Alternatives 2021 presentation with Dennis and Lee Horton: Using Peer Support and WRAP in Prison

Overview of WRAP

I recently worked with a group of four people developing WRAP. The following links are videos of that group. I think it is a great overview of WRAP. They shared some examples which were useful to me and may be useful to you. You can use it to review the WRAP process—or you can use it to develop a WRAP if you don’t yet have one.

WRAP 20th Anniversary Keynote Speech

This keynote is commemorating the 20th anniversary of WRAP, 20 years ago I would not have been able to predict any of the amazing things that have happened with WRAP and mental health recovery. WRAP has grown exponentially. All of us involved in its growth were careful and considered about each step. There have been some missteps. But here we are. I want to share with you some of the things I have learned and observed along the way.

WRAP came from the grassroots. It was and is the result of a on-going collaborative effort. Collaboration is the important word here. In that same 20 year time frame many individuals have come up with ideas without collaboration or enough collaboration, that they thought could overtake or take the place of WRAP. Some were academics or scholars, some were professionals. These programs and strategies have fallen by the wayside. WRAP endures. And much of the endurance is, I believe, because of the on-going collaborative process—a process that began about 10 years before WRAP, 30 years ago, when I began to reach out to people with mental health issues to find out how they coped every day. At the 2005 WRAP conference, a person who was then a key player said that WRAP had run its course. How wrong he was.

I want to emphasize the importance of the collaboration that has facilitated the on-going development of this work. This body of knowledge, and WRAP itself, is the result of an on-going informal, and from time to time more formal process, called in academic circles qualitative research. Qualitative research is the kind of research where you ask people to describe their experience and you glean your answers from their responses. Over and over and over, through the years, people with lived experience, peers, have been asked about their experience, what works for them, what helps and what doesn’t, and they have shared and shared and shared. I used this collaborative process in writing all my books, in developing the training formats, in figuring out first the Key Concepts and then later the Values and Ethics of WRAP. I believe it is what makes our work different, powerful and effective. It is based on what we have learned ourselves and what we practice in our lives, and not on something that people with no acknowledged lived experience thought was best for us, or that would keep us under control.

To start with 30 years ago, I was not even thinking about getting well, prevention or moving forward for myself or for others. Nobody else was either. I, like everyone else in mental health, from care providers and professionals to people who had had mental health issues for years, were convinced that if you had mental health issues there was no hope. You could never get better, and would likely get worse over time—that what you were experiencing was a “broken brain”, messed up genetics or messed up neurotransmitters. Through my own experience and the experience of others, collaboration, I now know without any shadow of a doubt, that people can help themselves, that they can get well and stay well, that they can move forward in their lives. Back in those early days, I was chastised repeatedly for giving people what they said was “false hope”. How about that?

One example of this collaborative process is the order of WRAP. The developers of WRAP, the people in that session 20 years ago in Bradford, VT, suggested starting first with the Wellness tools and then on to the Daily Maintenance Plan and working through to the Crisis Plan—this was in the days before we had the Post Crisis Plan. Then someone or several people suggested that perhaps we should start working on the Advance Directive and work backwards, that we should start with the worst of times and work back from that—thinking about what preceded the crisis, when things are Breaking down, and then what preceded When things are Breaking down. We tried it. I described that as one possibility in the book Winning Against Relapse which some of you may have—that has now been replaced by WRAP for Life. I thought it might work.

However, through collaboration, I have found over time that working from the crisis plan backwards, doesn’t work for most people. Let me explain why I think this was so, and why others tell me, that the system of beginning with Wellness Tools and working forward works so well. Usually when people come to a WRAP group for the first time, they are apprehensive, maybe even scared. Their interactions with others may have been very limited. They may have always been limited. Others may make all their decisions for them. They may not have any friends or supporters. They may never have attended a group. They probably have no idea what to expect.

So we begin with the easier and less personal part of WRAP—Wellness Tools. What can or do you do to help yourself get well and stay well? In the group, first the facilitator shares some ideas. And then people in the group take risks and start sharing ideas—very tentatively at first. It’s a pretty easy topic, something that is not hard to talk about. It is a great place to begin. Then we move on to the things we need to do for ourselves every day. Not so difficult.

As people get more and more used to the WRAP process, and being and sharing with others, the things we talk about get more and more difficult—but people can do it because, through the easier steps they have gained confidence and feelings of safety. Each section gets harder, and has a greater chance of bringing up issues that people may have had a hard time thinking and talking about. So by the time people get to thinking about When Things are Breaking Down, and The Crisis Plan, the really hard parts, they can do it much more easily than if we had started there. They have gotten some experience.

Parts of WRAP—Wellness toolbox—when we talked about the wellness toolbox, I don’t think any of us realized how important this would become—that it would be the cornerstone of WRAP, and that for many people this would be the first time they realized that there were things they could do to help themselves. At first we were only thinking of common tools, like getting 8 hours of sleep, exercising, doing a relaxation exercise, spending time outside in the sun. Now I have a list of hundreds of Wellness Tools on my computer. They are not all in my plan but when I get to a place in my life where I feel stuck, and when I know my WRAP needs to be revised, I have lots of options. And sometimes I just go to that list to find something to do that is different and intriguing, that fills the bill at the moment. I have done many, many WRAP trainings and at every training I learn new Wellness Tools and if I think they would work for me, I add them to my list. Almost every day I learn a new wellness tool. I am always on the look out for them. For instance, recently a woman wrote me and said that for her a wellness tool is to think about the things she has done well. So now, every night when I am going to sleep, I think of all the things I did well that day—made a great dinner, spent time with a sick friend, complimented my son, supported my brother, hugged my spouse. Just yesterday a friend told me that when she is really upset, triggered, it helps her to hug herself by crossing her arms across the chest, putting the right hand over her heart and holding on to the upper arm with her left hand. She also suggested going out doors for 15 minutes or even half an hour and noticing everything you see, everything you feel, everything you smell and everything you hear. It can really break a bad mood.

Soon after the development of WRAP, Ed and I went to Oklahoma City to do a WRAP training. We went for 5 days to do basic WRAP. Then several weeks later we went back to do the facilitator training. Our experience there was really instrumental in developing the WRAP training format. In between our visits, a 5-mile wide category 5 tornado ripped through Oklahoma City. People were stunned, anxious, upset. The whole landscape had been changed when we returned. We didn’t recognize the places we had been. But everyone from the first training attended the second training. At that second training, the facilitator training, those resilient people came up with hundreds of Wellness Tools. We papered the walls with their lists. I wish I had taken a picture of them.

The WRAP group format was actually developed in 1997 and 1998 and then as I tried various scenarios for presenting WRAP in those early days—using trial and error and collaborating with people about what worked and what didn’t. The format we use now is the evidence based format, the format that we have found through lots and lots of collaboration including formal research. This format works. Once people have been through the group they can do anything with their WRAP that they want to do. But they have a right to be first exposed to the evidence based formal. And as you probably know, because of the way WRAP groups work, many people stay connected with other members of their WRAP group or even all of them after the WRAP development is over. I have heard of many WRAP groups that have evolved into support groups. People have developed close, supportive relationships. People who had been told they would never get well, go on to do the things they want to do and be the way they want to be—some of them become WRAP facilitators and Advance level WRAP facilitators—people who had always thought or been told that their lives would be compromised.

Over and over I have seen that WRAP reaches people that nothing else seems to reach. For instance, there is the time that I was invited to speak at the institution where my mother was a patient for 8 years while I was growing up. They wanted me to talk to the staff. I agreed to that but said I also really wanted to talk to the patients. They reluctantly agreed. They warned me no one would come. And if they did come, they would behave badly. People could choose to come but they had to come in groups from their ward—and then I was told they would not be attentive or participate. But the auditorium filled up. Over a hundred patients came. And from the beginning they began to participate. Everyone. Asking questions. Sharing their experiences. It was incredible. They made statements like the man we met in Japan some years later who said, why didn’t someone tell me I could help myself 20 years ago.

The same thing happened at St. Elizabeth’s hospital in DC last year. I was warned that the patients would not attend a presentation, and if they did they would not pay attention and they might even become unruly. They had staff lined up across the back in case there was trouble. As soon as the patients became aware of what I was talking about, they moved slowly and quietly toward the front of the room, and began participating, at first hesitating, but then becoming more and more engaged. I think for the first time in a very long time they had a sense of hope.

Years ago, Ed and I were invited to speak at a state-wide recovery conference where recovery was a very new concept. We noted that people came in rickety school busses from clubhouses. The people from each club house were dressed the same in shorts and tee shorts to allow the staff to keep track of them. They were led in and told where to sit. They had to ask permission to use the bathroom or to go outside to smoke. As I began speaking, I noticed there were staff walking up and down the aisles, poking over-medicated people who had fallen asleep. So I announced from the podium that I understood that people were on medications that might make them sleepy so if they needed to sleep it was OK with me. Then I started reading the bill of rights and people started paying attention. I have the right to ask for what I want. And people started to sit up and take notice. Then, I hafe the right to say no to requests and demands I can’t meet. A man in the front row stood up and starting shouting, yes, yes. Then I have the right to make mistakes and not have to be perfect. More people stood up and started shouting. Then I have the right to follow my won values and standards. Before long all of the patients were standing up and shouting, yes, yes, yes. There were no more heads on the table for the rest of the presentation. They said they would invite us back but they never did. I hope those people are OK, that they found a way out, that they have WRAP.

One of the ways that WRAP is really different from other programs and strategies is the Values and ethics. Soon after I began sharing WRAP with others, it became clear that in order to be effective and safe, people needed to learn about WRAP in an environment that differed from the environments they were used to when they were introduced to other programs and strategies. So over time, and using the collaborative process, and with help from lots of you, we came up with the list of WRAP values and ethics so people can be assured, when they come to a WRAP group, that they will be given hope, that it will be self determined, that they will be encouraged to advocate for themselves, that they will feel empowered, that what they do and how they do it with WRAP will all be voluntary, that they will be Wtreated as equals, with dignity, compassion, mutual respect, and unconditional high regard, that there will be no limits put on their potential for recovery, that all aspects of WRAP are totally voluntary, that they, and no one else, is the expert on them, that the focus will be on their strengths and not on any perceived weaknesses, that there won’t be a lot of medical, clinical or diagnostic language, that the emphasis is on strategies that are simple and safe, that difficult feelings and behaviors are normal responses to bad things that have happened to us. I am noticing, and I know that many of you are too, that these values and ethics are not only part of WRAP, but are becoming an expected way of life. If I had known these values and ethics back years ago, and about WRAP, I would not have had the following experience.

A long time ago, I had a very, very bad time. It was a “When Things are Breaking Down” before we called it that. I went to see my counselor and in my conversation I said I thought I had to come to terms with the fact that I really am a manic-depressive. She agreed with that. These were the old, old times—in the days when computer paper was a long strip with punch holes down the side. We decided that I should make a banner with my computer and hang it across my bedroom wall, a banner that said “I am a manic-depressive” so that every morning when I first wake up I could see that sign and remind myself that I am a manic depressive and that I need to be ever-mindful of that fact, every day all day. What a bad, bad idea. I never did it. Good for me. First I personally have come to believe that the diagnosis is not helpful for me and is in fact harmful. That the diagnosis can keep me stuck in a place where I don’t want and don’t need to be. And now using WRAP, I know what to do to keep high and low moods that are uncomfortable, embarrassing and unsafe at bay using wellness tools. I think it would have been much better if that banner said I take personal responsibility for myself. I have lots of wellness tools that I can use if I feel that my mood is either too low for me or too high for me. I could just say, I am a great person and I know what to do to keep myself well.

I have learned that WRAP and all of recovery works best when we surround ourselves with good-hearted, well meaning people. In doing this work I have met many, many, many good-hearted people-people who really live the values and ethics—treating others as equals, with dignity, compassion and respect. Some I hear from often, some occasionally, some very occasionally. They all mean so much to me. Spending time with good-hearted people, people who treat me well, and avoiding people who treat me badly is on my list of well-tools. Sad to say, I have had to do some avoidance, or limiting contact with people who treat me badly, even in this work, even with people who know and purport to live the values and ethics. If you don’t really know what is going on with another person, and think or feel like you may be being treated not well or badly, stay away from that person or those people. Talk it through with someone in peer support. Find ways to get away from people who treat you badly and who won’t change. Like it says in the values and ethics. You deserve to be treated with dignity, compassion and respect at all times.

I want to end with a story about hope. Once, many years ago, I was flying back to New Haven from Chicago with a friend. We had just finished work on the first recovery video with Bill Hood. The plane was not full, only about 25 people on board I think. We had just attained altitude and the lunches had been passed out when I noticed things looked hazy. And they smelled weird. My friend thought she had a problem with her contacts. But in short order we realized to our horror, that the plane was filling up with smoke. There was a terse message from the pilot that we were going to be making an emergency landing in Cinncinati. The crew rushed to grab our not yet eaten lunches, having a hard time concealing their anxiety. The plane banked sharply and then, instead of bump, bump, bumping gradually down to a smooth landing, this jet was making tight concentric circles as we watched the ground quickly get closer and closer. Their was a heavy wind through the plane as well. I think they were trying to clear the smoke. As we got closer to the ground we saw the fire trucks coming across the field. We landed safely and they took us off the plane quickly as emergency personnel swarmed the plane and took us into a holding room—in Detroit, not Cincinnati as we expected. I think they didn’t want us to mix with the other passengers until we had calmed down. So we started talking to each other. A reasonable thing to do. And it was then that we realized that every single passenger, with out exception, grabbed the package of M&M’s off the lunch tray as the tray was being grabbed by the steward. I don’t eat M&M’s, but now I always travel with a package of M&M’s in my carry-on. Another Wellness Tool.

I hope you have a wonderful conference. I was looking forward to it, especially to interacting personally with each of you. That is most important to me. Please, please, do be in touch.

Quotes From Tacoma Gathering

Memorable quotes from a WRAP Tacoma gathering I attended on April 1, 2017:

Angela – When I found WRAP in 2012, I knew WRAP was a way I could bring recovery to my organization.

When you develop your WRAP, you start to embrace yourself.

Jennifer – WRAP keeps me well.

I recently formed the WRAP collaborative to bring WRAP to parts of Washington State that don’t have it, and maintain fidelity.

Karen – WRAP is on of the favorite classes at the Treatment Mall.

Harry Potter Emerges Super Start–Acronym for Hope, Personal Responsibility,
Education, Self Advocacy and Support

Larry – I don’t know if she knew how much she was changing how we treated visiting trainers. She requested a stool, and a few extra days to catch her breath when she arrived. The stool is still around the agency someplace.

Kathleen – WRAP is a conversation changer.

The part of WRAP I especially like-it encourages community, keeping people close to you. Transformative.

Michael – Uses WRAP App with Optum enrollees. 200 people in Pierce County are on employment rolls with Optum as peer supporters,

A lot of partners in the community chip in so we can bring WRAP into the community.

Rosemary –HUI-highly, unique individual. You have to have that hope, and praise is everything.

Project Return – Peer Support Network

I, Joana Arcangel, am a peer with lived experience – meaning I identify with mental health recovery. At the Hacienda of Hope and through our organization, Project Return Peer Support Network, we utilize these experiences and focus on strength-building through a person-centered approach to connect with and help others in their journey.

Learn more about Project Return: Full PDF – Click Here

Moving Forward

These days I am learning how to cope with being older and needing to find time in my life to take good care of myself, to enjoy my extended family that includes children, grandchildren and great grandchildren and a wonderful group of close friends. If it were not for this work I wouldn’t know so well how important all of these things are. As was my intention, gradually, over time, I have trained hundreds and hundreds of people to carry the work forward.

In 2005 I founded the Copeland Center for Wellness and Recovery to take over the training of people to facilitate WRAP groups. The training was (and is) based on the Mental Health Recovery and WRAP Facilitators Manual which I developed many years ago—in the late 1990’s and which I have revised many time since them. And now the Copeland Center has trained hundreds and hundreds of people all over the world to lead WRAP groups based on that manual and to teach people how to teach people to lead WRAP groups (based on the Advanced Level Facilitator’s Manual). It continues to do this good work.

I have continued to write books and develop resources to meet the growing demand for information. In order to publish, market and distribute those books, Ed (my spouse) and I set up a publishing house, WRAP and Recovery Books. That kept us really busy. WRAP and Recovery Books grew and grew and grew.

In July of this year, because I am well past retirement age, and to insure that this work continues into the future, we transferred responsibility for the marketing, distribution and publishing aspects of the work (WRAP and Recovery Books) to a company with amazing capacity to move this work forward, Advocates for Human Potential.

Knowing myself and what I like to do, I have decided to have this website and a Mary Ellen Copeland PhD Face book page as way to continue to keep in close touch with this work, and to spread the word in any way that can. From time to time that will include a presentation. I look forward to hearing from you.

The Beginning of WRAP

I have been thinking about where WRAP came from. It is such fun to go back and visit those times. I had compiled my data, started giving workshops based on what I learned (even though a psychiatrist told me I could never lead a workshop) and even began writing a book based on my findings (I was also told I could never write a book). I went to conferences and presented on my findings and they were packed with people. People were sick of hearing about medications and changes in their brains and just wanted to feel better and move on with their lives. A wonderful man, David Hilton, hired me to present workshops, one day a week for 8 weeks, in every county in New Hampshire. And then Vermont decided to do the same thing. I felt like I was on a roll. I was doing very well myself, using what I had learned from others. I had two published books based on my findings, I had purchased a condominium and was no longer living on Social Security Disability.

It was at one of those Vermont trainings that something really profound happened. I thought the training had gone very well. I was feeling good about it. But then a woman, Jesse Parker, stood up and said, “This is all well and good. But I have been in institutions all over the country and I wouldn’t have any idea how to organize this into my life.” So we, as a group of people living with mental health issues including Jane Winterling who was working with me, all of us together, over three intensive days, developed WRAP—just the way you know it now except with the addition of the Post Crisis Plan which came a bit later. I thought it was quite good so I took it home and on a wintry afternoon I developed my first personal WRAP. And right away I noticed how much better I felt, how well it worked for me in my life. I decided then that, with the help of others who I would teach over time, I would spread the word about WRAP far and wide. And together we have done that for almost 20 years now. This coming March will be the 20th anniversary of the time when that wonderful group of people braved the winter snow, ice and cold and developed WRAP.

The First Research Project

I sent out postcards to national, regional and local mental health agencies and organizations asking people to write or call me if they were willing to share their experiences. This was almost ten years before e-mail. E-mail and the Internet would have made this so much easier. I thought I would get a few responses—maybe 25 if I was lucky. Imagine my surprise when 125 people responded. I sent them the first survey. I planned on three surveys with the first survey being very general questions that were designed to help me figure out the questions I would ask in the next two surveys. The responses were overwhelming. People wrote and wrote and wrote. They wrote in the margins, and on the front and back covers. They sent tape recordings. The stacks of surveys grew higher and higher and higher in my living room. I had an early computer, figured out a system and began compiling the data, a little bit at a time. There were no programs at that time to do this kind of thing. I went to a university that had a program that taught people how to work with people who had mental health issues and that did some research. When they saw what I had they laughed at me and said I should have asked questions and then given people choices like 5 would be a lot and 1 not at all. I said I didn’t even know the questions to ask and they wouldn’t even go there. They said I reminded of a woman who had done something similar and had all her responses on index cards in a shoebox. They thought that was really funny and laughed about it. I wish I could find that woman. That university is gone now. And the people who laughed at me are long gone somewhere too—I don’t know where—but I do know they are not part of the mental health recovery movement.