Wellness Recovery Action Plan
Wellness Recovery Action Plan (WRAP) is a facilitated peer group program designed to support individuals who want to improve their wellness that can be applied to a range of areas individuals want to change, including mental health or substance use recovery.
WRAP aims to teach individuals how to:
- use recovery concepts such as hope, personal responsibility, education, self-advocacy, and support in their daily lives;
- identify activities and strategies that help them maintain wellness (i.e., wellness tools); and
- create plans with strategies for responding to and recovering from crises.
Trained WRAP facilitators deliver WRAP in groups. Session topics include an introduction to key concepts and ground rules, identifying personalized wellness strategies to combat negative feelings, developing a daily maintenance plan to enhance mental health, identifying early warning signs for recurrence of unwanted symptoms and targeted coping strategies, and developing a detailed crisis plan and post-crisis support plan.
The Prevention Services Clearinghouse’s independent systematic review of WRAP found that at least one study carried out in a usual care or practice setting achieved a rating of moderate or high on design and execution and demonstrated a sustained favorable effect of at least 6 months beyond the end of treatment on at least one target outcome.
As of December 2025, the ACF Assistant Secretary has final approval authority over the determination of the program or service rating. For more information, please visit the FAQ on the rating determination policy.
Date Last Reviewed by the Prevention Services Clearinghouse (Handbook Version 2.0): Aug 2026
Date Program or Service Description Last Updated: Aug 2026
Sources
The following sources informed the program or service description, target population, and program or service delivery and implementation information: the program or service developer’s website and the studies reviewed.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, download the Handbook of Standards and Procedures, Version 2.0
Target Population
WRAP is designed for individuals who have identified an area of their life they want to change. WRAP has been used to support wellness in a range of areas, including mental health and substance use recovery.
Dosage
Trained facilitators deliver WRAP in a group setting, with meetings typically occurring weekly for 2–2.5 hours over 8–12 weeks.
Location/Delivery Setting
Recommended Locations/Delivery Settings
WRAP is typically offered in community settings.
Location/Delivery Settings Observed in the Research
- Community Center (e.g., religious or recreational facility)
- Mental Health Center, Treatment Center, Therapist Office
Education, Certifications and Training
WRAP must be delivered by certified WRAP facilitators who have been trained by a WRAP Advanced Level Facilitator (ALF). ALFs are peers who have completed advanced WRAP training and certification through a licensed WRAP organization. Facilitators must complete refresher training every three years to maintain certification. ALFs must complete refresher training every two years to maintain certification.
Program or Service Documentation
Book/Manual/Available documentation used for review
Advocates for Human Potential Inc. (2024). Wellness Recovery Action Plan® (WRAP)® Facilitator Manual (Updated ed.). Human Potential Press.
Available languages
Materials for WRAP are available in English and Spanish.
Other supporting materials
For More Information
Website: https://www.wellnessrecoveryactionplan.com/
Contact form: https://www.wellnessrecoveryactionplan.com/contact-us/
Email: info@wellnessrecoveryactionplan.com
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Wellness Recovery Action Plan |
|---|---|
| Identified in Search | 8 |
| Eligible for Review | 6 |
| Rated High | 3 |
| Rated Moderate | 0 |
| Rated Low | 3 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
|
95% Confidence Interval
|
Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|---|---|
| Adult well-being: Parent/caregiver mental or emotional health | 0.13 | [-0.04, 0.29] | 5 | 3 (58) | 641 |
Favorable:
32 No Effect: 26 Unfavorable: 0 |
| Adult well-being: Parent/caregiver physical health | 0.01 | [-0.66, 0.68] | 0 | 1 (1) | 34 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
| Composite Outcomes | 1 (1) | 34 |
Favorable:
0 No Effect: 1 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention condition and a negative number favors the comparison condition. A range of comparison conditions, including no intervention, minimal intervention, placebo or attention, treatment as usual, and head-to-head comparison conditions are eligible for review (see Section 4.1.7 of the Handbook Version 2.0). Different types of comparison conditions may affect the magnitude of the effect sizes across studies. For example, an intervention compared to a no treatment comparison condition may produce a larger effect size than the same intervention compared to another intervention because the other intervention may itself be effective. The effect sizes shown may be derived from samples that overlap across studies. Effect sizes, confidence intervals, and implied percentile effects from any outcomes that assess outcomes across multiple domains (i.e., composite outcomes) are not shown in the Summary of Findings table. This is because combining different outcomes that represent several different domains may result in an average effect size that is not interpretable as a finding from any specific domain. See the Individual Study Findings table for the individual findings from any composite outcomes. For informational purposes, the number of studies, findings, and participants as well as counts of favorable, no effect, and unfavorable findings are displayed here for composite outcomes.
See the Individual Study Findings table for information about the specific comparison conditions used in each study and the Studies Reviewed section for information about any overlapping samples. The effect sizes presented here are provided for informational purposes only and are not used in determining a program or service rating.
| Outcome | Effect Size
|
Implied Percentile Effect
|
Months after treatment when outcome measured
|
Number of Participants | |
|---|---|---|---|---|---|
| Adult well-being: Parent/caregiver mental or emotional health | |||||
| Study 15847 - WRAP vs. FOCUS (Ben-Zeev, 2018) | |||||
| Symptom Checklist - 9 | 0.07 | 2 | 0 | 149 | |
| Symptom Checklist - 9 | 0.05 | 1 | 3 | 144 | |
| Beck Depression Inventory-II | 0.19 * | 7 | 0 | 148 | |
| Beck Depression Inventory-II | 0.15 | 5 | 3 | 144 | |
| Psychotic Symptom Rating Scales (% Score Greater Than 0) | 0.25 | 9 | 0 | 149 | |
| Psychotic Symptom Rating Scales (% Score Greater Than 0) | 0.39 | 15 | 3 | 143 | |
| Recovery Assessment Scale: Total Score | 0.18 * | 7 | 0 | 148 | |
| Recovery Assessment Scale: Total Score | -0.01 | 0 | 3 | 144 | |
| Study 15848 - WRAP vs. Services as Usual Waitlist (Cook, 2012a) | |||||
| Brief Symptom Inventory: Depression | 0.11 * | 4 | 0 | 458 | |
| Brief Symptom Inventory: Depression | 0.15 * | 6 | 6 | 448 | |
| Brief Symptom Inventory: Anxiety | 0.18 * | 6 | 0 | 458 | |
| Brief Symptom Inventory: Anxiety | 0.10 * | 3 | 6 | 448 | |
| Recovery Assessment Scale: Total | 0.21 * | 8 | 0 | 453 | |
| Recovery Assessment Scale: Total | 0.18 * | 7 | 6 | 439 | |
| Recovery Assessment Scale: Personal Confidence | 0.14 * | 5 | 0 | 456 | |
| Recovery Assessment Scale: Personal Confidence | 0.14 * | 5 | 6 | 445 | |
| Recovery Assessment Scale: Goal Orientation | 0.20 * | 7 | 0 | 458 | |
| Recovery Assessment Scale: Goal Orientation | 0.18 * | 7 | 6 | 446 | |
| Recovery Assessment Scale: Willingness to Ask for Help | 0.10 * | 3 | 0 | 458 | |
| Recovery Assessment Scale: Willingness to Ask for Help | 0.14 * | 5 | 6 | 447 | |
| Recovery Assessment Scale: Reliance on Others | 0.17 * | 6 | 0 | 454 | |
| Recovery Assessment Scale: Reliance on Others | 0.18 * | 7 | 6 | 443 | |
| Recovery Assessment Scale: No Symptom Domination | 0.18 * | 7 | 0 | 458 | |
| Recovery Assessment Scale: No Symptom Domination | 0.04 | 1 | 6 | 445 | |
| Brief Symptom Inventory: Global Severity Index | 0.19 * | 7 | 0 | 458 | |
| Brief Symptom Inventory: Global Severity Index | 0.08 | 3 | 6 | 448 | |
| Brief Symptom Inventory: Positive Symptom Total | 0.14 * | 5 | 0 | 458 | |
| Brief Symptom Inventory: Positive Symptom Total | 0.03 | 1 | 6 | 448 | |
| Hope Scale: Total Score | 0.09 * | 3 | 0 | 449 | |
| Hope Scale: Total Score | 0.13 * | 5 | 6 | 434 | |
| Hope Scale: Agency | 0.13 * | 5 | 0 | 454 | |
| Hope Scale: Agency | 0.15 * | 6 | 6 | 438 | |
| Hope Scale: Pathways | 0.03 | 1 | 0 | 451 | |
| Hope Scale: Pathways | 0.09 | 3 | 6 | 438 | |
| World Health Organization Quality of Life - Brief: Environment | 0.07 | 2 | 0 | 458 | |
| World Health Organization Quality of Life - Brief: Environment | 0.24 * | 9 | 6 | 431 | |
| Brashers' Patient Self-Advocacy Scale: Total Score | 0.15 * | 6 | 0 | 458 | |
| Brashers' Patient Self-Advocacy Scale: Total Score | 0.20 * | 7 | 6 | 447 | |
| Brashers' Patient Self-Advocacy Scale: Mindful Non-adherence | 0.12 * | 4 | 0 | 456 | |
| Brashers' Patient Self-Advocacy Scale: Mindful Non-adherence | 0.22 * | 8 | 6 | 447 | |
| Brashers' Patient Self-Advocacy Scale: Education | 0.14 * | 5 | 0 | 458 | |
| Brashers' Patient Self-Advocacy Scale: Education | 0.14 * | 5 | 6 | 447 | |
| Brashers' Patient Self-Advocacy Scale: Assertiveness | 0.11 * | 4 | 0 | 458 | |
| Brashers' Patient Self-Advocacy Scale: Assertiveness | 0.10 * | 3 | 6 | 447 | |
| Study 15854 - WRAP vs. Waitlist (O'Keeffe, 2016) | |||||
| Mental Health Recovery Star: Managing Mental Health | -0.16 | -6 | 0 | 34 | |
| Mental Health Recovery Star: Living Skills | 0.16 | 6 | 0 | 34 | |
| Mental Health Recovery Star: Social Networks | -0.22 | -8 | 0 | 34 | |
| Mental Health Recovery Star: Relationships | 0.33 | 13 | 0 | 34 | |
| Mental Health Recovery Star: Addictive Behavior | 0.45 | 17 | 0 | 34 | |
| Mental Health Recovery Star: Work | -0.10 | -3 | 0 | 34 | |
| Mental Health Recovery Star: Responsibilities | -0.25 | -9 | 0 | 34 | |
| Mental Health Recovery Star: Identity and Self-Esteem | -0.09 | -3 | 0 | 34 | |
| Mental Health Recovery Star: Trust and Hope | -0.08 | -3 | 0 | 34 | |
| Mental Health Recovery Measure | -0.23 | -8 | 0 | 34 | |
| Hospital Anxiety and Depression Scale: Total Score | -0.35 | -13 | 0 | 34 | |
| Hospital Anxiety and Depression Scale: Anxiety | -0.36 | -14 | 0 | 34 | |
| Hospital Anxiety and Depression Scale: Depression | -0.31 | -12 | 0 | 34 | |
| Beck Depression Inventory-II | -0.44 | -16 | 0 | 34 | |
| Adult well-being: Parent/caregiver physical health | |||||
| Study 15854 - WRAP vs. Waitlist (O'Keeffe, 2016) | |||||
| Mental Health Recovery Star: Physical Health and Self-Care | 0.01 | 0 | 0 | 34 | |
| Composite Outcomes | |||||
| Study 15854 - WRAP vs. Waitlist (O'Keeffe, 2016) | |||||
| World Health Organization Quality of Life Brief Version | -0.29 | -11 | 0 | 34 | |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention condition and a negative number favors the comparison condition. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Version 2.0, Sections 6.4 and 6.5 and may not align with effect sizes reported in individual publications. The Prevention Services Clearinghouse uses information reported in study documents and, when necessary, information provided by study authors in response to author queries to assign study ratings and calculate effect sizes (see Section 8.4.2 in the Handbook of Standards and Procedures, Version 2.0). The Prevention Services Clearinghouse typically relies on study-reported p-values to form the basis of the assessment of statistical significance for a finding, but will perform its own statistical test of a finding using any available information in study documents or author queries, as needed (see Section 6.3 in the Handbook of Standards and Procedures, Version 2.0). As a result, the effect sizes and statistical significance reported in the table may not align with the estimates as they are reported in study documents.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Demographic Characteristics
|
Populations of Interest*
|
Household Socioeconomic Status
|
||
| Study 15848 - WRAP vs. Services as Usual Waitlist | ||||||
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Canton, Cleveland, Columbus, Dayton, Lorain, Toledo, OH, USA | 2006 |
Average age: 45.8 years
63% Caucasian
28% Black 5% Hispanic or Latino 3% American Indian or Alaskan Native 1% Asian or Pacific Islander 0.4% Other Race or Ethnicity
66% Female
34% Male |
DSM-IV-TR diagnoses: 38% bipolar disorder, 25% depressive disorder, 12% schizophrenia, 10% schizoaffective disorder, 13% other | 15% Employed | ||
| Study 15847 - WRAP vs. FOCUS | ||||||
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Chicago, IL | 2015 |
Average age: 49 years
65% African American
27% White 7% Other or more than 1 race
59% Male
|
Clinical diagnosis: 49% schizophrenia or schizoaffective disorder, 28% bipolar disorder, 23% major depressive disorder | -- | ||
| Study 15854 - WRAP vs. Waitlist | ||||||
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Dublin, Ireland | 2012 |
Average age: 48.1 years
53% Female
47% Male |
100% Diagnosed with a mental or behavioral disorder |
50% Employed 39% Unemployed 11% Retired |
||
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated High
Study 15848Cook, J. A., Copeland, M. E., Floyd, C. B., Jonikas, J. A., Hamilton, M. M., Razzano, L., Carter, T. M., Hudson, W. B., Grey, D. D., & Boyd, S. (2012). A randomized controlled trial of effects of Wellness Recovery Action Planning on depression, anxiety, and recovery. Psychiatric Services, 63(6), 541-547. https://doi.org/10.1176/appi.ps.201100125
Cook, J. A., Copeland, M. E., Jonikas, J. A., Hamilton, M. M., Razzano, L. A., Grey, D. D., Floyd, C. B., Hudson, W. B., Macfarlane, R. T., Carter, T. M., & Boyd, S. (2012). Results of a randomized controlled trial of mental illness self-management using Wellness Recovery Action Planning. Schizophrenia Bulletin, 38(4), 881-891. https://doi.org/10.1093/schbul/sbr012
Jonikas, J. A., Grey, D. D., Copeland, M. E., Razzano, L. A., Hamilton, M. M., Floyd, C. B., Hudson, W. B., & Cook, J. A. (2013). Improving propensity for patient self-advocacy through wellness recovery action planning: Results of a randomized controlled trial. Community Mental Health Journal, 49(3), 260-269. https://doi.org/10.1007/s10597-011-9475-9
This study was conducted in a usual care or practice setting (Handbook Version 2.0, Section 7.2.2)Study 15847
Ben-Zeev, D., Brian, R. M., Jonathan, G., Razzano, L., Pashka, N., Carpenter-Song, E., Drake, R. E., & Scherer, E. A. (2018). Mobile health (mHealth) versus clinic-based group intervention for people with serious mental illness: A randomized controlled trial. Psychiatric Services, 69(9), 978-985. https://doi.org/10.1176/appi.ps.201800063
Ben-Zeev, D., Razzano, L. A., Pashka, N. J., & Levin, C. E. (2021). Cost of mHealth versus clinic-based care for serious mental illness: Same effects, half the price tag. Psychiatric Services, 72(4), 448-451. https://doi.org/10.1176/appi.ps.202000349
This study was conducted in a usual care or practice setting (Handbook Version 2.0, Section 7.2.2)Study 15854
O'Keeffe, D., Hickey, D., Lane, A., McCormack, M., Lawlor, E., Kinsella, A., Donoghue, O., & Clarke, M. (2016). Mental illness self-management: A randomised controlled trial of the Wellness Recovery Action Planning intervention for inpatients and outpatients with psychiatric illness. Irish Journal of Psychological Medicine, 33(2), 81-92. https://doi.org/10.1017/ipm.2015.18
This study was conducted in a usual care or practice setting (Handbook Version 2.0, Section 7.2.2)Studies Rated Low
Study 15850Fukui, S., Starnino, V. R., Susana, M., Davidson, L. J., Cook, K., Rapp, C. A., & Gowdy, E. A. (2011). Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery. Psychiatric Rehabilitation Journal, 34(3), 214-222. https://doi.org/10.2975/34.3.2011.214.222
This study received a low rating because the standards for addressing missing data were not met.Study 15849
Cook, J. A., Jonikas, J. A., Hamilton, M. M., Goldrick, V., Steigman, P. J., Grey, D. D., Burke, L., Carter, T. M., Razzano, L. A., & Copeland, M. E. (2013). Impact of Wellness Recovery Action Planning on service utilization and need in a randomized controlled trial. Psychiatric Rehabilitation Journal, 36(4), 250-257. https://doi.org/10.1037/prj0000028
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 15852
Mak, W. W. S., Chan, R. C. H., Pang, I. H. Y., Chung, N. Y. L., Yau, S. S. W., & Tang, J. P. S. (2016). Effectiveness of Wellness Recovery Action Planning (WRAP) for Chinese in Hong Kong. American Journal of Psychiatric Rehabilitation, 19(3), 235-251. https://doi.org/10.1080/15487768.2016.1197859
This study received a low rating because the standards for addressing missing data were not met.Studies Not Eligible for Review
Study 15846
Alaca, C., Coskun, S., & Aygun, O. (2026). The effects of wellness recovery action plan based psychoeducation program on the psychosocial health of caregivers of alzheimer's patients. Home Health Care Management & Practice, 38(1), 34-43. https://doi.org/10.1177/10848223251326873
This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)Study 15853
Mak, W. W. S., Tsoi, E. W. S., & Wong, H. C. Y. (2022). Brief Wellness Recovery Action Planning (WRAP) as a mental health self-management tool for community adults in Hong Kong: A randomized controlled trial. Journal of Mental Health, 33(2), 236-243. https://doi.org/10.1080/09638237.2022.2069723
This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)