The Wellness Recovery Action Plan: Creating an Instruction Manual for Your Mental Health
Imagine you wake up one day and discover that you feel a bit “off.” Maybe you’re more irritable than usual, or maybe you just feel unmotivated. Maybe you find yourself straying from your normal morning routine. You can tell that something is different, but you can’t quite put your finger on it, so you try to go about your day as normal.
Later that day, something happens that upsets you. Perhaps someone makes a rude comment toward you, or perhaps you receive a piece of troubling news. This only worsens your mood, and you’re unable to stop thinking about the upsetting event as the day progresses. You keep revisiting it in your mind, but you don’t know what to do to make yourself feel better, so you simply try to ignore these thoughts as much as possible and make it through the rest of the day.
You succeed, but you don’t feel any better the next day. Or the day after that. Or next week. In fact, you seem to be getting worse. Little things that bother you keep happening each day, and your mood just won’t improve. You feel like there’s a dark cloud hanging over you everywhere you go. You’ve lost all interest in things you used to enjoy, and you realize that if something doesn’t change soon, your mental health is going to be in a very bad place. But no matter how hard you try, you can’t figure out what you need to do to start feeling better again.
At times like these, you might wish you had an instruction manual to tell you what’s wrong with your mental health and how you can fix it. The bad news is that no such manual exists—but the good news is that it’s possible to create one. It’s called a Wellness Recovery Action Plan (or WRAP), and it’s a tool you can use to track your mental wellness, identify sources of stress, and regain control when your health takes a turn for the worse.
In this blog post, Cummins’ Carman Allen, a Certified Recovery Specialist and Recovery Coach, walks us through the ins and outs of WRAP and how anyone can use it to create a personal instruction manual for their mental health.
Getting a Handle on WRAP
"WRAP is for individuals who are trying to identify their own process for recovery. It's a way to give them some tools," says Carman Allen, Certified Recovery Specialist at Cummins Behavioral Health.
The Wellness Recovery Action Plan was first developed in 1997 by a group of people who were searching for ways to overcome their own mental health challenges. The most prominent of these individuals was Mary Ellen Copeland, PhD, who remains the public face of WRAP today.
At its core, WRAP is a self-determined, evidence-based tool that a person can use to get well and stay well. The key to WRAP lies in self-observation, self-awareness, and thoughtful planning. As we said above, you can think of it as an instruction manual for your mental health that tells you what to do to stay well and how to start feeling better if you become unwell. “WRAP covers a vast amount of techniques people can use to be able to help themselves,” explains Cummins’ Carman Allen.
A WRAP (sometimes called a WRAP plan) consists of seven major elements:
- Wellness toolbox: These are activities you do in your life that help you feel well. They might include a wide variety of activities that are beneficial for your mental health, such as getting plenty of sleep every night, eating a healthy diet, exercising, talking with friends or family members, journaling, practicing relaxation techniques, practicing gratitude, receiving counseling, reading a book, enjoying nature, and so on.
- Daily plan, or what you’re like when you’re well: This is the routine you should follow every day to help yourself stay well. You can also look at this section as a description of what you do and how you feel on a day-to-day basis when you are mentally well.
- Stressors (also called triggers): These are external events and situations that might make you feel uncomfortable if they happen to you. Although it’s normal to be upset by these things, they can be detrimental to our wellness if we don’t have some method of dealing with them. A few common examples might include having someone argue with you or receiving bad news.
- Early warning signs: These are internal, subtle indications that you are beginning to feel worse. For example, you might feel more irritable then normal, sadder than normal, or you might find yourself replaying an upsetting event in your mind.
- When things are breaking down: These signs occur when you are feeling much worse than normal and are nearing a state of mental and emotional crisis. Some examples include feeling sad or angry all the time, problems at work or in school, problems in your relationships, or even hallucinations.
- Crisis plan: If your mental health deteriorates to the point that you are in crisis, you may not be able to make good decisions for yourself during that time. Your crisis plan identifies who should make important decisions for you and gives instructions about the types of assistance you do and do not want. Some of the details included in a crisis plan are: who should and should not assist with your care, which medications and treatments are preferred and which are not acceptable, what you do and do not want from your supporters during a crisis, and how they will know when you’re able to take care of yourself again.
- Post-crisis plan: This section lays out tasks and timelines for healing and returning to everyday life after a mental health crisis. This plan can be started prior to a crisis, but it will likely need to be completed or adjusted as you are beginning to recover from the crisis, as you should then have a clearer picture of what you need to do for yourself to get well.
How to Assemble Your Own WRAP
The nice thing about WRAP is that it isn’t too difficult to begin putting together a plan of your own. The WRAP website provides a variety of tools and resources you can use to start creating your own WRAP, including several reasonably-priced textbooks and workbooks. However, it’s also common to work with a behavioral health professional as you put your plan together. “Some people have the support of a therapist, or they can use it with a peer recovery specialist,” Carman says.
Although your WRAP should follow the basic structure laid out above, the details of each section should fit your personality and specific life circumstances. “What I love about the WRAP plan is that you, the person, the individual, get to identify what needs to go in it,” Carman explains. Even when she’s assisting a client with creating their WRAP, she is careful to act only as a guide and sounding board, ultimately leaving the final decisions to them. “I’m just there to help that person navigate the plan and identify their wellness tools, and that’s empowering,” she says.
When working on your WRAP, it’s important to remember that nothing is set in stone. In fact, you should expect the information in your plan to change as your life circumstances change. According to Carman, this is a normal part of keeping your WRAP up to date:
“Let me make this clear: this is a living, breathing document. Personally, I have a WRAP plan. I started my WRAP plan several years ago when I first got into mental health services myself. And since then, I have readdressed it over the years as I’ve gotten a job, as I’ve gotten better, as I’ve gotten married—every change in my life. Because those sections—triggers, early warning signs, when things are breaking down—all of those things are constantly changing. So I’m constantly reinventing it to meet where my needs are at that time. Where your plan starts off today, more than likely it will not stay there, because you’re going to hopefully get better, and you may find out, ‘Hey, this isn’t triggering me anymore,” or, “Things are getting better, so that’s absolutely not an early warning sign for me now.’ It will continue to take a life of its own.”
Tips for Living by Your WRAP
Let’s say you’ve reviewed a number of WRAP resources, you’ve done some brainstorming or spoken with a behavioral health professional, and you’ve put together your own plan. What happens next? How can you apply this personal instruction manual you’ve created to monitor and manage your mental health?
According to Carman, it all begins with understanding what you’re like when you’re well. “I have a mental illness,” she explains. “I understand this from many standpoints. My personal perspective is this: How do I know when I’m symptomatic? I know because I have identified what I’m like when I’m well. That is the first and most important part.”
Carman continues,
“For me, one of my big things when I’m well is I love to get up, open my curtains, do my daily meditations, all that kind of stuff. Suppose I don’t do that for two or three days. That’s not a big issue; maybe I just don’t feel like it. If I’m looking at seven to ten days that I haven’t done it, I understand that something else is going on here. I’ve created my own gauge. And it’s not an open-ended thing, like, ‘Oh, it’s OK, it’ll be alright next week.’ I know I have a time frame. As another example, some people with depression may understand that, ‘If I lay around for two or three days, or four days, or even a week, that’s not the worst it’s been for me. Now, if I’m going into two weeks, now I need to do something different.’ So, the basis is to first identify what you’re like when you’re well, and then you figure out, what do I do for myself when I’m well? And that’s not necessarily every day, but it’s more days than not.”
The challenge with mental wellness is that even when we’re doing all the things we should to stay well, we can still take a turn for the worse. When this happens, we need to be extra vigilant about stressors/triggers. Carman says, “In the course of those days that I’m not feeling my best, I’m also trying to be aware of what triggers can create another barrier. Suppose I’m feeling depressed, I haven’t gotten up, and now I have some bad news. Now I have a compound issue.”
The most important thing to remember about stressors/triggers is that sometimes they can’t be avoided. In these situations, we need to be able to deal with them in a way that minimizes risk for our mental health. As Carman points out, your WRAP can also help you with this:
“What have I put in place for that trigger, and what can I do now that the trigger is here? Because the fact is that triggers are going to happen, and we don’t have to stop our lives because they happen. What I do is I go back and I figure out, ‘OK, when this happens, this is what I said I’m going to do.’ Because the WRAP plan is set up in this way: not only do you identify the trigger, you identify your action plan for the trigger. So it’s not just, ‘That’s my trigger, I don’t know what to do about it.’ That would not be very helpful. Once you identify those triggers as much as you can—and you’ll continue to do that, because as I said, this is a living, breathing document—’OK, this is what triggered me.’ Maybe anxiety, maybe fear. ‘OK, what am I fearful of?’ I’m going to ask the questions, I’m going to talk to somebody. And so now I’m pulling in my responsibility, what I’m accountable for. Because people can’t help you if they don’t know.”
WRAP is an easy-to-assemble, highly flexible, effective tool for managing your mental health on a day-to-day basis. As Carman Allen says, “The purpose of the WRAP plan is to help people identify how to get through mental health challenges. Because you talk to people all the time, and you say, ‘How did you get through that?’ And they say, ‘I don’t know, I just did it.’ The fact is, I need to know how I got through it, because more likely than not, I’m going to need to get through something else at another time. And the quicker I can pull that to my remembrance and start practicing that, the quicker I can get through it and get back to feeling better.”
We would highly encourage all our readers to take the time to put together a WRAP for use in their own lives. If you’d like assistance from a behavioral health professional, please give us a call at (888) 714-1927 to see if services at Cummins Behavioral Health might be right for you!
If you liked this article about the Wellness Recovery Action Plan, then you might also enjoy our blog on the Stages of Change model and how you can use it to make meaningful changes in your life!