Wellness Recovery
Action Plan Workbook
WORKBOOK
To be used in conjunction with Wellness Recovery
Action Plan, written by Mary Ellen Copeland, MS, MA
TABLE OF CONTENTS
Good Days And Bad Days Page 1
Wellness Toolbox Page 3
Daily Maintenance Plan Page 4
Triggers Page 5
Early Warning Signs Page 6
When Things Are Breaking Down Page 7
Crisis Planning Page 8
Post Crisis Plan Page 15
Notes/Additional Information Page 20
Good Days and Bad Days
Everybody has good days and bad days. Good days and bad days dont
just happen. Usually they are related to what is going on in our lives.
In preparation for creating a Wellness Recovery Action Plan (WRAP),
many people have found it helpful to think through the following
questions. You may find it helpful to write a few notes.
What am I like when I am having a good day?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
What are some things that I can do that help me have good days?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
What am I like when I am having a bad day?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-1-
What are some of the things that cause me to have bad days?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
When I am having a bad day, what have I learned that I can do to turn
it around to make it a good day?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-2-
Wellness Toolbox
List things you do to keep yourself well and the things you do to help
yourself feel better when you dont feel well. List any tools that you
currently use or would like to try. You can keep adding new ones or
cross off ones that arent right for you.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-3-
Daily Maintenance Plan
Describe yourself when you are feeling all right. Be sure to include
general characteristics, feelings/emotions (like happy, upbeat, calm,
etc.), thought processes (like clearheaded, can remember things, etc.)
and behaviors (make up my bed, laugh a lot, enjoy being around people,
etc.:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Make a list of things you know you need to do for yourself every day to
keep feeling good:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-4-
Triggers
Make a list of events and/or circumstance that, if they happened,
might increase your symptoms or cause you to have unpleasant or
distressing feelings:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Make a list of what you need to do in order to keep your symptoms
from getting worse:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Make a list of things that have worked for you in the past to help
restore your wellness:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-5-
Early Warning Signs
Make a list of your early warning signs (feelings, thoughts, behaviors,
etc.) that indicate you need to take further action:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Make a list of what you need to do about your early warning signs in
order to keep your symptoms from getting worse:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-6-
When Things Are Breaking Down
Make a list of the symptoms which, for you, mean that things have
worsened and are close to the crisis stage:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Make a list of things you can do that you think will help reduce your
symptoms when they have progressed to this point:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-7-
Crisis Planning
Part One: What Im like when Im feeling well. Describe what you
are like when you are well:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Part Two: Symptoms. Describe symptoms that would indicate to
others that they need to take over responsibility for your care and
make decisions on your behalf:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-8-
Part Three: Supporters. List at least five people you have chosen to
take over for you when the symptoms you listed come up. Be sure to
write the name, telephone number, relationship and any particular role
you want them to play in your plan:
Name Phone # Relationship Role In My Crisis Plan
Part Four: Medication. List the name of your physician or physicians
and your pharmacy and their telephone numbers:
Name Phone #
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-9-
List any allergies you have:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List the medications you are currently using and why you are taking
them:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List those medications you would prefer to take if medications or
additional medications became necessary and why you would choose
them:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List those medications that should be avoided and give the reasons:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-10-
Part Five: Treatments. List treatments that help reduce your
symptoms when you are in a crisis situation:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List treatments you would want to avoid:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Part Six: Home/Community Care/Respite Center. Set up a plan so
that you can stay at home or in the community and still get the care
you need:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-11-
Part Seven: Treatment Facilities. List treatment facilities where
you would prefer to be hospitalized if that became necessary:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List treatment facilities you wish to avoid:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Part Eight: Help From Others. List those things that your
supporters can do for you that would help reduce symptoms:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-12-
Make a list of things you need others to do for you, like feed the pets,
get the mail, etc.:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List things that you have discovered through past experience that
supporters might do that could worsen the situation, like being
impatient, invalidation, etc.:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Part Nine: When My Supporters No Longer Need To Use This
Plan. Make a list of indicators that your supporters no longer need to
follow this plan:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-13-
Part Ten: If I Am In Danger. If my behavior endangers me or
others I want my supporters to:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
I developed this plan on (date) ______________________________
with the help of ________________________________________
Any plan with a more recent date supersedes this one.
Signed ___________________________ Date _______________
Witness __________________________ Date _______________
Witness __________________________ Date _______________
Attorney __________________________ Date _______________
Durable Power of Attorney (if you have one)
__________________________________ Phone No. __________
-14-
Post Crisis Plan
I will know that I am out of the crisis and ready to use this post
crisis plan when I am able to:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
How would you like to feel when you have recovered from this crisis
(refer to the section where you described what you are like when you
are having a good day)? This list may be different from the one
written before:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
I would like the following people to support me if possible during this
post crisis time:
Name Phone # Relationship What I need them to do
-15-
What are some things you need to do every day while recovering from
this crisis?
List things and people you need to avoid while you are recovering from
this crisis:
What are signs that you may be beginning to feel bad, i.e., anxiety,
worry, sleep disturbances?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List wellness tools you will use if you start to feel bad. Start with
those that you MUST dothe others are choices:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-16-
List when and what do you need to do to prevent any further
repercussions from this crisis:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Signs That This Post Crisis Phase Is Over:
List things to do for yourself every day:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List any changes to your crisis plan that might ease your recovery:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List any changes you want to make to your lifestyle or life goals:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-17-
What did you learn from this crisis?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
List any changes you want to make in your life as a result of what you
have learned:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
If you do want to make some changes, when and how will you make
them?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-18-
Resuming Responsibility:
Responsibility:__________________________________________
Who has been doing this while you were in crisis?________________
While you are resuming this responsibility, you need (who)
________________________to:___________________________
_____________________________________________________
Plan for resuming:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Responsibility:__________________________________________
Who has been doing this while you were in crisis?________________
While you are resuming this responsibility, you need (who)
________________________to:___________________________
_____________________________________________________
Plan for resuming:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Responsibility:__________________________________________
Who has been doing this while you were in crisis?________________
While you are resuming this responsibility, you need (who)
________________________to:___________________________
_____________________________________________________
Plan for resuming:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-19-
Notes/Additional Information
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-20-
Notes/Additional Information
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-21-
Notes/Additional Information
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
-22-
This Workbook Belongs To:
_________________________________________
Name
_________________________________________
Address
_________________________________________
City State Zip
_________________________________________
Telephone Number
If this workbook is found, please return to me at the above address.
Thank you.
This Workbook was put together by Julie Spores, Ike Powell and Lynn Thogersen
For the Georgia Mental Health Consumer Network
January 2005
Cover Design by Jerome Lawrence