The Role of Wellness Recovery Action Planning in Integrated Care Matthew R. Federici M.S., C.P.R.P Executive Director The Copeland Center for Wellness & Recovery [email protected] 610-215-0319

Ruth Pasillas-Gonzales Advanced Level WRAP® Facilitator Assistant Director NYAPRS Training Collective 917-597-5781

Workshop Objectives The Role of Wellness Recovery Action Planning in Integrated Care is an interactive workshop overview on the history, development and description of the evidenced based self-directed program, WRAP®. Further, participants will learn about WRAP® and its role and benefits in various areas of health and wellness.

Through participation in the workshop you will be able to: 1. Describe the basic origin, approach and structure of WRAP® 2. List the benefits and applications of WRAP® to one's individual wellness goals 3. Identify next steps to implementing WRAP on a personal level or for systems of care in various health and wellness challenges.

WRAP FACILITATION For… • WRAP® has been found by many people to be helpful for many areas of life challenges. • Expand your personal WRAP® for that life challenge and spend some time with it before Facilitating

4 Parts to the Study of Mental Health Recovery: 1. 2. 3. 4.

Key Concepts Wellness toolbox Wellness Recovery Action Plan Recovery Topics 1. 2. 3. 4.

Building Self Esteem Peer Support Trauma Recovery Work related issues

WRAP® Includes: • • • •

Wellness Toolbox Daily Maintenance Plan Triggers and Action Plan Early Warning Signs and Action Plan • When Things are Breaking Down and Action Plan • Crisis Plan • Post Crisis Plan

Evidence Based: • WRAP was delivered in eight weekly sessions of 2.5 hours each week. • Sessions were co facilitated by 2 individuals in mental health recovery. • Coursework included examples from the lives of the educators and participants, individual and group exercises, and voluntary homework assignments.

VALUES & ETHICS • The heart of Great WRAP® Facilitation is the Values and Ethics established by Mary Ellen Copeland and a core group of people who were passionate about sharing this life transforming process. • Through these Values and Ethics we “Bring the materials to life” in our trainings. – Advanced Level Facilitator

WRAP FACILITAION: SPOILERS! • Making WRAP® Mandatory – Employees or Provider organization must have at least ___ WRAPs with “consumer” – State that people “have to participate in the group or you can not be here” – Making the development of any part of WRAP a condition for payment for services or access to other services

WRAP FACILITAION: Spoilers • Requiring people to share any part of their WRAP® with others • Having “observers” in WRAP® groups • Giving advice – i.e. you should develop a WRAP®; you need to add that to your “toolbox” • Keeping some one’s plan without their asking you to first • Presenting WRAP® as a specific form to be completed • NOT FOLLOWING THE VALUES AND ETHICS!

WRAP®=Supporting Recovery Possibilities-NYAPRS

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WRAP®=Improved Health-NYAPRS • WRAP has incredible utility for those of us with cooccurring mental health, addiction and physical health issues. • In the context of national health care reform opportunities such as health homes or the integration of physical health and behavioral health through managed care, WRAP would be well positioned as an offering that would address wellness needs in all such domains.

WRAP®= Improved Health-NYAPRS • As healthcare reform in New York State and across the nation calls for the integration of physical and behavioral healthcare, the need for effective and evidence based practices that support people in promoting wellness, health and recovery through practices such as Wellness Recovery Action Planning is stronger than ever • the state of our country’s chronic illness (1 out of every 2 people in US have a chronic illness, 7 out of every 10 deaths due to chronic illness), life expectancy of people with psychiatric disabilities is 25 years less than general population, hence, reasons to apply what we know about promoting wellness through tools such as WRAP®.

Health Related Wellness Tool Box using the Key Recovery Concepts-NYAPRS • Start with the end in mind – Every day my choices are Creating Powerful Lungs and Rock Solid Fitness – I can effortlessly walk up and down the subway stairs carrying my Laptop and LCD Projector

• Build a WRAP® Plan specifically for Health – Concentrate First on building my Life Transforming Wellness Tool Box 13

Health Related-Wellness Tool Box (WTB)

using The Key Recovery Concepts-NYAPRS •

Hope - People who experience mental health difficulties get well, stay well and go on to meet their life dreams and goals. Personal Responsibility - It's up to you, with the assistance of others, to take action and do what needs to be done to keep yourself well. Education - Learning all you can about what you are experiencing so you can make good decisions about all aspects of you life. Self Advocacy -Effectively reaching out to others so that you can get what it is that you need, want and deserve to support your wellness and recovery. Support - While working toward your wellness is up to you, receiving support from others, and giving support to others will help you feel better and enhance the quality of your life.

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MY WTB For Creating Powerful Lungs and Rock Solid Fitness - NYAPRS HOPE

PERSONAL RESPONSIBILITY

EDUCATION

SELFADVOCACY

SUPPORT

*Inspirational TV Programs about individuals that lost weight and kept it off

*Keep a food journal *Address emotional eating by ID & getting support *No snacks after 8pm *Take daily peak flow meter readings

*Internet Research on foods that provide my body fuel and benefit *Health Related Biblical Scripture

*Call Empire, AARP, AAA and see if they offer discounts to a local Gym

*Join Weight Watchers or a 12 step food related program which would be more cost effective *Call a friend when I feel like binge eating

*Interview people I know that have lost weight

Develop 1-3 Accountability Buddies

*Call Empire Ins. About programs available for individuals with Asthma

*Start a *Call 311 for neighborhood local free or low cost health Walking Group alternatives 15

WRAP® = PERSONAL TRANSFORATION “This [WRAP] has changed my life completely. I used to think of myself as this “mentally ill” person. Now I am a person who knows how to take care of myself and help myself in difficult times. If I am feeling badly or having a hard time, I take action. And there are so many simple, safe things I can do.”

WRAP® = PEER SUPPORT “Because WRAP has positively affected my life I'm better at helping people in their recovery process. First of all, I'm an example how WRAP can work for somebody. And because I feel better about myself, I’m able to be a better a listener. I'm more alert, I'm more confident…”

WRAP® = Multiple Purposes; One Person • “Frankly, I use my WRAP plan for everything in my life, and I do have health issues including diabetes. It is as important as my daily meds.....” -Angel July 11 • “I have three WRAPs. One for my Mental Health, one for my diabetes, and one for work. It is an amazing tool.” -Tammie July 11 • “I use WRAP for living well with MS.” - Nannette July 11

WRAP® = Peer Support, Cancer and Weight Loss • “I used WRAP with my WRAP buddy for weight loss and more importantly, as a tool to get through a Stage 3 cancer and 6 subsequent surgeries. As a person with a spinal cord injury and other physical challenges, WRAP has helped me stay relatively healthy and free of skin breakdowns and related health issues when I follow my DMP and any needed Action Plans. WRAP=Living well which keeps me well.” - Margo July 12

WRAP® = Holistic • “I made a WRAP plan to get me through total knee replacement surgery with very good results. I did slip into a short depression, but the plan helped me pull out of it in no time as I identified it early with the help of the folks I had entrusted to alert me early.! It was so confidence building and I am moving forward with work on a Diabetic daily maintenance plan.” –Mary 11 Jul 2011

WRAP® = A Different Kind of Crisis Plan • I used WRAP to get through Hepatitis C treatment. Part of my crisis plan included what to do if I was hospitalized with dehydration, which happened quite a lot during the treatment. The ER at the hospital knew I had a WRAP and knew exactly what to do, along with the paramedics and my doctor. –Diana July 15

WRAP FACILITAION: Final Thoughts on for the Agency and System • Facilitates formal and informal WRAP® group opportunities – i.e. as a part of service offerings; ”after hours”; churches; coffee shops etc…

• Develops and fosters a network of Facilitators • Focuses on WRAP® as a process, a “way of life” and mutual learning, not a document or form to be put into a file • All inclusive and creates an atmosphere that is based on our common human pursuit of wellness not diagnosis, illness or deficit orientation.