WRAP came out of a body of knowledge and research that Mary Ellen Copeland, PhD, completed in the past 20 years. Today, there is a lot of research taking place uses WRAP. For quite some time, SAMHSA has considered WRAP an exemplary practice and soon WRAP will be proven as an evidence-based practice through the work of Judith Cook, PhD, and others.
Results of a Randomized Controlled Trial of Mental Illness Self-management Using Wellness Recovery Action Planning
The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning (WRAP) by comparing it with usual care. The primary outcome was reduction of psychiatric symptoms, with secondary outcomes of increased hopefulness, and enhanced quality of life (QOL). A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health settings in 6 Ohio communities and randomly assigned to the 8-week intervention or a wait-list control condition. Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed effects random regression analysis. Compared to controls, at immediate postintervention and at 6-month follow-up, WRAP participants reported: (1) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total, (2) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness, and (3) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale. These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms, enhances participants’ hopefulness, and improves their QOL over time. This confirms the importance of peerled wellness management interventions, such as WRAP, as part of a group of evidence-based recovery-oriented services.
Download the article: WRAP-Randomized_Controlled_Trial_Research_Findings
Developing the Evidence Base for Peer-Led Services: Changes among Participants following Wellness Recovery Action Planning (WRAP) Education in Two Statewide Initiatives
Objective: The purpose of this analysis was to evaluate the outcomes of two statewide initiatives in Vermont and Minnesota, in which self-management of mental illness was taught by peers to people in mental health recovery using Wellness Recovery Action Planning (WRAP). Methods: Pre-post comparisons were made of reports from 381 participants (147 in Vermont and 234 in Minnesota) on a survey instrument that assessed three dimensions of self-management: 1) attitudes, such as hope for recovery and responsibility for one’s own wellness; 2) knowledge, regarding topics such as early warning signs of decompensation and symptom triggers; and 3) skills, such as identification of a social support network and use of wellness tools. Results: Significant positive changes in self-management attitudes, skills and behaviors were observed on 76% of items completed by Vermont participants (13 of 17 survey items), and 85% of items completed by Minnesota participants (11 of 13 items). In both states, participants reported significant increases in: 1) their hopefulness for their own recovery; 2) awareness of their own early warning signs of decompensation; 3) use of wellness tools in their daily routine; 4) awareness of their own symptom triggers; 5) having a crisis plan in place; 6) having a plan for dealing with symptoms; 7) having a social support system; and 
ability to take responsibility for their own wellness. Conclusions: Given the rapid growth of this intervention in the U.S. and internationally, these results contribute to the evidence base for peer-led services, and suggest that more rigorous investigations are warranted in the future.
Keywords: illness management, recovery, peer support, program evaluation
Initial outcomes of a mental illness self-management program based on wellness recovery action planning.
Cook JA, Copeland ME, Hamilton MM, Jonikas JA, Razzano LA, Floyd CB, Hudson WB, Macfarlane RT, Grey DD.
Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor St., 4th Floor, M/C 912, Chicago, IL 60612, USA. cook@ripco.com
OBJECTIVE: This study examined changes in psychosocial outcomes among participants in an eight-week, peer-led, mental illness self-management intervention called Wellness Recovery Action Planning (WRAP). METHODS: Eighty individuals with serious mental illness at five Ohio sites completed telephone interviews at baseline and one month after the intervention. RESULTS: Paired t tests of pre- and postintervention scores revealed significant improvement in self-reported symptoms, recovery, hopefulness, self-advocacy, and physical health; empowerment decreased significantly and no significant changes were observed in social support. Those attending six or more sessions showed greater improvement than those attending fewer sessions. CONCLUSIONS: These promising early results suggest that further research on this intervention is warranted. Confirmation of the efficacy and effectiveness of peer-led self-management has the potential to enhance self-determination and promote recovery for people with psychiatric disabilities.
Psychiatr Serv. 2009 Feb;60(2):246-9.
