Individual Perspectives on the Wellness Recovery Action Plan (W.R.A.P.) as an Intervention in Mental Health Care
DOI:
https://doi.org/10.61841/n29ctd75Keywords:
Wellness Recovery Action Plan,, Wellness Recovery Action Plan, Recovery,, Mental Health,, Occupational Therapy,, IrelandAbstract
Objective: This study explored the experience of individuals with mental health difficulties who completed the Wellness Recovery Action Plan (W.R.A.P.) intervention. Participant perspectives on the therapeutic elements of the WRAP, its role in recovery and constructive feedback are presented.
Methods: Using descriptive phenomenological methods, in-depth semi-structured interviews were conducted with four individuals with mental health difficulties who attended a WRAP programme in a community mental health centre in Ireland.
Results: Overall, participants felt that completing the WRAP was a therapeutic group experience. The identification of early warning signs and crisis planning proved particularly valuable by individuals who felt more empowered to actively manage their own mental health. Qualitative perspectives from this study point to the importance of introducing the WRAP early in an individual’s recovery journey, and providing multiple opportunities to repeat and review the process.
Conclusions and Implications for Practice: Results support the findings of earlier studies in which the WRAP
was found to be a self-management programme that contributes to the recovery of individuals with mental health difficulties. Group peer support was valued by participants, but future research should study the effectiveness of the WRAP in comparison to other peer support programmes.
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References
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16 (4), 11–23.
Aronson, J. (1994). A pragmatic view of thematic analysis. The Qualitative Report, 2 (1). Retrieved from http://nsuworks.nova.edu/tqr/vol/iss1/3
Attride-Stirling, J. A. (2001). Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1 (3), 385- 405.
Bellack A. & Drapalski, A. (2012). Issues and developments of the consumer recovery construct. World Psychiatry, 11 (3), 156-160.
Bond, G. & Campbell, K. (2008). Evidenced-based practices for individuals with severe mental illness. Journal of Rehabilitation, 74 (2), 33-44.
Campbell, J. (1997). How consumers/survivors are evaluating the quality of psychiatric care. Evaluation Review, 21 (3), 357-363.
Caras, S. (1999). Reflections on the recovery model. Unpublished paper.
Cohen, O. (2005). How do we recover? An analysis of psychiatric survivor oral histories. Journal of Humanistic Psychology, 25 (3), 333-354.
Conrad, K. J., Yagelka, J. R., Matters, M. D., Rich, A. R., Williams, V. & Buchanan, M. (2001). Reliability and validity of a modified Colorado Symptom Index in a national homeless sample. Mental Health Services Research, 3 (3), 141-53.
Cook, J., Copeland, M. E., Corey, L., Buffington, E., Jonikas, J., Curtis, L. & Nichols, W. (2010). Developing the evidence-base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two state-wide initiatives. Psychiatric Rehabilitation Journal, 34 (2), 113-120.
Cook, J., Copeland, M. E., Floyd, C. B., Jonikas, J. A., Hamilton, M. M., Razzano, L., Carter, T. M., Hudson, W. B., Grey,
D. D. & Boyd, S. (2012). A randomized controlled trial of effects of Wellness
Recovery Action Planning on depression, anxiety, and recovery. Psychiatric Services, 63 (6), 541-547.
Cook, J. A., Copeland, M. E., Hamilton, M. M., Jonikas, J. A., Razzano, L. A., Floyd, C. B., Hudson, W. B., Macfarlane,
R. T. & Grey, D. D. (2009). Initial outcomes of a mental illness self-management program based on Wellness Recovery Action Planning. Psychiatric Services, 60 (2), 246-249.
Cook, J. A., Copeland, M. E., Jonikas, J. A., Hamilton, M. M., Razzano, L.A., Grey, D. D. & Boyd, S. (2011). Results of a randomized controlled trial of effects of mental illness self-management using Wellness Recovery Action Planning.
Schizophrenia Bulletin, 38 (4), 881-891.
Cook, J., Jonikas, J., Hamilton, M., Goldrick, V., Steigman, P., Grey, D., Burke, L., Carter, T., Razzano, L. & Copeland,
M. (2013). Impact of Wellness Recovery Action Planning on Service Utilization and Need in a Randomized Controlled Trial. Psychiatric Rehabilitation Journal, 36 (4), 250-257.
Copeland, M. E. (1997). Wellness recovery action plan. Dummerston, VT: Peach Press.
Copeland, M. E. (2001). Wellness Recovery Action Plan: A system for monitoring, reducing and eliminating uncomfortable or dangerous physical symptoms and emotional feelings.
Occupational Therapy in Mental Health, 17, (3/4), 127-150.
Copeland, M. E. (2004). Leading a mental health recovery and WRAP facilitator training. Brattleboro, VT: Peach Press.
Copeland, M. E. (2008). The WRAP Story: First Person Accounts of Personal and System Recovery and Transformation. Peach Press.
Davidson, L., O’Connell, M., Tondora, J., Styron, T. & Kangas, K. (2006). The top ten concerns about recovery encountered in the mental health system transformation. Psychiatric Services, 57, (5), 640-645.
Davidson, L., Tondora, J., Lawless, M. S. O’Connell, M. J. & Rowe, M. (2009). A practical guide to recovery- oriented practice: Tools for transforming practice. New York: Oxford University Press.
Department of Health & Children (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. Dublin: Stationary Office. Retrieved from http://www.dohc.ie/publications/vision_for_change.html
Derogatis, L. R. (1993). Brief Symptom Inventory: Administration, procedures and scoring manual (4th ed.). Minneapolis, MN: NCS Pearson Incorporated.
Doughty, C., Tse, S., Duncan, N. & Mc Intyre, L. (2008). The Wellness Recovery Action Plan (WRAP): Workshop evaluation. Australian Psychiatry, 16 (6), 450-456.
Drew, N. (1999). A return to Husserl and researcher self-awareness. In: Polifroni, E. C. & Welch, M. (eds.) Perspectives on philosophy of science in nursing: An historical and contemporary anthology. Philadelphia: Lippincott Williams & Wilkins, pp. 263-272.
Druss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S., Sterling, E., DiClemente, R. & Lorig, K. (2010). The health and recovery peer (HARP) program: A peer-led intervention to improve medical self- management for persons with serious mental illness. Schizophrenia Research, 118 (1-3), 264-70.
Foster, G., Taylor, S. J., Eldridge, S. E., Ramsay, J., & Griffiths, C. J. (2007). Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev, 4(4).
Fukui, S., Starnino, V., Susana, M., Davidson, L., Cook, K., Rapp, C. & Gowdy, E. (2011). Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope and recovery. Psychiatric Rehabilitation Journal, 34 (3), 214-222.
Giffort, D., Schmook, A., Woody, C., Vollendorf, C. & Gervain, M. (1995). Recovery Assessment Scale. Chicago, IL: Illinois Department of Mental Health.
Heller, T. Roccoforte, J. A. & Cook, J. A. (1997). Predictors of support group participation among families of people with mental illness. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 46 (4), 437-442.
Howard, P. B., El-Mallakh, P., Rayens, M. K. & Clark, J. J. (2003). Consumer perspectives on quality of inpatient mental health services. Archives of Psychiatric Nursing, 17 (5), 205–217.
Husserl, E. (1970). Logical investigations (J. N. Findlay, Trans.). New York: Humanities Press.
Jacobsen, N. ( 2001). Experiencing recovery: a dimensional analysis of recovery narratives. Psychiatric Rehabilitation Journal, 24 (3), 248-256.
Jacobson, N. (2003). Defining recovery: An interactionist analysis of mental health policy developments. Qualitative Health Research, 13 (3), 378-393.
Koch, T. (2006). Establishing rigour in qualitative research: the decision trail. Journal of Advanced Nursing, 53 (1), 91- 103.
Lee, R.M. (2000). Unobtrusive methods in social research. Buckingham, Open University Press.
Lloyd, C., Waghorn, G. & Williams, P. (2008). Conceptualising recovery in mental health rehabilitation. British Journal of Occupational Therapy, 71 (8), 321-328.
Lorig, K. Holman, H. (2003). Self-management education: History, definition, outcomes and mechanisms. Annals of Behavioural Medicine, 26 (1), 1-7.
Macnee, C. & McCabe, S. (2008). Understanding nursing research: Reading and using research in evidence-based practice (2nd ed.). Philadelphia: Wolters Kluwer and Lippincott Williams and Wilkins.
McDaniel, R. W. & Bach, C.A. (1996). Focus group research: The question of scientific rigor. Rehabilitation Nursing Research, 5 (2), 53-59.
McLean, A. (1995). Empowerment and the psychiatric/ex-patient movement in the United States: contradictions, crisis, and change. Social Science in Medicine, 40 (8), 1053-1071.
Mental Health Commission (2005a). A vision for a recovery model in Irish mental health Services. Dublin: Mental Health Commission. Retrieved from http://www.mhcirl.ie/file/discpapvforarecmod.pdf
Mueser, K., Corrigan, P., Hilton, D., Tanzman, B., Schaub, A., Gingerich, S., Essock, S. M., Tarrier, N., Morey, B,. Vogel- Scibilia, S. & Herz, M. I. (2002). Illness management and recovery: a review of the literature. Psychiatric Services, 53 (10), 1271-1284
Natanson, M. (1973). Edmund Husserl: Philosophy of infinite tasks. Evanston, IL: Northwestern University Press.
Novacek, J,. & Raskin, R. (1998). Recognition of warning signs: a consideration for cost- effective treatment of severe mental illness. Psychiatric Services, 49 (3), 376–378.
O'Leary, Z. (2004). The essential guide to doing research. London: Sage Publications.
Olsen, R. (2008) ‘Self-selection bias’. In: P. J. Lavrakas (Ed.) Encyclopaedia of survey research methods, (pp. 809-811). Thousand Oaks, CA: Sage Publications.
Onken, S. J., Craig, C. M., Ridgway, P., Ralph, R.O. & Cook, J.A. (2007). An analysis of the definitions and elements of recovery: a review of the literature. Psychiatric Rehabilitation Journal, 31 (1), 9- 22.
Pallaveshi, L., Balachandra, K., Subramanian, P. & Rudnick, A. (2014). Peer-led and professional-led group interventions for people with co-occurring disorders: A qualitative study. Community Mental Health Journal, 50 (4), 388-394.
Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W. & Engel, R. R. (2001). The effect of family interventions on relapse and re-hospitalization in schizophrenia—a meta-analysis. Schizophrenia Bulletin, 27 (1), 73–92.
Ridgeway, P. & Press, A. (2004). Assessing the Recovery-orientation of your mental health program: A User's guide for the Recovery-Enhancing Environment Scale (REE). Kansas: University of Kansas
Rudnick, A. (Ed.). (2012). Recovery of people with mental illness philosophical and related perspectives. London: Oxford University Press.
Salzer, M. S. (1997). Consumer empowerment in mental health organisations: concept, benefits, and impediments. Administration and Policy in Mental Health, 24 (5), 425–434.
Sheehan, A. (2002). Inspirations: A photographic record of recovery. London: NIMHE.
Silverman, D. (1997). Discourses of Counselling: HIV Counselling as Social Interaction. London: Sage Publications.
Slade, M. (2009). Personal recovery and mental illness. A guide for mental health professionals. Cambridge: Cambridge University Press.
Starnino, V. R., Mariscal, S., Holter, M. C., Davidson, L. J., Cook, K., S. Fukui, S. & Rapp, C. A. (2010). Outcomes of an illness self-management group using wellness recovery action planning. Psychiatric Rehabilitation Journal, 34 (1), 57-60.
Stocks, M. L. (1995). In the eye of the beholder. Psychiatric Rehabilitation Journal, 19 (1), 89-91. Strauss, J .S. (1996). Subjectivity. Journal of Nervous and Mental Disease, 184 (4), 205-212.
Torrey, W., Rapp, C., Van Tosh, L., McNabb, C. & Ralph, R. (2005). Recovery principles and evidenced-based practice: Essential ingredients of service improvement. Community Mental Health Journal, 41 (1), 91-100.
Tymieniecka, M. T. (2003). Introduction: Phenomenology as the inspirational force of our times. In: Tymieniecka, M. T. (ed.) Phenomenology world-wide: foundations-expanding dynamics-life-engagements: A guide for research and study. London: Kluwer Academic, pp. 1-10.
Wallcraft, J. (2005). Recovery from mental breakdown. In: J. Tew (Ed.). Social perspectives in mental health (pp.200- 227). Philadelphia: Jessica Kingsley Publishers.
Wiles, R. (2013). What are qualitative research ethics? London: Bloomsbury Academic.
Wilson, J. M., Hutson, S. P. & Holston, E. C. (2013). Participant satisfaction with Wellness Recovery Action Plan (WRAP). Issues in Mental Health Nursing, 34 (12), 846-854.
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