A randomized controlled trial of effects of Wellness Recovery Action Planning on depression, anxiety, and recovery

Judith A Cook, Mary Ellen Copeland, Carol Bailey Floyd, Jessica A Jonikas, Marie M Hamilton, Lisa Razzano, Tina M Carter, Walter B Hudson, Dennis D Grey, Sherry Boyd
Psychiatric Services: a Journal of the American Psychiatric Association 2012, 63 (6): 541-7

OBJECTIVE: The purpose of this study was to test the effectiveness of the Wellness Recovery Action Planning (WRAP) self-management intervention in reducing depression and anxiety and in increasing self-perceived recovery among individuals with a serious mental illness.

METHODS: Participants were recruited from outpatient community mental health settings in six Ohio communities: Canton, Cleveland, Columbus, Dayton, Lorain, and Toledo. With a single-blind, randomized controlled trial design, 519 individuals were assigned to WRAP or to services as usual and assessed at baseline and at two- and eight-month follow-ups. The intervention consisted of eight weekly 2.5-hour sessions delivered by peers in recovery from serious mental illness who were certified WRAP educators.

RESULTS: The mean number of WRAP sessions attended was five, and fidelity ranged from 90% to 92%. Analysis using mixed-effects random regression revealed interactions of study condition by time in each outcome area. Compared with the control group, intervention participants reported significantly greater reduction over time in Brief Symptom Inventory depression and anxiety subscales and significantly greater improvement in total Recovery Assessment Scale scores as well as the subscales measuring personal confidence and goal orientation.

CONCLUSIONS: Training in mental illness self-management reduced depression and anxiety and improved participants' self-perceived recovery over time. Results confirmed the importance of WRAP as part of a group of evidence-based, recovery-oriented interventions.

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