Coping techniques: WRAP plan

A wellness and recovery plan is a way to more effectively manage symptoms. WRAP plans tend to be cumulative. You add to them over time as you learn more about what you want in your life, and what things support that and what things get in the way. In this way the plan is always in process. Imagine though that you can begin it in a very simple form, with just two or three sentences in each section or in many cases just a simple list. You can add to it as more ideas come to you. The way to make use of the plan is to consult it on a daily basis at first, until you’re familiar with it. And remember, the plan becomes more effective as you continue to add to it.

1. The first section of a wellness plan is a toolbox to support your ongoing wellness and recovery from symptoms. The first tool we’ll consider is just a description of how you are when you’re doing well. This can be very helpful to refer to on days when symptoms make life more challenging—it can act as a reminder of what’s possible for you, and that can increase your feelings of hope. Therefore, what is a good day like for you? What does that mean in terms of what you do, and in terms of how you feel? And, what qualities do you exhibit when you’re at your best? Are you calm, relaxed, alert, engaged, good-humored? Be realistic, but claim what’s yours.

Another tool here is a list of what you need to do on a daily basis to support your higher levels of functioning. These would be practices and coping techniques that have proven helpful to you. Depending on what your wellness involves (for instance, do you deal with depression or anxiety, bipolar or substance use, trauma or stress) you may find helpful ideas under some of the other headings in the Coping Techniques section of my webpage, at petercashorali.com. Daily practices can also include getting some physical activity, making sure that you eat sensibly, making sure you get enough sleep, getting out of the house, making social contact with someone and meditation. They might also include balancing your checkbook, keeping your home clean and giving yourself enough time to get to school or work without having to rush. Or maintaining a very stable schedule from day to day. Here the important thing is to start a list of what works for you. And to add to it, as you discover new things that work.

A third tool in this section is a list of those things you enjoy that don’t have negative consequences for you. This can include places you like to go, people you want to spend time with, as well as your favorite movies, TV shows and books. Do you like to put on energetic music and dance? That goes here. What about taking a hot bath with scented candles? Or spending time with your pet? Noting to yourself what you like is linked to higher levels of self-esteem, so don’t stint here.

2. The second section of the wellness plan is a list of your triggers. What events, interactions and thoughts act to trigger your symptoms? What things make you feel bad? Most of us respond to increased stress, for instance. So stress (having to take a test at school, or attend a meeting at work, or have a difficult conversation with someone) could be a trigger for depression, or for using or other acting out, or for anxiety. Be sure to note what each trigger is a trigger for.

As well, identify places or interactions where you are likely to encounter each trigger. In our example of stress you might expect to encounter triggers for a stress response at work, or when going for a medical appointment, or meeting with a particular family member.

3. The third section is a place to write down early warning signs of any approaching crisis. Here “crisis” means a period of intensified symptoms. What are your early warning signs? What do you feel, think, do that usually mean you’re entering a challenging time in terms of the symptoms you deal with? It might mean some sleep disturbance or irritability, a mild increase in fearful thoughts about the environment or feeling disconnected from people.

4. What are the signs that tell you things are reaching a crisis? For you does that mean that you’re not getting out of bed or showering? Or that you’re hearing voices? Or that you’re getting in fights with people?

5. The fifth section is where you plan ahead to meet any crisis. For instance, if you deal with depression, and in a crisis you have thoughts about harming yourself, this is where you would write out details of a crisis plan for that possibility. Who would you want to make contact with, and what would be a helpful thing for them to do? In the example we’re considering you might include calling a close friend or family member and telling them that you’re going through a hard time, or calling 911 or going to your local ER and letting them know that you’re having trouble keeping yourself safe. This could also be the place where you keep the phone numbers for a friend or the Suicide Hotline, as well as the address for the nearest ER. You might also consider putting reminders here for what you don’t want to do in the presence of a crisis (such as isolate, or drink) and who you don’t want to make contact with (such as people who make you feel bad).