WRAP REcognized as EBP by SAMHSA

NYAPRS Note: After years of hard work by many, many people, Mary Ellen Copeland’s Wellness Recovery Action Plan (WRAP) has been recognized by SAMHSA's National Registry for Evidence-Based Programs and Practices.

There are numerous certified WRAP trainers in New York, including NYAPRS’ Ruth Pasillas-Gonzalez. For more information, contact her at ruthg@nyaprs.org.

Wellness Recovery Action Plan (WRAP)

Date of Review: September 2010

Wellness Recovery Action Plan (WRAP) is a manualized group intervention for adults with mental illness. 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 mental illness. 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--activities they can use to help themselves feel better when they are experiencing mental health difficulties and to prevent these difficulties from arising
• 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 appropriate actions on his or her own behalf
• Help each participant develop an individualized postcrisis plan for use as the mental health difficulty subsides, to promote a return to wellness

WRAP groups typically range in size from 8 to 12 participants and are led by two trained cofacilitators. Information is imparted through lectures, discussions, and individual and group exercises, and key WRAP concepts are illustrated through examples from the lives of the cofacilitators and 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 continually 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. Referrals to WRAP are usually made by mental health care providers, self-help organizations, and other WRAP participants. Although the intervention is used primarily by and for people with mental illnesses of varying severity, WRAP also has been used with people coping with other health issues (e.g., arthritis, diabetes) and life issues (e.g., decisionmaking, interpersonal relationships) as well as with military personnel and veterans.

Descriptive Information

Areas of Interest	Mental health treatment
Outcomes	1: Symptoms of mental illness 2: Hopefulness 3: Recovery from mental illness 4: Self-advocacy 5: Physical and mental health
Outcome Categories	Mental health Quality of life Social functioning Treatment/recovery
Ages	26-55 (Adult)
Genders	Male Female
Races/Ethnicities	American Indian or Alaska Native Asian Black or African American Hispanic or Latino White Race/ethnicity unspecified
Settings	Residential Outpatient Other community settings
Geographic Locations	Urban Suburban Rural and/or frontier
Implementation History	In 1997, WRAP was first implemented, and the first edition of the book "Wellness Recovery Action Plan" was published. Since then, more than a million 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. 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, nationally and internationally. As of February 2010, more than 2,000 people had been trained as a WRAP facilitator, and 120 of these individuals had been trained as an advanced-level facilitator. 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, exist 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.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: Yes Evaluated in comparative effectiveness research studies: No
Adaptations	The book "Wellness Recovery Action Plan" and other WRAP implementation materials have been translated into many languages, including Chinese, French, Japanese, Polish, and Spanish. In addition, many international trainings and presentations have been adapted to accommodate unique cultural perspectives on mental health, language differences, and cultural norms.
Adverse Effects	Preliminary data analysis conducted for a study published in 2009 by Cook et al. (see Study 2) indicated that participation in WRAP may have had negative effects on empowerment. However, this finding has not been replicated in subsequent evaluations and analyses with larger samples. To date, no additional accounts of adverse effects of WRAP have been published.
IOM Prevention Categories	IOM prevention categories are not applicable.

Learn More by Visiting:

• http://www.mentalhealthrecovery.com/
• http://www.copelandcenter.com/

The NREPP review of this intervention was funded by the Center for Mental Health Services (CMHS).

Reposted at darkestcloset.blogspot.com.