PS377 Unit 2 WRAP Recovery Planning Paper Example

Ray Wrote His Own Warning Signs: A PS377 Unit 2 Recovery Planning Paper

[Student Name]

Purdue University Global

PS377: Models of Peer Recovery

Unit 2 Recovery Planning Paper

[Instructor Name]

[Date]

The writer, the center, the participant and every detail are composite and illustrative; the articles cited are real.

Why a Written Plan

Ray, forty-eight, came to our Louisville recovery community center after his fourth detox stay. He had never had a written plan for staying well; every previous discharge had ended with a list of phone numbers. Five weeks into his recovery, his outpatient counselor suggested a Wellness Recovery Action Plan, and Ray asked if I would help him with it at the center. As a peer specialist in training, my role was to support him in writing his own plan, not to write it for him.

How the Plan Is Built

The Wellness Recovery Action Plan, usually called WRAP, grew out of the experience of people living with mental health conditions, who designed it as a tool they could direct themselves. It has several parts, each written by the person in their own words.

A wellness toolbox lists things that help the person feel well, such as people, activities and routines. A daily maintenance plan describes what the person is like when well and what they need to do each day to stay that way. A triggers section lists events that might set off problems and a plan for each. An early warning signs section lists subtle changes that suggest things are starting to slip and what to do about them. A section on when things are breaking down lists more serious signs and stronger steps. A crisis plan, written while well, tells supporters what to do if the person cannot act for themselves. And a post-crisis plan describes how to recover afterward.

Ray's Plan

Ray wrote his plan over three sessions at the center, at a table near the coffee pot, in block capitals. His wellness toolbox included walking his neighbor's dog, calling his sister in Ohio, and the Tuesday night veterans' recovery meeting. His daily maintenance plan said: "Eat breakfast. Take my meds. Talk to one sober person. Be home by nine." His triggers were the anniversary of his discharge from the Army, payday Fridays and the bar on his walking route.

His early warning signs were the part he worked on longest. He wrote: "Skipping breakfast. Not answering my sister. Saying 'I'm fine' a lot. Walking past the bar instead of around the block." For each, he wrote a step: call me, call his sister back the same day, go to an extra meeting.

No one else could have written that his warning sign was walking past the bar instead of around the block.

Supporting Without Directing

Peer support in WRAP means asking questions, not supplying answers. When Ray stalled on his crisis plan, I shared that my own plan names my sponsor and my sister, and asked who he trusted. He named his sister and the veterans' meeting leader, and wrote that if he was drinking and would not answer, they should call the Veterans Crisis Line and his outpatient counselor. I did not suggest what his warning signs should be, even when I thought I saw ones he missed; I asked what his sister would say she noticed first.

Why a Peer Helps With the Plan

A counselor could have helped Ray fill in the same forms. What a peer adds is different. Davidson et al. (2012) drew on studies and practice experience with peer support in serious mental illness and concluded that peers can do many of the same tasks as other staff with similar results, while adding things others find harder to offer: hope drawn from their own recovery, a relationship closer to equals and a model of someone who has used the same tools. When Ray doubted that a written plan could help a man who had relapsed four times, I showed him a worn page from my own plan, six years old. He said later that the page did more than anything I told him.

What the Research Shows

Cook et al. (2012) conducted a randomized controlled trial of WRAP groups led by trained peers for adults with serious mental illness. Compared with a control group, those in the WRAP groups showed larger drops in symptoms and larger gains in hope and quality of life by follow-up. Because the groups were peer-led, the trial also supports peers as effective facilitators.

Canacott et al. (2019) pooled the published evaluations of WRAP in a meta-analysis. They found evidence that WRAP improved personal recovery outcomes, such as hope and self-reported recovery, while evidence for clinical outcomes such as symptoms was more limited and the quality of studies varied. They called for more rigorous trials.

Neither study focused on substance use disorders. WRAP was developed for mental health, and its use in addiction recovery rests on adaptation and practice experience more than on trials.

Adapting WRAP for Substance Use

For Ray, the plan needed sections the original structure does not name. His triggers included cues for drinking, such as the bar and payday, not only stressors. His early warning signs included thoughts like "one beer won't hurt," which his counselor calls relapse thinking. His crisis plan covered what to do if he was drinking, not only if he was in emotional crisis, and named the detox unit he preferred. These adaptations kept the structure while fitting his recovery.

The Plan in Use

In his ninth week, Ray called me on a Friday afternoon. He had skipped breakfast twice, had not called his sister back and had walked past the bar that morning. "Three of my signs," he said. He had read them in his plan. We met at the center, he went to an extra meeting that evening and he called his sister. He did not drink. He told his counselor the following week that seeing his own words on paper made the slide hard to deny.

Limits

A plan is only as useful as its owner's willingness to look at it, and many people put theirs in a drawer. WRAP also depends on reading and writing comfort; for participants with limited literacy, plans may need pictures or recorded audio. And the research base for addiction recovery specifically is thin, so programs using WRAP should track their own outcomes.

Conclusion

Ray's handwritten WRAP named his own toolbox, triggers and warning signs, and in his ninth week it caught a slide before he drank. Cook and colleagues' trial and Canacott and colleagues' meta-analysis support WRAP's effects on hope and personal recovery, with weaker evidence for clinical outcomes and little research in addiction specifically. Supporting rather than directing kept the plan his.

References

Canacott, L., Moghaddam, N., & Tickle, A. (2019). Is the Wellness Recovery Action Plan (WRAP) efficacious for improving personal and clinical recovery outcomes? A systematic review and meta-analysis. Psychiatric Rehabilitation Journal, 42(4), 372-381. https://doi.org/10.1037/prj0000368

Cook, J. A., Copeland, M. E., Jonikas, J. A., Hamilton, M. M., Razzano, L. A., Grey, D. D., Floyd, C. B., Hudson, W. B., Macfarlane, R. T., Carter, T. M., & Boyd, S. (2012). Results of a randomized controlled trial of mental illness self-management using Wellness Recovery Action Planning. Schizophrenia Bulletin, 38(4), 881-891. https://doi.org/10.1093/schbul/sbr012

Davidson, L., Bellamy, C., Guy, K., & Miller, R. (2012). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 11(2), 123-128. https://doi.org/10.1016/j.wpsyc.2012.05.009