The Way WRAP Works
WRAP was developed in 1997 by a group of people who had been dealing with difficult feelings and behaviors for many years. They were working together to feel better and get on with their lives. Since its creation, WRAP has been developed into a curriculum and co-facilitation practice that has been studied extensively, with more research being done every year.
In 2010, WRAP was designated as an evidence-based practice by the United States–based Substance Abuse and Mental Health Services Administration (SAMHSA). Randomized controlled trials of the co-facilitated WRAP peer group model showed improvements in WRAP participants compared to controls from baseline to 8-month follow-up, including:
- Reduced psychiatric symptoms, especially depression and anxiety
- Increased hopefulness
- Increased quality of life
- Increased recovery
- Increased empowerment
- Increased self-advocacy
The evidence for WRAP’s effectiveness is based on the co-facilitated WRAP peer group model, which is how WRAP was designed. In this model, two specially trained and certified peer Co-Facilitators meet with a group of voluntary participants for about 2 hours once a week for 8 to 12 weeks. There’s no robust evidence base for any other implementation of WRAP.
That’s not to say people can’t buy materials and work on WRAP independently with whatever support they want—they certainly can! But that can’t be considered the equivalent of the model that was studied.
People seeking to create and maintain their own wellness and recovery deserve the best materials and support possible. This means:
- Using WRAP and WRAP materials as they were researched, developed, written, published, and updated (only available on this website through our bookstore); and
- Using the manualized co-facilitation practice as designed, with fidelity to the evidence-based practice.
Tips for Recognizing WRAP
Here are some key elements that let you know a program is using WRAP as it was designed:
- Co-Facilitators are peers trained and certified by the Copeland Center for Wellness and Recovery. They should have been trained or completed a refresher in the last 2 years. They work together, not as solo facilitators.
- WRAP is for everyone and focuses on life experiences, strengths, and goals, not diagnoses, illnesses, or deficits. If people are required to have received or identify with specific diagnoses or conditions, or if they have to meet “readiness criteria” to participate, it’s not WRAP. The only criteria for someone to use WRAP is that they want to.
- Participants choose whether to participate and create a plan and direct what they include in that plan. They also decide whether and with whom to share their plan. WRAP is 100 percent voluntary. If participants are required to create plans, required to do their plans a certain way, or required to share them with others, it’s not WRAP.
- WRAP is a self-directed peer group intervention. It’s not a clinical tool, a safety contract, a treatment plan, or a clinician checklist. Those tools can be useful at appropriate times, but they aren’t WRAP.
The Copeland Center has developed a guide that explains how to implement WRAP with fidelity to the evidence-based model. Download the guide for more information about the way WRAP works.
The Evidence-Based Model
The information below originally appeared in SAMHSA’s evidence-based program registry, which is no longer available. Language was provided by Advocates for Human Potential, Inc. (WRAP copyright and trademark holder), and the Copeland Center (authorized training and certification partner).
Wellness Recovery Action Plan (WRAP®) is a manualized group intervention for symptom and illness management that is delivered in a self-help group context. 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 a crisis plan 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 post-crisis 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 Co-Facilitators. Information is imparted through lectures, discussions, and individual and group exercises, and key WRAP concepts are illustrated through examples from the lives of the Co-Facilitators and participants.
The intervention is typically delivered over 8 weekly 2.5-hour sessions. It can be adapted for shorter or longer times to more effectively meet the needs of participants, as long as all essential components are covered in no less than 16 hours of instruction and interaction. Participants sometimes 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 participation is strictly voluntary. 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 people with mental illnesses of varying severity, WRAP also has been used by people coping with health issues (e.g., arthritis, diabetes, Hepatitis C, HIV/AIDS), other disabilities (e.g., intellectual/developmental disabilities, physical disabilities), substance use disorders, life issues (e.g., trauma, decision-making, interpersonal relationships), life course transitions (e.g., youth, older adults), and former or current service in the armed forces (e.g., military personnel, veterans).
WRAP Research and Evidence Base
WRAP has been studied extensively, with more data available every year. This list of articles is updated regularly. To submit additional articles for inclusion, please contact us.
- Petros, R., & Solomon, P. (2021). How adults with serious mental illness learn and use Wellness Recovery Action Plan’s recovery framework. Qualitative Health Research, 31(4), 631–642.
- Petros, R., & Solomon, P. (2020). Examining factors associated with perceived recovery among users of Wellness Recovery Action Plan. Psychiatric Rehabilitation Journal, 43(2), 132–139.
- Icenogle, M., Busenhart, C. A., Buller, C., Peterson, J. M., Schwartz, L., Whitney, L., & Teel, C. (2020). A creative action plan for mental wellness: Tools for primary care in rural and underserved settings. Creative Nursing, 26(4), e102–e109.
- Canacott, L., Tickle, A., & Moghaddam, N. (2020). Perceptions of Wellness Recovery Action Plan (WRAP) training: A systematic review and metasynthesis. Mental Health Review Journal, 25(4), 345–366.
- 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.
- Ashman, M., Halliday, V., & Cunnane, J. G. (2017). Qualitative investigation of the Wellness Recovery Action Plan in a UK NHS crisis care setting. Issues in Mental Health Nursing, 38(7), 570–577.
- Mak, W. W. S., Chan, R. C. H., Pang, I. H. Y., Chung, N. Y. L., Yau, S. S. W., & Tang, J. P. S. (2016). Effectiveness of Wellness Recovery Action Planning (WRAP) for Chinese in Hong Kong. American Journal of Psychiatric Rehabilitation, 19(3), 235–251.
- O’Keeffe, D., Hickey, D., Lane, A., McCormack, M., Lawlor, E., Kinsella, A., Donoghue, O., & Clarke, M. (2016). Mental illness self-management: A randomised controlled trial of the Wellness Recovery Action Planning intervention for inpatients and outpatients with psychiatric illness. Irish Journal of Psychological Medicine, 33(2), 81–92.
- Olney, M. F., & Emery-Flores, D. S. (2016). “I get my therapy from work”: Wellness Recovery Action Plan strategies that support employment success. Rehabilitation Counseling Bulletin, 60(3), 175–184.
- Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429–441.
- Cook, J. A., Jonikas, J. A., Hamilton, M. M., Goldrick, V., Steigman, P. J., Grey, D. D., Burke, L., Carter, T. M., Razzano, L. A., & Copeland, M. E. (2013). Impact of Wellness Recovery Action Planning on service utilization and need in a randomized controlled trial. Psychiatric Rehabilitation Journal, 36(4), 250–257.
- Federici, M. R. (2013). The importance of fidelity in peer-based programs: The case of the Wellness Recovery Action Plan. Psychiatric Rehabilitation Journal, 36(4), 314–318.
- Jones, N., Corrigan, P. W., James, D., Parker, J., & Larson, N. (2013). Peer support, self-determination, and treatment engagement: A qualitative investigation. Psychiatric Rehabilitation Journal, 36(3), 209–214.
- Jonikas, J. A., Grey, D. D., Copeland, M. E., Razzano, L. A., Hamilton, M. M., Floyd, C. B., Hudson, W. B., & Cook, J. A. (2013). Improving propensity for patient self-advocacy through wellness recovery action planning: Results of a randomized controlled trial. Community Mental Health Journal, 49(3), 260–269.
- Pratt, R., MacGregor, A., Reid, S., & Given, L. (2013). Experience of wellness recovery action planning in self-help and mutual support groups for people with lived experience of mental health difficulties. The Scientific World Journal, Article 180587.
- 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.
- Cook, J. A., 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., 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.
- Higgins, A., Callaghan, P., DeVries, J., Keogh, B., Morrissey, J., Nash, M., Ryan, D., Gijbels, H., & Carter, T. (2012). Evaluation of mental health recovery and Wellness Recovery Action Planning education in Ireland: A mixed methods pre-post evaluation. Journal of Advanced Nursing, 68(11), 2418–2428.
- Pratt, R., MacGregor, A., Reid, S., & Given, L. (2012). Wellness Recovery Action Planning (WRAP) in self-help and mutual support groups. Psychiatric Rehabilitation Journal, 35(5), 403–405.
- Fukui, S., Starnino, V. R., Susana, M., Davidson, L. J., Cook, K., Rapp, C. A., & Gowdy, E. A. (2011). Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery. Psychiatric Rehabilitation Journal, 34(3), 214–222.
2010 and Earlier
- Cook, J. A., Copeland, M. E., Corey, L., Buffington, E., Jonikas, J. A., Curtis, L. C., Grey, D. D., & Nichols, W. H. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34(2), 113–120.
- Copeland, M. E. (2002). 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.
- Doughty, C., Tse, S., Duncan, N., & McIntyre, L. (2008). The Wellness Recovery Action Plan (WRAP): Workshop evaluation. Australasian Psychiatry, 16(6), 450–456.
- Davidson, L. (2005). Recovery, self management and the expert patient – Changing the culture of mental health from a UK perspective. Journal of Mental Health, 14(1), 25–35.
- Hill, L., Roberts, G., & Igbrude, W. (2010). Experience of support time and recovery workers in promoting WRAP. The Psychiatrist, 34(7), 279–284.
- 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.
- Sterling, E. W., von Esenwein, S. A., Tucker, S., Fricks, L., & Druss, B. G. (2010). Integrating wellness, recovery, and self-management for mental health consumers. Community Mental Health Journal, 46(2), 130–138.
- Zhang, W., Wong, S. Y. Li, Y., Yeh, H., & Zhao, Y. (2009). The Wellness Recovery Action Plan (WRAP): Effectiveness with Chinese consumers. Aotearoa New Zealand Social Work, 21(4), 94–102.