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Mental illness self-management: a randomised controlled trial of the Wellness Recovery Action Planning intervention for inpatients and outpatients with psychiatric illness

Published online by Cambridge University Press:  28 April 2015

D. O’Keeffe*
DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
D. Hickey
Saint John of God Hospital Limited, Stillorgan, Dublin, Ireland
A. Lane
Department of Psychiatry, Psychotherapy and Mental Health Research, Saint Vincent’s University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
M. McCormack
Department of Clinical Psychology, University of Liverpool, Liverpool, UK
E. Lawlor
DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland Saint John of God Hospital Limited, Stillorgan, Dublin, Ireland
A. Kinsella
Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland, Dublin, Ireland
O. Donoghue
Saint John of God Hospital Limited, Stillorgan, Dublin, Ireland
M. Clarke
DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
*Address for correspondence: D. O’Keeffe, DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Blackrock, Co. Dublin, Ireland. (Email:



Wellness Recovery Action Planning (WRAP) is a cross-diagnostic, patient-centred, self-management intervention for psychiatric illness. WRAP utilises an individualised Wellness Toolbox, a six part structured monitoring and response system, and a crisis and post-crisis plan to promote recovery. The objective of this study was to evaluate the effect of WRAP on personal recovery, quality of life, and self-reported psychiatric symptoms.


A prospective randomised controlled trial, based on the CONSORT principles was conducted using a sample of 36 inpatients and outpatients with a diagnosis of a mental disorder. Participants were randomly allocated to Experimental Group or Waiting List Control Group conditions in a 1:1 ratio. Measures of personal recovery, personal recovery life areas, quality of life, anxiety, and depression were administered at three time points: (i) pre-intervention, (ii) post-Experimental Group intervention delivery, and (iii) 6-month follow-up. Data was analysed by available case analysis using univariate and bivariate methodologies.


WRAP had a significant effect on two personal recovery life areas measured by the Mental Health Recovery Star: (i) addictive behaviour and (ii) identity and self-esteem. WRAP did not have a significant effect on personal recovery (measured by the Mental Health Recovery Measure), quality of life, or psychiatric symptoms.


Findings indicate that WRAP improves personal recovery in the areas of (i) addictive behaviour and (ii) identity and self-esteem. Further research is required to confirm WRAP efficacy in other outcome domains. Efforts to integrate WRAP into recovery-orientated mental health services should be encouraged and evaluated.

Original Research
© College of Psychiatrists of Ireland 2015 

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