By Sarah A.H. Ho

Wellness Recovery Action Plan, or WRAP, is a method of using self-knowledge to monitor and reduce troubling or dangerous physical or emotional symptoms.

WRAP was devised by Mary Ellen Copeland, herself a psychiatric survivor, who saw the need for a structured, consumer-directed system of self-discovery. Since any individuals recovery is driven first and foremost by his or her own self-awareness, WRAP walks a person step-by-step through a process that deepens familiarity with his or her own illness. Each section in the manual becomes a chapter in one's resulting "WRAP Book," which evolves into a highly personal account of the journey. Some of its chapters are entitled Wellness Toolbox (what one feels like when one is well); Daily Maintenance Plan; Triggers; When Things Are Breaking Down; Supporters; and Post-Crisis Planning.

That WRAP can be effective to prevent relapse or suicide and to speed recovery after a crisis is a certainty in the mind of Anela Ka’iliawa, herself a psychiatric survivor. She is 25 years old, the mother of two children (ages five and seven), and is a Hawaii Certified Peer Specialist whose WRAP Book is a work of art. She has taught the process to clients at the many conferences and workshops.

Below, Anela shares her personal history and experiences with WRAP.

Q: How did you first become interested in WRAP?
A: The first time was in 2001-2 at a psychosocial rehab program. I had to work on WRAP for about one hour a day as a requirement of the program, and I hated doing it like a chore. The questions were really triggering me, and I felt I was going to cry every minute with past traumas coming up.

But what really got me doing it was the suicidal death of my house mate, Cynthia. She participated in the peer specialist training in 2004, and came back and preached WRAP to me, the consumer being in charge. When she passed away in 2005, she left some things for me, and I found out she'd never had a WRAP Book. Really stunning. If she'd had one for herself, maybe she could have saved herself.

Q: Your WRAP Book is beautiful. What motivates you to work on it so artistically?
A: When you work on it, it's hard work, and has stuff you don't necessarily want people to know. So, I thought, I'm going to put in pictures that make me happy: my children, my family. Ribbons from a present from Cynthia, shells from her, pictures of vegetation, some quotations. It's become an expression of all of me. I've been able to incorporate every aspect of my life: my child, my community, my interpersonal relationships. Now, I don't see any limit to it. With every new crisis, there is new stuff to add, as my insights grow and my support system evolves and changes. I work on it whenever there's a new trigger, or a new sign of breaking down.

Q: How important would you say WRAP is to your continued wellness?
A: It’s my foundation – the building blocks. It’s the place I’m most honest. There are things in there I haven’t told my therapist. It has let me redefine my life, make it meaningful.

Q: Specifically, how has WRAP helped you during crisis?
A: About one and a half years into working on WRAP, something clicked. I had a moment of clarity. I was literally in the bathroom, feeling suicidal, looking in the mirror, and I said, 'Well, here we are again.' Suddenly I thought of Cynthia. If she’d had WRAP, maybe she’d have made it. Maybe I can choose to overcome whatever I have to. I’m gonna fall, but I can get back up. I get to be the living proof that my friend couldn't be. My illness gets the best of me sometimes, but I know now there is help. WRAP has given me my strength back. If I give up, no one else will ever know what I can give or have been given.

Q: It sounds as though you had a moment of grace.
A: Yes. And that moment has come over and over. Now that I know what grace is, I recognize it. Always at the worst moments, it comes. Maybe ten times now.

Q: Those moments are clearly gifts, aren't they? And they all go into your book?
A: Yes, they do. I love to brag about my WRAP. I leave everything in there, so I can see my progress: triggers crossed out, goals met. It's become a sort of artistic diary. When God is ready to take me home, I'd like my son to see my WRAP, to see what his mom has been through.

Q: And now you use your WRAP Book to teach others and help them stay well. How does that look?
A: I've actually found that I have to be careful about whom I show my WRAP to. Some people can be cruel, make a joke, or make light of an issue. Once I shared it with a certified peer specialist trainer, and a lot of questions came up about a loved one's death that I wasn’t ready to answer. I also showed it to some friends and had our relationships change for the worse, because they don't understand.

However, when I show my book to another psychiatric survivor, we meet in the familiar territory of "our shared secret," because we both suffer from a brain disorder. Our relationship becomes intensified. The other person can see WRAP as opening a world of possibilities.

This is what drives me to keep doing it, to show and inspire others. I can be a super role-model. People see that they can regain control, take back the reins, instead of a case manager or family members doing it. We both reap benefits, too.

Q: So, at the heart of it, what would you say makes WRAP so effective?
A: Somewhere along the road I lost my sense of responsibility, that "I'm an adult, in charge of me." That’s what makes WRAP unique: it gives people the opportunity to have their whole life back and be in control.

Q: What other thoughts would you like to add?
A: When Mary Ellen Copeland came up with this plan, I don’t think she had any idea how powerful WRAP would be.
I know of three people who can really testify to its having saved their lives. It saved mine, too.

Sarah Ho's last column for MIWatch discussed consumer participation in the design of a jail diversion program.