Transcript WRAP Presentation 2

WRAP
Wellness Recovery
Action Plan
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WRAP Plans
• WRAP is a framework or a tool to
help us gain more control over our
lives and the way we feel
• WRAP belongs to you and you
decide how you want to use it
• It is designed to help us identify
what works and what doesn't work
and how we can get better at
staying well
• It can help you communicate with
family, friends and mental health
professionals, to let them know
what you need them to do
• It can be done alone, with
supporters, in a group or one to
one
• It is practical and based on
common sense
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WRAP includes
• Wellness tools
• Daily Maintenance Plan
• Identifying Triggers plus action
plan
• Identifying Early Warning Signs
plus action plan
• Signs that Things are Breaking
Down and action plan
• Crisis Plan
• Post Crisis Plan
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Wellness tools
What am I like when I am well /
feeling alright?
e.g.
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active
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calm
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spontaneous
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fun
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creative
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outgoing
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Wellness Toolbox
What are some of the tools you use to
keep you well? What have you found
helpful in everyday life ?
What works for you?
e.g.
• relaxation
• phone a friend
• going for a walk
• bungee jumping
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Wellness Tools
What helps make sense of life
for you or gives it value?
e.g.
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creativity,
religious beliefs
a philosophy
special memory
dancing
important music
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Wellness Tools
• What are some of the things
you feel you may want to work
on to keep yourself well?
e.g.
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take a holiday
eat less chocolate
eat more chocolate
drink less
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Daily Maintenance List
• What do I need to do for myself
every day to keep myself feeling as
well as possible?
e.g.
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get my sleep
eat properly
see my friends
get some exercise
take vitamins
take medication
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Maintenance List
• What are some of the things I
need to do every month / year
to keep my overall wellness
and sense of wellbeing?
e.g.
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plan a holiday
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see a relation
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keep in touch with a friend
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start a project / course /
new job
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review life goals / ambitions
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Triggers
Triggers are things that happen to us
which may set off a chain reaction of
uncomfortable or unhelpful thoughts
or behaviour
e.g.
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problems at work
anniversary of loss or trauma
way that others treat you
being overtired / over worked
family conflict
physical illness
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Triggers Action Plan
What have you found that controls /
reduces triggers when they occur or
helps to avoid making things worse?
e.g.
• controlling breathing
• focusing on priorities
• avoiding stressful situations
• talk to a counsellor / friend
• play an instrument
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Early Warning Signs
These are internal, are subtle signs or
patterns of change. They may be very
individual to you and indicate you may
need to do something to avoid things
getting worse. What are my early warning
signs?
e.g.
• reaction to being ‘told off’
• withdrawal
• making a drama into a crisis
• strong emotions
• forgetfulness
• being obsessed with thoughts
• being ‘mentally tired’
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Early Warning Signs
Action Plan
What can you do to make things
better when you notice early warning
signs? What has helped you in the
past?
e.g.
• talking to a friend or counsellor
• rationalising thoughts
• being assertive
• getting organised
• focussing exercises
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When Things Start to
Break Down
This is when things are getting bad
and you are having a hard time or the
situation has become uncomfortable,
serious or dangerous. It may be
necessary
to
take
immediate,
assertive action to avoid a crisis
e.g.
• Sleeping all the time
• Not sleeping
• Eating problems
• Obsession with negative thoughts
• Suicidal thoughts or self harm
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When Things are
Breaking Down Action
Plan
The plan needs to be clear and
directive with fewer choices to
prevent things getting worse. Survival
techniques.
e.g.
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Call a doctor or mental health
professional
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take time off from work
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arrange for someone to stay
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stay with someone you trust
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do things on the daily
maintenance list
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Crisis Planning
• This part of the plan should be
written when you are feeling
well. It can be given to other
people to help them look after
you when you are not well. It
gives you more control even
when it seems that things are
out of control.
• It may take time to develop and
set up, but can save you and
others frustration and time, and
increase the chances that your
needs will be met.
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Crisis Plan includes:• What you are like when you are well
• Indicators that others may need to ‘take
over’
• Who ‘takes over’ and who doesn’t
• Information on health care contacts and
medication
• Acceptable and unacceptable treatments
• Home/community/ respite plan
• Acceptable and unacceptable hospital
facilities
• Things others can do that would help
• Things others might do that would make
you feel worse
• A list of tasks for others
• Indicators that the plan is no longer
needed
• Signatures of key people
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What I am like when I
am feeling well
• Repeat the first section of the
WRAP to ensure that others
can identify what you are
usually like when you are well
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Symptoms
What are the signs that indicate that others
may need to become involved. Describe
how others would know that they need to
take over some or full responsibility for your
care and make decisions on your behalf.
What are you like when you need help?
e.g.
• Unable to stay still
• Compulsive behaviour
• Self neglect
• Self harm
• Not performing routine tasks
• Self destructive, abusive or violent
behaviour
• Substance abuse
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Supporters
• List the key people you want to be
involved or take over. You could
include family members, friends or
health professionals.
• Ask the people involved if it is OK
to include them on your list. Tell
them what would be involved.
Show them a copy of your crisis
plan
• You may wish to set up a meeting
to talk the plan through
• You may want to name some
people for certain tasks such as
taking care of children or pets
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Those you do not want
involved
• Make a list of people you do
not want involved with reasons
if possible
• Include a section on how you
want supporters to settle
disputes if they disagree. You
may want to say that a majority
need to agree or that a
particular person or persons
can make that decision
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Medication and
Treatments
• Give phone numbers of key
people such as GP or mental
health worker
• List the medications or
treatments you would prefer or
are acceptable with reasons
• Medications or treatments that
should be avoided and why
• Include complementary or
alternative therapies which you
have found helpful / unhelpful
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Alternatives to hospital
• Develop a plan so that you can
stay at home or at a place of
your choice within the
community. This may be for a
crisis or can be for respite to
avoid a crisis
• You may wish to spend time
reviewing or even visiting the
options open to you
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Help from Others
List things others could do for
you that would help
e.g.
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Listen without interrupting
Hold me, or let me move around
Take me for a walk
Reassure me
Keep me from hurting myself or
Others
Pay my bills
Child or pet care
Buying groceries
Talking to employer
Cleaning the house
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Things that would not help
or could worsen my
symptoms
e.g.
• panicking
• using force or restraints
• not listening
• getting angry with me
• patronising me
• not keeping me informed
• making plans behind my back
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When I feel better and
don’t need this plan
Develop a list of indicators that your
supporters can use to determine
when they no longer need to use this
plan
e.g.
• When I am looking after myself
• When I have had a good
night’s sleep
• When I start planning ahead
• When I am able to speak
about what happened
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When you have
completed your crisis plan
• Update it when you learn new
information or change your mind
about things
• You can increase the likelihood of
your plan being followed by signing
it in the presence of witnesses.
Give your supporters a new copy
every time you revise it
• There is no absolute guarantee that
the plan will be followed, and it
could overridden by the Mental
Health Act. However, it is your best
chance for your wishes to be
honoured
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Post Crisis Planning
Each crisis, though painful, may
provide new insights into developing
your crisis plan
e.g.
• what you have learned from the
crisis
• changes you need to make in your
life as a result of what you have
learned
• if you have been hospitalised –
where you will go when discharged
and who you want to be with you
• things that would help your
recovery if they are taken care of
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WRAP and
carers/supporters.
1. Maintaining wellness for
ourselves
• WRAP is for you just as much as
the person you are supporting. We
can all use WRAP to help us
maintain our wellness.
• WRAP recognises that there will be
times when you will be supported
by the person you are supporting.
They can be part of your WRAP
plan as much as the other way
round.
• It recognises and values the
important role that carers play in
keeping people well
• It can give us more control over our
lives and more choices
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WRAP and
carers/supporters.
2. Providing support
• “I have heard carers wring their hands
and say so many times during a crisis,
“what can I do?”, “what can I do?” This
is a way to get round some of that.” –
Mary Ellen Copeland
• It recognises that crises rarely come
out of nothing and are part of a
process. That process may be
predictable, but does not have to be
inevitable
• It offers a way of capturing the
knowledge and experience in a way
that may be able to diminish the impact
of, or even avoid, the next crisis.
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