What is WRAP An Introduction to the Concept

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What is WRAP An Introduction to the Concept Co-Facilitated by Gerard Thomas & Jen

What is WRAP An Introduction to the Concept Co-Facilitated by Gerard Thomas & Jen Padron

Greetings & Hello everyone my name is Gerard Thomas, I am a Vietnam era

Greetings & Hello everyone my name is Gerard Thomas, I am a Vietnam era veteran honorably discharged from the US Army in 1971. I am a resident of Washington DC & a consumer of services from Pathways to Housing DC. I’m a trained Certified Advance Level WRAP Facilitator. I conduct WRAP groups & workshops that teach about wellness tools & strategies, such as medication management, changing negative thoughts to positive, developing a wellness lifestyle, & motivating people to work toward recovery – feeling the way they want to feel, making their lives the way they want them to be. I’ve also been trained and certified by the DC Dep’t of Behavioral Health as a Certified Peer Specialist. I assist people who have psychiatric symptoms to discover the strengths they have and can use to enhance their recovery, emphasizing the underlying concepts necessary to recovery: hope, personal responsibility, education, selfadvocacy, & support. I’m also active with the DC Department of Behavioral Health as a mental health advocate and a WRAP Facilitator. I have been using WRAP since 2006. . . I know from my own life experience that a duel diagnosis is not the end of the world and that a meaningful and positive life is possible with the correct kind of services and the right kinds of support. When recovery and support are based on mutuality & self-determination people can and do get well, and stay well for long periods of time, and do what they want to do with their lives.

Jen Padron, M. ed, CPS Associate Director/Principal Investigator/Project Director, DC Recovery Network Jen has

Jen Padron, M. ed, CPS Associate Director/Principal Investigator/Project Director, DC Recovery Network Jen has consulted with Vanguard Communications, to SAMHSA on wellness and social inclusion initiatives nationwide and for a Stanford University and NASHMPD Expert Q&A on experienced psychosis and cultural attunement. Currently, she’s currently a Consultant to Southern Methodist University on an NIMH and University of Texas at Austin Hogg Foundation funded study of Latina/o youth and early-experienced psychosis. She is a WRAP Facilitator, State of Georgia Certified Peer Specialist and State of Texas Advanced Certified Peer Specialist, and Community Health Worker Promotora. Her passion is working actively to grow a US Peer Leadership and Workforce where a CPS, RC and CHW portfolio of services will drive co-located behavioral and physical health recovery-oriented service care systems. Jen is a Ph. D Candidate, earning her Ph. D in Public Health late ’ 15. She believes in service and is a volunteer board of director member to ACHMA College for Behavioral Health Leadership and sits on committees for peer services | supports national initiatives.

Mental Health Recovery Including: Wellness Recovery Action Planning® WRAP® Mary Ellen Copeland, Ph. D

Mental Health Recovery Including: Wellness Recovery Action Planning® WRAP® Mary Ellen Copeland, Ph. D

There are Four Parts to the study of Mental Health Recovery: 1. Key Recovery

There are Four Parts to the study of Mental Health Recovery: 1. Key Recovery Concepts… 1. 2. 3. 4. Hope Personal Responsibility Education Self Advocacy 5. Support …and Issues That Need Attention: ü Getting Good Health Care ü Medication Management 2

There are Four Parts to the study of Mental Health Recovery: 2. Wellness Toolbox

There are Four Parts to the study of Mental Health Recovery: 2. Wellness Toolbox 3. Wellness Recovery Action Planning 4. Recovery Topics: • Building Self-Esteem • Changing Negative Thoughts to Positive Ones • Peer Support • Work Related Issues • Trauma Recovery • Suicide Prevention 3

Mental Health Recovery Additional Issues: • Living Space • Lifestyle • Motivation This workshop

Mental Health Recovery Additional Issues: • Living Space • Lifestyle • Motivation This workshop and the concepts, skills and strategies you learn while in this workshop are complementary to your health care treatment program. They are not a replacement for your treatment program. 4

Key Recovery Concepts • Hope • Personal Responsibility • Education • Self-Advocacy • Support

Key Recovery Concepts • Hope • Personal Responsibility • Education • Self-Advocacy • Support 6

There is Much to Hope For! You can get well and stay well for

There is Much to Hope For! You can get well and stay well for long periods of time! 7

There is Much to Hope For! You can work toward and meet your goals!

There is Much to Hope For! You can work toward and meet your goals! You can lead a happy and productive life! 8

There is Much to Hope For! You don’t need, nor will you benefit from,

There is Much to Hope For! You don’t need, nor will you benefit from, dire predictions about your future. 9

There is Much to Hope For! Your supporters and care providers need to: •

There is Much to Hope For! Your supporters and care providers need to: • encourage you, • help you to feel better, • assist and support you in staying well. 10

Personal Responsibility • You are the expert on yourself! • You know what you

Personal Responsibility • You are the expert on yourself! • You know what you want and need! • It is up to you to take personal responsibility for your own wellness and your own life! 11

Education Learn all you can about yourself so you can make good decisions about:

Education Learn all you can about yourself so you can make good decisions about: • Treatment • Lifestyle • Career • Relationships • Living Space • Leisure Time Activities • All Aspects of Your Life 13

Education Go to www. mentalhealthrecovery. com for free educational articles and information, lists of

Education Go to www. mentalhealthrecovery. com for free educational articles and information, lists of resources and organizations, recovery stories, and mental health recovery and WRAP resources you can purchase including books, CDs and DVDs. 16

 Self-Advocacy Become a strong advocate for yourself. This means: “Going for it” with

Self-Advocacy Become a strong advocate for yourself. This means: “Going for it” with courage, persistence and determination; expressing yourself clearly and calmly until you get what you need for yourself. 17

 Self-Advocacy • Believe in yourself • Know your rights and insist that they

Self-Advocacy • Believe in yourself • Know your rights and insist that they are respected (see the following Bill of Rights) 18

 Self-Advocacy Set personal goals and work toward meeting them by: üGetting the facts

Self-Advocacy Set personal goals and work toward meeting them by: üGetting the facts üPlanning your strategy üGathering support üTargeting your efforts 19

Developing & Keeping a Strong Support System Support from family, friends, and care providers

Developing & Keeping a Strong Support System Support from family, friends, and care providers is definitely helpful. Being effectively supported will help you feel better and enrich your life. You will benefit from having at least five good friends or supporters you can call on when you need or want … 27

Developing & Keeping a Strong Support System • Someone to talk to • Companionship

Developing & Keeping a Strong Support System • Someone to talk to • Companionship • To have a good time • Help in figuring things out and making decisions • Someone to take over for you and keep you safe when you can’t take care of yourself 28

Issues that May Need Attention: Health Care Medications 81

Issues that May Need Attention: Health Care Medications 81

Health Care There may be medical reasons that are causing you to feel badly.

Health Care There may be medical reasons that are causing you to feel badly. Some of the most common include: • Hypo- or hyperthyroidism and other endocrine gland problems • Various chronic or acute disease processes 82

Have a Complete Physical Examination At least once a year and whenever your symptoms

Have a Complete Physical Examination At least once a year and whenever your symptoms change or worsen This examination needs to include a complete battery of thyroid tests. 84

Medication Issues You may choose to take medications for the short or long term

Medication Issues You may choose to take medications for the short or long term to help you feel better. This choice is up to you. 92

Medication: • Know the possible side-effects and if they occur, report them to your

Medication: • Know the possible side-effects and if they occur, report them to your health care provider. • Use medications only as prescribed. • Work closely with a competent pharmacist who knows you well. • Use a simple system to assure consistent use of medications. 96

Medication: • Report any lapses in medication treatment to your care provider. • Insist

Medication: • Report any lapses in medication treatment to your care provider. • Insist on regular blood testing. • Pay close attention to lifestyle issues such as diet, exercise, light, rest and stress. • Avoid using alcohol or illegal drugs. 97

WRAP® Wellness Recovery Action ® Plan Mary Ellen Copeland, Ph. D 219

WRAP® Wellness Recovery Action ® Plan Mary Ellen Copeland, Ph. D 219

WRAP Includes: § Wellness Toolbox § Daily Maintenance Plan § Triggers and Action Plan

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 Planning § Post Crisis Planning 220

Wellness Recovery Action Plan Was developed by a group of people who had been

Wellness Recovery Action Plan Was developed by a group of people who had been dealing with difficult feelings and behaviors for many years People working to feel better and get on with their lives 221

WRAP Will: 1. Help you stay as well as possible 2. Help you keep

WRAP Will: 1. Help you stay as well as possible 2. Help you keep track of difficult feelings and behaviors, and develop action plans to help you feel better 222

WRAP Will: 3. Tell others what to do for you when you feel so

WRAP Will: 3. Tell others what to do for you when you feel so badly you can’t make decisions, take care of yourself and keep yourself safe. 223

You Can Use WRAP As a tool to help insure your success if you

You Can Use WRAP As a tool to help insure your success if you are planning changes in your life, like: § Getting a Job § Changing Jobs 224

You Can Use WRAP § Increasing your Work Hours § Taking on More Responsibilities

You Can Use WRAP § Increasing your Work Hours § Taking on More Responsibilities § Getting More Education or Training § Leaving Supported Housing 225

You Can Use WRAP § Moving § Beginning or Leaving a Relationship § Working

You Can Use WRAP § Moving § Beginning or Leaving a Relationship § Working on Relationship Issues § Having a Child 226

You Can Use WRAP To Address Other Life Issues like: Chronic or Acute Illness

You Can Use WRAP To Address Other Life Issues like: Chronic or Acute Illness Addictions Breaking Bad Habits Losing Weight Trying Out New Interests Caring for Ill or Elderly Family Member 227

WRAP You could develop a separate WRAP to deal with each of these issues

WRAP You could develop a separate WRAP to deal with each of these issues or you could include these issues in one WRAP. 228

WRAP There is only one person who can write your WRAP- YOU! You and

WRAP There is only one person who can write your WRAP- YOU! You and only you decide: § If you want to write a WRAP § How much time it takes you to do it § When you want to do it § Which parts you want to do 229

WRAP You and only you decide: § Who you want, if anyone, to help

WRAP You and only you decide: § Who you want, if anyone, to help you with it § How you use it § Who you show it to § Where you keep it § Who, if anyone, has copies of your Crisis Plan 230

WRAP You may want to develop your WRAP in a three ring binder with

WRAP You may want to develop your WRAP in a three ring binder with filler paper and a set of five tabs. However, you can develop your WRAP using any paper or notebook style. 231

WRAP You could develop it on your computer or even on a tape recorder.

WRAP You could develop it on your computer or even on a tape recorder. You may want to ask a friend to support you as you work on your WRAP. 232

Begin a WRAP by: Developing a list of your Wellness Tools These are things

Begin a WRAP by: Developing a list of your Wellness Tools These are things you do to keep yourself well, and the things you do to help yourself feel better when you don’t feel well. 233

Begin a WRAP by: You may have discovered wellness tools yourself or learned about

Begin a WRAP by: You may have discovered wellness tools yourself or learned about them from others. Most of them are simple, safe, and free. You will use these tools to develop your WRAP. 234

Common Wellness Tools § Reaching out to others for support § Checking in with

Common Wellness Tools § Reaching out to others for support § Checking in with a care provider § Peer Counseling § Focusing Exercises § Stress Reduction and Relaxation Techniques 235

Common Wellness Tools § Doing things that divert your attention/Things you enjoy § Journal

Common Wellness Tools § Doing things that divert your attention/Things you enjoy § Journal writing § Eating or avoiding certain foods § Exercise § Light 236

Common Wellness Tools § Doing things that help you sleep well § Modifying your

Common Wellness Tools § Doing things that help you sleep well § Modifying your daily life § Taking action to keep yourself safe § Daily Planning § Spiritual practices 237

Common Wellness Tools You will be able to think of many other Wellness Tools

Common Wellness Tools You will be able to think of many other Wellness Tools that are helpful to you. You can keep your list in the front of your binder, on your computer, or wherever is most convenient for you. 238

Daily Maintenance List On the first tab in your binder write “Daily Maintenance List”.

Daily Maintenance List On the first tab in your binder write “Daily Maintenance List”. Insert it in your binder, followed by several sheets of binder paper. On the first page, describe how you feel when you feel well. Do it in list form. 239

Daily Maintenance List Some words that others have used are: Bright Outgoing Humorous Athletic

Daily Maintenance List Some words that others have used are: Bright Outgoing Humorous Athletic Content Reasonable Happy Optimistic Competent Industrious Responsible Withdrawn 240

Daily Maintenance List Some words that others have used are: Introverted Active Compulsive Quiet

Daily Maintenance List Some words that others have used are: Introverted Active Compulsive Quiet Cheerful Boisterous Talkative Energetic Dramatic Calm Curious Reserved 241

Daily Maintenance List You may also want to include on this page any specific

Daily Maintenance List You may also want to include on this page any specific things you want to work on in your WRAP like: § Building your self-esteem § Going back to work § Getting a different job 242

Daily Maintenance List § Learning new skills § Losing or gaining weight § Addressing

Daily Maintenance List § Learning new skills § Losing or gaining weight § Addressing addictions § Relieving the effects of trauma 243

Daily Maintenance List § Healing from an illness, injury or surgery § Dealing with

Daily Maintenance List § Healing from an illness, injury or surgery § Dealing with a chronic illness like Fibromyalgia or Arthritis 244

Daily Maintenance List On the next page make a list of things you need

Daily Maintenance List On the next page make a list of things you need to do for yourself every day to keep feeling well. 245

Daily Maintenance List Examples (Be Specific): § Get up at 7: 00 AM on

Daily Maintenance List Examples (Be Specific): § Get up at 7: 00 AM on weekdays so I can get to work on time. § Pack a healthy lunch and snacks to take to work. § Eat three healthy meals and three healthy snacks. 246

Daily Maintenance List Examples (Be Specific): § Drink at least six 8 -ounce glasses

Daily Maintenance List Examples (Be Specific): § Drink at least six 8 -ounce glasses of water § Get half an hour exposure to outdoor light. § Take medications and vitamins. § Exercise for a least half an hour. 247

Daily Maintenance List Examples: § Relax or meditate for at least 20 minutes. §

Daily Maintenance List Examples: § Relax or meditate for at least 20 minutes. § Write in a journal for at least 15 minutes. § Spend half an hour enjoying a fun, affirming or creative activity. 248

Daily Maintenance List On the next page make a reminder list for things you

Daily Maintenance List On the next page make a reminder list for things you might choose or need to do on any day. Reading through this list daily and doing those things that need to be done reduces the stress in your life and helps keep you on track. 249

Daily Maintenance List Ideas of things that might be on this list include: §

Daily Maintenance List Ideas of things that might be on this list include: § Setting up an appointment with a care provider § Calling your Vocational Rehabilitation Counselor § Making some possible employment contacts § Signing up for a class 250

Daily Maintenance List § Studying § Spending time with a good friend § Being

Daily Maintenance List § Studying § Spending time with a good friend § Being in touch with my family § Spending extra time with my partner § Peer Counseling 251

Daily Maintenance List § Getting more sleep § Buying groceries § Having some personal

Daily Maintenance List § Getting more sleep § Buying groceries § Having some personal time § Planning something fun for the weekend 252

Daily Maintenance List § Spending time with children or pets § Planning a vacation

Daily Maintenance List § Spending time with children or pets § Planning a vacation § Taking a hot bubble bath § Going to a support group 253

Triggers External events or circumstances may make you feel very uncomfortable. These are normal

Triggers External events or circumstances may make you feel very uncomfortable. These are normal reactions to life events - but if you don’t respond to them, they may actually make you feel worse. 254

Triggers On the Second Tab write “Triggers” and put in several sheets of binder

Triggers On the Second Tab write “Triggers” and put in several sheets of binder paper. On the first page write down those things that, if they happened, might make you feel worse. 255

Triggers Examples: § Problems at work § Difficult relationships with co-workers § Benefits being

Triggers Examples: § Problems at work § Difficult relationships with co-workers § Benefits being questioned or denied § Doing work that is hard for you § Anniversary of loss or trauma § Traumatic news 266

Triggers Examples: § Being very overtired § Work stress § Family friction § Physical

Triggers Examples: § Being very overtired § Work stress § Family friction § Physical illness § Sexual harassment § Aggressive sounding noises § Feeling left out § Financial problems 277

Triggers Examples: § Reminders of abandonment § Intimacy § Excessive stress § Guilt/Criticism/Put-Downs §

Triggers Examples: § Reminders of abandonment § Intimacy § Excessive stress § Guilt/Criticism/Put-Downs § Spending too much time alone § Being teased 258

Triggers Action Plan On the page after your list of Triggers, develop a plan

Triggers Action Plan On the page after your list of Triggers, develop a plan that you feel will keep you from feeling worse if a triggering event occurs 259

Triggers Action Plan Sample Plan: If Any of My Triggers Come Up I Will:

Triggers Action Plan Sample Plan: If Any of My Triggers Come Up I Will: § Make sure I do everything on my Daily Maintenance List § If work related, talk to my Vocational Counselor or employer § Focus on tasks that are easy for me to do well 260

Triggers Action Plan Sample Plan: § Get one thing done that I know I

Triggers Action Plan Sample Plan: § Get one thing done that I know I can do well § Do a reality check § Talk to a support person § Write in my journal § Get some vigorous exercise 261

Triggers Action Plan Sample Plan: § Peer Counsel with a friend § Play my

Triggers Action Plan Sample Plan: § Peer Counsel with a friend § Play my guitar for an hour § Do a Deep Breathing or a Relaxation Exercise 262

Early Warning Signs are internal and may be unrelated to reactions to stressful situations.

Early Warning Signs are internal and may be unrelated to reactions to stressful situations. They are subtle signs of change that indicate you many need to take some further action. 263

Early Warning Signs On the third tab write “Early Warning Signs”. Follow this with

Early Warning Signs On the third tab write “Early Warning Signs”. Follow this with several sheets of binder paper. On the first page make a list of Early Warning Signs you have noticed. 264

Early Warning Signs Examples: § Forgetfulness § Anxiety or Nervousness § Inability to experience

Early Warning Signs Examples: § Forgetfulness § Anxiety or Nervousness § Inability to experience pleasure § Lack of motivation § Feeling slowed down or speeded up 265

Early Warning Signs Examples: § Avoiding doing Daily Maintenance items § Being uncaring or

Early Warning Signs Examples: § Avoiding doing Daily Maintenance items § Being uncaring or apathetic § Avoiding others or isolating § Being obsessed with things § Feeling unconnected to my body § Increased irritability or negativity 266

Early Warning Signs Examples: § Increase in smoking § Not keeping appointments § Spending

Early Warning Signs Examples: § Increase in smoking § Not keeping appointments § Spending money impulsively § Aches and Pains § Feelings of hopelessness § Beginning of irrational though patterns 267

Early Warning Signs Action Plan On the next page develop a plan of things

Early Warning Signs Action Plan On the next page develop a plan of things to do everyday until you feel better – a plan you think will help you from feeling worse if you notice Early Warning Signs. 268

Early Warning Signs Action Plan Sample Plan: § Do everything on my Daily Maintenance

Early Warning Signs Action Plan Sample Plan: § Do everything on my Daily Maintenance Plan § Tell a supporter how I am feeling § Peer Counsel § Do a Focusing Exercise 269

Early Warning Signs Action Plan Sample Plan: § Do three 10 minute Relaxation Exercises

Early Warning Signs Action Plan Sample Plan: § Do three 10 minute Relaxation Exercises § Spend at least 1 hour involved in an activity I enjoy § Ask others to take over my household responsibilities 270

Early Warning Signs Action Plan § Surround myself with loving, affirming people § Take

Early Warning Signs Action Plan § Surround myself with loving, affirming people § Take a Mental Health Day § Arrange to leave work early § Get plenty of rest 271

When Things are Breaking Down or Getting Worse You may begin to feel even

When Things are Breaking Down or Getting Worse You may begin to feel even worse – very uncomfortable, like the situation is serious – and even dangerous – but you are still able to take some action in your own behalf. This is a very important time. It is necessary to take immediate, assertive action to prevent a crisis. 272

When Things are Breaking Down or Getting Worse On the fourth tab write “When

When Things are Breaking Down or Getting Worse On the fourth tab write “When Things are Breaking Down”. Follow this with several sheets of binder paper. Make a list of the feelings and behaviors which, for you, mean that things have worsened and are close to the crisis stage. 273

When Things are Breaking Down or Getting Worse Examples: § Can’t concentrate at work

When Things are Breaking Down or Getting Worse Examples: § Can’t concentrate at work § Losing track of what I’m doing § Feeling very oversensitive and fragile § Irrational responses to others 274

When Things are Breaking Down or Getting Worse § Feeling very needy § Unable

When Things are Breaking Down or Getting Worse § Feeling very needy § Unable to sleep for (how long? ) § Sleeping all the time § Avoiding eating § Racing thoughts 275

When Things are Breaking Down or Getting Worse Examples: § Substance abuse § Obsessed

When Things are Breaking Down or Getting Worse Examples: § Substance abuse § Obsessed with negative thoughts § Unusual behaviors § Dissociation (blacking out, losing time) 276

When Things are Breaking Down or Getting Worse Examples: § Seeing things that aren’t

When Things are Breaking Down or Getting Worse Examples: § Seeing things that aren’t there § Risk taking behaviors, like driving too fast § Thoughts of self-harm § Taking your anger out on others 277

When Things are Breaking Down or Getting Worse On the next page, write an

When Things are Breaking Down or Getting Worse On the next page, write an action plan to use each day When Things are Breaking Down. The plan now needs to be clear and very directive, with many things you “must” do and fewer choices. 278

When Things are Breaking Down or Getting Worse Sample: § Call my Doctor or

When Things are Breaking Down or Getting Worse Sample: § Call my Doctor or care provider, ask for and follow their advice § Arrange for at least three days off from work and any other responsibilities § Talk to a supporter § Arrange for someone to stay with me 279

When Things are Breaking Down or Getting Worse § Take action so I can’t

When Things are Breaking Down or Getting Worse § Take action so I can’t hurt myself if things get worse § Do everything on my Daily Maintenance List § Do two Peer Counseling sessions, three Deep Breathing Relaxation Exercises, two Focusing Exercises § Write in my journal for half an hour § Get half an hour of exercise 280

Crisis Planning The next section of the WRAP is the Crisis Plan. In spite

Crisis Planning The next section of the WRAP is the Crisis Plan. In spite of your best planning and assertive action, you may find yourself in a crisis situation where others will need to take over responsibility for your care. You may feel as though you are totally out of control. 281

Crisis Planning Write your Crisis Plan when you are well. Your plan will instruct

Crisis Planning Write your Crisis Plan when you are well. Your plan will instruct others about how to care for you when you are not well. It keeps you in control even when it seems like things are out of control. 282

Crisis Planning Others will know what to do, saving everyone time and frustration, while

Crisis Planning Others will know what to do, saving everyone time and frustration, while insuring that your needs will be met. Develop this plan slowly when you are feeling well. 283

Crisis Planning On the fifth tab write “Crisis Plan. ” Insert quite a few

Crisis Planning On the fifth tab write “Crisis Plan. ” Insert quite a few sheets of lined paper or use a form. This part of WRAP is different from other parts of the plan because you will give it to others so they have it when needed. The Crisis Plan has 9 parts. 284

Crisis Planning It Includes: § What you are like when you are well §

Crisis Planning It Includes: § What you are like when you are well § Indicators that others need to “take over” § Who “takes over” and who doesn’t 285

Crisis Planning § Information on your Health Care Contacts and Medications § Acceptable and

Crisis Planning § Information on your Health Care Contacts and Medications § Acceptable and Unacceptable Treatments § Home/Community Care/Respite Plan 286

Crisis Planning § Acceptable and Unacceptable Hospital Facilities § Things others can do that

Crisis Planning § Acceptable and Unacceptable Hospital Facilities § Things others can do that would help § Things other might do that would make you feel worse 287

Crisis Planning § A list of chores and tasks for others § Indicators that

Crisis Planning § A list of chores and tasks for others § Indicators that the plan is no longer needed § Signatures of key people 288

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Describe what you

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Describe what you are like when you are feeling well, as a reference point for people who may not have met you before. (You can copy this from the first part of the first section of WRAP. ) 289

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Examples: Bright Outgoing

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Examples: Bright Outgoing Humorous Athletic Reasonable Responsible Industrious Withdrawn Active Talkative Energetic Dramatic 290

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Examples: Introverted Compulsive

Crisis Planning Part 1: “What I’m Like When I’m Feeling Well” Examples: Introverted Compulsive Cheerful Boisterous Happy Optimistic Content Calm Quiet Reserved Curious Competent 291

Crisis Planning Part 2: Signs that Supporters Need to Take Over List those signs

Crisis Planning Part 2: Signs that Supporters Need to Take Over List those signs that indicate to others that they need to take over responsibility for your care and make decisions on your behalf. 292

Crisis Planning Part 2: Signs that Supporters Need to Take Over Examples: § Uncontrollable

Crisis Planning Part 2: Signs that Supporters Need to Take Over Examples: § Uncontrollable pacing, unable to stay still § Inability to stop compulsive behaviors § Catatonic/unmoving for long periods of time § Neglecting personal hygiene (# of days? ) § Not cooking or doing any housework (days? ) 293

Crisis Planning Part 2: Signs that Supporters Need to Take Over Examples: § Not

Crisis Planning Part 2: Signs that Supporters Need to Take Over Examples: § Not understanding what people are saying § Self destructive, abusive or violent behavior § Criminal activities § Destroying property § Substance abuse § Threatening suicide or acting suicidal 294 § Not getting out of bed at all, refusing to eat

Crisis Planning Part 3: Supporters List at least 5 people you want to take

Crisis Planning Part 3: Supporters List at least 5 people you want to take over for you. You can include family members, friends and/or care providers. Ask the people you choose if it is OK for you to include them on this list. Tell them what would be involved. Show them a copy of your plan. 295

Crisis Planning Part 3: Supporters If they say they can do it, GREAT! If

Crisis Planning Part 3: Supporters If they say they can do it, GREAT! If not, they can still be a good friend. Peers often provide this support for each other. You may want to set up a meeting with your supporters so they know each other and to discuss your plan. 296

Crisis Planning Part 3: Supporters Include a list of people you do not want

Crisis Planning Part 3: Supporters Include a list of people you do not want to be involved in decision making or care. You can also write why you do not want them involved. Also describe how you want supporters to settle disputes if they disagree. 297

Crisis Planning Part 4: Medication Provide the following information: § Names and Phone Numbers

Crisis Planning Part 4: Medication Provide the following information: § Names and Phone Numbers of your Physician and Pharmacy § Your Insurance Company Name, Phone Number, and ID Numbers § Allergies § Medications and Health Care preparations you are currently using, why you are using them, dosage and when you take them 298

Crisis Planning Part 4: Medication § Medications you would prefer to use if medications

Crisis Planning Part 4: Medication § Medications you would prefer to use if medications (or additional medications) become necessary and why you would choose them § Medications that would be acceptable to you if medications became necessary, and why you would choose them § Medications that should be avoided and why 299

Crisis Planning Part 5: Treatments List those treatments you would like and those that

Crisis Planning Part 5: Treatments List those treatments you would like and those that you would want to avoid. Include “alternative” therapies that have helped as well as those that have not been helpful. 300

Crisis Planning Part 6: Home/Community Care/ Respite Center Hospitalization is often not the best

Crisis Planning Part 6: Home/Community Care/ Respite Center Hospitalization is often not the best option. Develop a carefully devised plan so that you can stay at home or in the community and still get the care you need. In order to do this, find out what resources are available in your community. 301

Crisis Planning Part 7: Treatment Facilities List those treatment facilities where you would prefer

Crisis Planning Part 7: Treatment Facilities List those treatment facilities where you would prefer to be hospitalized if that became necessary, and those you wish to avoid. 302

Crisis Planning Part 8: Help From Others List things others can do for you

Crisis Planning Part 8: Help From Others List things others can do for you that would help: § Listen without interrupting. § Hold me or let me pace. § Lead me through a Relaxation Exercise. § Peer Counsel with me. § Take me for a walk. § Provide materials so I can draw or paint 303

Crisis Planning Part 8: Help From Others § Let me express my feelings. §

Crisis Planning Part 8: Help From Others § Let me express my feelings. § Don’t talk to me (or, do talk to me). § Encourage me, reassure me. § Feed me good food (be specific). § Keep me from hurting myself, even it that means you have to restrain me or get help from others. § Keep me from hurting you or others 304

Crisis Planning Part 8: Help From Others Include a list of specific tasks you

Crisis Planning Part 8: Help From Others Include a list of specific tasks you will need others to do for you, and who you would like to take care of these things. 305

Crisis Planning Part 8: Help From Others Examples: § Paying bills § Child and

Crisis Planning Part 8: Help From Others Examples: § Paying bills § Child and pet care § Talking to employers § Buying groceries § Household chores 306

Crisis Planning Part 8: Help From Others List things that others should avoid doing,

Crisis Planning Part 8: Help From Others List things that others should avoid doing, things that would not help or might make the situation worse. Examples: § Using force § Spending too much time alone § Being teased 307

Crisis Planning Part 8: Help From Others § Restraint and/or seclusion § Getting angry

Crisis Planning Part 8: Help From Others § Restraint and/or seclusion § Getting angry with me § Impatience and invalidation § Not being heard § Trying to entertain me § Certain kinds of music and videos 308

 Crisis Planning Part 9: When my Supporters No Longer Need to Use This

Crisis Planning Part 9: When my Supporters No Longer Need to Use This Plan When you feel better, your supporters will no longer need to follow this plan. Develop a list of indicators that your supporters can use to determine when they no longer need to follow this plan. 309

 Crisis Planning Part 9: When my Supporters No Longer Need to Use This

Crisis Planning Part 9: When my Supporters No Longer Need to Use This Plan Examples: § When I have slept through the night for three nights § When I begin cooking for myself § When I eat at least two good meals a day § When I am taking care of my personal hygiene needs 310

 Crisis Planning Part 9: When my Supporters No Longer Need to Use This

Crisis Planning Part 9: When my Supporters No Longer Need to Use This Plan § When I can carry on a conversation § When I keep my living space organized § When I can be in a crowd without being anxious § When I return to work § When I can sit still for 10 minutes 311

Crisis Planning You have now completed your Crisis Plan! Update it when you learn

Crisis Planning You have now completed your Crisis Plan! Update it when you learn new information or change your mind about things. Give your supporters new copied of your Crisis Plan each time you revise it. You can help assure that your Crisis Plan will be followed by signing it in the presence of two witnesses. 312

 It will further increase its potential for use if you appoint and name

It will further increase its potential for use if you appoint and name a supporter with Durable Power of Attorney. Since the legality of these documents varies from state to state, you cannot be absolutely sure the plan will be followed. However, it is your best assurance that your wishes will be honored. 313

Post Crisis Planning The time when you are healing from a crisis can be

Post Crisis Planning The time when you are healing from a crisis can be very important. Although you feel ready to begin taking care of yourself again, you may still be dealing with difficult feelings as well as the aftermath of the crisis. You may find that you start feeling worse - like you are heading for another crisis. 314

Post Crisis Planning Thinking about this time before you even have a crisis, and

Post Crisis Planning Thinking about this time before you even have a crisis, and perhaps giving it more attention when you are starting to feel better after a crisis, may help you have an easier time recovering and moving on. 315

Post Crisis Planning Addressing the following issues and creating a Timetable for Resuming Responsibilities

Post Crisis Planning Addressing the following issues and creating a Timetable for Resuming Responsibilities may guide you through the process. 316

Post Crisis Planning § When will you know you are ready to use a

Post Crisis Planning § When will you know you are ready to use a Post Crisis Plan? § How you would like to feel when you have recovered from the crisis? § Who do you want to support you through this time? 317

Post Crisis Planning If you have been hospitalized, where will you go when your

Post Crisis Planning If you have been hospitalized, where will you go when your are discharged? Who you would like to take you there? Who you would like to stay with you? 318

Post Crisis Planning § Things that will ease your recovery if they are taken

Post Crisis Planning § Things that will ease your recovery if they are taken care of. § Things you can ask someone else to do for you. § Things that can wait until you feel better. § Things you need to do for yourself everyday 319

Post Crisis Planning Things you might need to do everyday. Things and people you

Post Crisis Planning Things you might need to do everyday. Things and people you need to avoid. Signs that you are beginning to feel worse. 320

Post Crisis Planning § Wellness Tools you will use if you are starting to

Post Crisis Planning § Wellness Tools you will use if you are starting to feel worse. § Things you need to do to prevent further loss. § Signs that you can return to using your Daily Maintenance Plan. 321

Post Crisis Planning Changes in your Wellness Recovery Action Plan. Changes you want to

Post Crisis Planning Changes in your Wellness Recovery Action Plan. Changes you want to make in your lifestyle or life goals. What you learned from the crisis. 322

Post Crisis Planning § People you need to thank. § Changes you want to

Post Crisis Planning § People you need to thank. § Changes you want to make in your life as a result of what you have learned. § What do you need to do to prevent further repercussions from this crisis? 323

Post Crisis Planning People you need to apologize to. People with whom you need

Post Crisis Planning People you need to apologize to. People with whom you need to make amends. Medical, legal or financial issues that need to be resolved. 324

Post Crisis Planning Timetable for Resuming Responsibilities § Identify the responsibility, such as work,

Post Crisis Planning Timetable for Resuming Responsibilities § Identify the responsibility, such as work, children, or buying groceries. § List who has been taking care of this task, such as your sister, partner or friend. 325

Post Crisis Planning § Describe what you need while you are resuming this responsibility,

Post Crisis Planning § Describe what you need while you are resuming this responsibility, for instance, someone to go with you, someone to watch your child in the morning, a half day schedule. 326

Post Crisis Planning Create a Step by Step plan for resuming responsibility, for instance,

Post Crisis Planning Create a Step by Step plan for resuming responsibility, for instance, going to work for one day the first week, two days the second week, three days the third week. 327

Conclusion You have now reviewed the Wellness Recovery Action Plan! Perhaps you have started

Conclusion You have now reviewed the Wellness Recovery Action Plan! Perhaps you have started to work on your own plan or are helping someone else develop their plan. 328

WRAP If so, give yourself credit for the work you are doing. You may

WRAP If so, give yourself credit for the work you are doing. You may even want to give yourself a reward from time to time. You can begin using your Wellness Recovery Action Plan as your guide to daily living whenever you want to. 329

WRAP At first you may want to review your plan everyday, following your Daily

WRAP At first you may want to review your plan everyday, following your Daily Maintenance Plan, and taking other action as needed. 330

WRAP After a while you will notice that you remember your plan and only

WRAP After a while you will notice that you remember your plan and only need to refer to it from time to time, unless you are having a difficult time. 331

WRAP You may want to revise your plan when you discover new Wellness Tools

WRAP You may want to revise your plan when you discover new Wellness Tools and find that some things work better for you than others. 332

Resources For further help in developing your WRAP, check out the resources at Mental.

Resources For further help in developing your WRAP, check out the resources at Mental. Health. Recovery. com and WRAPand. Recovery. Books. com 333

Recovery Topics Mary Ellen Copeland, Ph. D 334 1

Recovery Topics Mary Ellen Copeland, Ph. D 334 1

Recovery Topics 1. Self-Esteem 2. Changing Negative Thoughts to Positive Ones 3. Peer Support

Recovery Topics 1. Self-Esteem 2. Changing Negative Thoughts to Positive Ones 3. Peer Support 4. Work-Career 5. Trauma Recovery 6. Suicide Prevention 7. Additional Issues a. Living Space b. Lifestyle c. Motivation 335