraw to my room, spend most of them time in bed, fail to take shower or carry out cleaning duties.

List those people you want to take over for you when the symptoms you
listed above are obvious. They can be family members, friends or health care professionals. You may want to name some people for certain tasks like taking care of the children or paying the bills and others for tasks like staying with you and taking you to health care appointments.
These are my supporters:

Crajie Patts
A childhood friend who have been with me in happy and sad moments. They empathize with me and know what I am going through.

Phone number

Cate Maine

A friend who takes care of me when I am depressed and feeling alone. She knows how to keep me company and discuss anything I am going through.

Phone number

Lindey Matt

A therapist whom I have been seeing for the last two years. She is always friendly and ready to help me in times of trouble.

Phone number

Mike Mark
One of my closest friend at the workplace who is hopeful that I will ever make it in life and this brings me great joy.

Phone number

Sherlyn Paterson
A neighbor and former high school teacher who encourages me when I feel down.

Phone number

There may be health care professionals or family members that have made decisions that were not according to your wishes in the past. They could inadvertently get involved if you do not include the following:

I do not want the following people involved in any way in my care or treatment:

David Lee

He was abusive with his words when I tried to seek help from him. David believes my behavior is out of desire to get attention and make others suffer. He is a family relative.

Lois Pearl

I do not want her involved in my life’s decision since she subscribes to awkward religious beliefs that my problems is an attack by evil spirits.

It would only be human nature if sometimes your supporters had
different opinions on what should happen. It could be helpful to your supporters if you describe how you want possible disputes between them settled. For instance, you may want to say that a majority need to agree, or that a particular person, or two people you name can make the decision.

When my supporters disagree amongst themselves, this is how I would like the dispute settled:

In case my supporters are in a deadlock there are two important people who should have authority. They include Mike Mark who is a colleague at the workplace and Lindey Matt my counselor. They have been with me and they understand my problems more than anyone else.

My General Practitioner is Lindey Matt
Contact +61 312 462 512.

My Psychiatrist is Noah Walker
Contact +61 162 594 164.

My Care co-ordinator is Henry William
Contact +61 412 345 678.

List the medications you are currently taking and why you are taking them. Include the name of who prescribes them.

1. Sertraline (Zoloft)
The medication is effective in controlling depression and panic attacks. I take the medication when negative events occur in my life.

2. Orlistat (Alli, Xenical)
I am taking the drug to control the obese condition. I take the medication alongside a diet and exercise program.

List those medications you would prefer to take if medication or additional medications became necessary, and why you would chose those

1. Naltrexone
I am taking the medication to eliminate cravings for alcohol.

2. Codeine
The drug is effective in treating pain especially due to the low sensitivity to pain.

List those medications that must be avoided and give reasons

I should avoid taking Orlistat (Alli, Xenical) since it has limited abilities to treat obesity. Evidence-based research shows that exercise and diet programs are effective in addressing obesity issues.

List other treatments that help reduce your symptoms and when they
should be used:

Other treatments include celexa (citalopram) which is an effective drug for depressive disorders. It helps relieve the symptoms of depression. I should swallow the medication with water.

Other methods include die and exercise programs. They will be effective in reducing weight and controlling food intake.

List treatments you would want to avoid, and why:

Some of the treatments that can worsen the condition include benzodiazepines. The drugs have severe side effects including dizziness, slurred speech, and drowsiness.

Part 6. Alternatives to being in hospital: staying at home or using other safe places

Set up a plan so that you can stay at home or in the community and still get the care you need

The best plan is to stay at home to interact with the family members and friends. The interaction will relieve the mind and lower effects of depression. It will also help me to actively participate in diet and exercise programs.

If it becomes necessary to have treatment somewhere or to attend
hospital where would you prefer to be?

Cumberland hospital is a public psychiatric hospital in Westmead. The facility has qualified professionals and a friendly service policy.

List treatment facilities you want to avoid and why

Westmead Hospital is one of the treatment facilities I want to avoid. The reason is that the hospital has received negative reports of mishandling patients.

List those things that others can do for you that would help reduce
your symptoms or make you more comfortable when you are in crisis – This is what helps me:

I believe the best care others can show is spending time together happy. I believe spending time together will replace the negative experiences and suppress the negative memories.

List those things you need others to do for you and who you want to do what:

What I need done Who I’d like to do it

Going out for coffee when I feel depressed and unable to do anything Mike Mark

Spending time in the house and watching soccer Cate Maine

List those things that others might do, or have done in the past, that would not help or might even worsen your state

1. Some believe I am just an attention seeker without a real problem.

2. Condemning the behavior without understanding the root cause.

3. Walking away from me and failing to help believing I am just interested playing the victim card.

If my behaviour endangers me or others I want my supporters to:

I want them to come spend time with me at home and encourage me to get some cleaning duties done.

Encourage me to go out and face the world despite the troubles.

I also expect encouragement from the supporters that the situation will get better despite the current situation.

How will your supporters know when it is safe to stop this Crisis Plan?
Describe what positive changes indicate to your supporters that you are in control of things again, and they no longer need to use this plan.

You will know it is safe to cease using this plan when:
They will know its safe when I can get out of bed and out of the house. When I am looking jovial and interested in working and interacting with other people. The new behavior change should last for weeks to ascertain I am in control of things.

You can help ensure that your crisis plan will be followed by signing it in
the presence of two witnesses. It will further increase its potential for use if you identify your supporters and name people who are prepared to back up your needs and preferences.

I developed this plan on (date) With the help of:

Signed Date Witness Date Witness Date

This plan takes over from any with an earlier date

If despite your best efforts at caring for yourself and working with
others, you still go through a crisis – this is not the end of the world, nor does it mean you cannot recover. Recovery is a process that you can get back to at any time and after any experience, no matter how bad. But in order to do so it will be very helpful to reflect on what has happened to you and learn from it. Some can do this alone, most of us are greatly helped by having someone we trust to turn to, and talk it over together.

After a crisis you may be exhausted and badly shaken, so pick your time when you are ready and willing to make sense of it, and you have the energy to do so.

Then talk and think through what has happened, and compare this with the WRAP you have written so far.

What have you learned about yourself and others through this crisis?

Some of the lessons that I have learned is that medications should be combined especially for patients with bipolar disorder. For example, they require mood stabilizer to avoid causing more problems such as manic episodes.

Are there parts of your WRAP that didn’t work out as you had hoped?

All the parts worked effectively well. The only medications that did not work well was antidepressants.

What changes can you make now to your WRAP to make a further crisis less likely?
One of the changes is to avoid prescription of antidepressants. The drugs can cause manic episodes among patients.

~~~For this or similar assignment papers~~~