Heather’s #MadCovidDiaries – 6th of October 2020
Whole ass-ing a Wellness Recovery Action Plan.
I’ve spent the last 5 years facilitating Wellness Recovery Action Plan Groups. I’m going to preface this entry by explaining why many peoples shoulders go up around their ears at the mention of Wellness Recovery Action Planning. It’s understandable.
Wellness Recovery Action Planning, or WRAP as it is better known, is an American import. The NHS has embraced WRAP with enthusiasm because recovery models are so hot right now! However WRAP has not always been delivered with much integrity. You’d never know it from some of the knock off versions, but WRAP was a grassroots survivor collaboration that began in the 1990s with a second generation psychiatric survivor and researcher Mary Ellen Copeland. Copeland was angry at the crappy care she had received and began a nationwide research project to find out how people were living with chronic illness. What began as a survivor collaboration became a global movement with a clinical evidence base.
WRAP works well because it is powered by the facilitators commitment to specific ethics & values baked into WRAP. Skip those ethics and values and the recovery element starts to fall apart, it turns into something else. As it is now, a WRAP derivative can be a few weeks of worksheets and a heavy dose of positive pop psychology. As much as the NHS bangs on about the WRAP value of personal responsibility, they don’t always apply that to quality control when delivering WRAP type sessions.
WRAP was designed to challenge the medical model, WRAP creator Mary Ellen Copeland talks freely about her dissatisfaction with being stuck on psychiatric medication and welfare, she also shares her mother Kate’s story of being given a dustbin diagnosis and institutionalised. Kate’s bond with the one nurse who listened to her allowed Kate to reclaim her life and succeeded despite the structural oppressions she faced. WRAP also takes a wide view of a persons life within the context of social disability and intersectional social justice models. One of my dreams is to run an activist WRAP for sustaining campaigners who are at risk of burnout.
As one of my heroes, Parks and Rec’s Ron Swanson, would say ‘why half ass something when you could whole ass it?’ WRAP is a whole ass kind of project and I take a high degree of personal responsibility for offering it properly; in a world where black lives do matter, where people suffer as much from oppressive systems as they might be suffering from ill health, let’s offer tools that work on those systems too.
Usually, I facilitate one WRAP group a year; each group takes between 10 and 14 weeks to complete. Once you add in the preparation and behind the scenes supervision, a WRAP takes lot of energy. Every WRAP I facilitate fires me up because I know the group members are going to get the life changing offer I got. WRAP offered me a chance to meet my peers on my terms, I was met with acceptance and together we shared survival strategies that it turns out actually worked for me. I have spent the last decade using my WRAP plan to navigate life and it has grown with me.
A WRAP session would involve 2 hours of activities like peer listening, sharing good food, swapping resources, creative time to make something, a few minutes of silly play time to let off steam then onto peace and quiet to round it off. WRAP is useful, gritty work that can address injustice. No more lavender baths and colouring books! I welcome the tough cookies who bring well worn cynicism to the group, especially those who have been kicked out of other groups or been shunted out of services. I can include people who want to come along but who have also just crashed into crisis, who are in psychotic episodes or who have been declared ‘difficult’/’complex’/’high needs’/’anti social.’ That was my situation when I stumbled into a WRAP group myself; I wouldn’t offer WRAP if it wasn’t useful to the people who are also excluded from mainstream care.
Wellness Recovery Action Planning involves staking your claim on who you are now, not just the definitions other people gave you. It’s about rebuilding what you feel you lost, routines, boundaries, relationships, reasons to go on. Together we mourn what cannot be restored, because such losses need to be honoured. Then we do our utmost to future proof you so that when the next relapse hits, you can trust that your wishes, your needs are central; you have the plan, the power and the support in place. In WRAP, you’ll be heard people by who respect you. We won’t try to fix you only blame you for our failures. We’ll sit with you and listen to you. Our experience is here for you if you ask for it. There is action planning and strategizing, sure, but I care much less about worksheets than I do that you get what you need today to get through tomorrow.
This year I joined in to deliver a pilot project in Leeds. The team knew that a 12 week face to face WRAP, including 3 sessions of triggering crisis planning, could not be delivered via Zoom. So we took the first foundational sections that offered day to day stability in lockdown and ran them via Zoom. We paired that up with a weekly email bulletin and a Google classroom full of resources so that group members didn’t have to struggle to absorb the material over Zoom, Zoom fatigue is real and we recognised that. Each session had to be adapted to fit the needs of the group that week as the rules of lockdown changed and new waves of anxiety washed over us.
The traditional WRAP 3 co-facilitator team grew to a team of 6 diverse facilitators who all had and used our own WRAP plans. This WRAP included a diverse group of around 10 people (including health professionals ) struggling through this lockdown with physical and mental ill health, as well as the housing and money stuff that keeps so many up at night.
If there was ever a time to whole ass a WRAP, it is during COVID19. Now distractions are gone and pain is amplified in every news story, every nightmare, every month flying by without normality. Now all the social contracts we made – go to work, do the right things and trust in institutions to look after us – has been destroyed. Those of us who already found life hard are finding it harder whilst the able bodied world wakes up to what ‘hard’ can feel like.
I was not so much surprised by the compassion that flowed in the group as I was humbled. Group members whole-assed their way through the foundations of the plan, sharing skills and holding onto hope for their fellow group members who found hope lacking that week. Despite being alone in our living rooms, we bonded. Little self care changes rang in big relief. We talked about Black Lives Matter, masks, insomnia, shielding and what it is to job hunt during COVID19. The experts on living well were the group members in that Zoom room, and I felt lucky to be there to witness that.
Leeds has now been able to offer two concurrent WRAPs, day and evening sessions to meet the maximum need. I’m in therapy now so I’ll be behind the scenes, helping the team with supervision and preparing for a face to face future where we can finish the full WRAP with 2020’s zoom group members. I hope this will show that WRAP can be a tool that offers something relevant to people. I hope it demonstrates that while the way it is delivered in a pandemic can be adapted, something like WRAP needs whole-ass commitment to values and to ethics. This is a time for the right tools, offered in the most inclusive, generous, pragmatic way possible to meet the need. Our mad community deserve the best we have to give and we need to be clear on how and why we offer it.
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