Guillermo Billy Diaz's Wellness Recovery Action Plan

Transcription

1 Wellness Toolbox: Tools that have helped me in the past These pages guide me through my Wellness Recovery Action Plan (WRAP). I store my WRAP so I can access and review it regularly and for making changes in my plan whenever I feel I need to. It guides me in times of trouble. My Wellness Toolbox is the key to my WRAP. It provides me with the basic underpinning for all the other parts of my WRAP; the cornerstone. It lists the things I have done in the past, or do now, to stay well. I Walk, Buy a Mountain Dew and a Snickers bar, Help Others, Respond to s, Watch a movie at night... It also includes things I do to help myself continue to feel well when I am feeling well. In my Wellness Toolbox I include: singing, playing a particular volleyball, reading, drinking water, praying, and calling friends. Each of these things is considered a Wellness Tool. Because it is such a beneficial source of information to me, my Wellness Toolbox is referred to often when getting ideas to complete my WRAP. Thus, it is important for me to take time to create a good Wellness Toolbox that reflects my personal interests and promotes my recovery. taking medications, vitamins, minerals, herbal supplements attending a support group see my counselor peer counseling exchange listening focusing exercises relaxation exercises stress reduction exercises get a medication check get a second opinion talk to a friend - I find this to be really helpful talk to a health care professional guided imagery journaling (writing in my Wellness notebook) creative affirming activities exercise diet considerations getting as much natural light as possible extra rest taking time off from home taking time off from work responsibilities hot packs (or cold packs) do something "normal" (washing hair, shaving) call a warm or hot line surround myself with people who are positive, affirming and loving wear something that makes you feel good look through old pictures, scrapbooks and photo albums make a list of your accomplishments spend ten minutes writing down everything good you can think of about yourself do something that makes you laugh do something special for someone else Page 1 of 24

2 get some little things done repeat positive affirmations focus on and appreciate what is happening right now take a warm bath listen to music, make music or sing My list of tools also includes things I want to avoid: Alcohol, sugar and caffeine Getting overtired Certain people Going to bars Section 1: Your Daily Maintenance Plan Feeling Well List: What I'm like when I'm feeling well My Daily Maintenance Plan The first part of my WRAP is my Daily Maintenance Plan. My Feeling Well List is part of my Daily Maintenance Plan. This is where I describe my definition of myself when I am feeling all right. My Feeling Well list is my list of words that describe me when I am feeling well: Happy Easy-Going Fun jokes Enjoys life as it is presented I refer to this list when I am unsure how I am feeling, and when I am feeling so badly I can t remember what I felt like when I felt well. bright cheerful talkative outgoing active energetic humorous supportive easy to get along with content peaceful calm quiet Page 2 of 24

3 Daily Activities: I need to do this for myself every day My list of daily activities. Things I know I need to do for for my Wellness every day to keep myself feeling all right. A daily maintenance plan helps me recognize those things which I need to do to remain healthy, and then to plan my days accordingly. When things have been going well for a while and I notice I am starting to feel worse, this is the place to remind me of what I did to get better in the past. When I'm starting to feel out of sorts, I can often trace it back to not doing something on my Daily Maintenance List. Over time my Daily Maintenance List may seem silly or simplistic to me, and I may be tempted to skip or skim over it. However, I find that it is the most important part of the whole plan. Often I am surprised at how much better I will feel after taking these positive steps on my own behalf. When I am beginning to work on recovery from an episode, keeping up with a daily maintenance list can seem impossible. So I keep the daily maintenance list simple and short: smile at people brush my teeth eat fruit take a walk for fresh air play with a pet do something fun for 1/2 hour watch a video before going to bed Daily Reminders: Things I might need to do My list of things I might need to do on any given day. My reminder list for things I might need to do. Reading through this list daily helps keep me on track. On any given day there are things I might need to do, things I don t need to do every day, but if I need to do them on a certain day and I don t do them, it can cause stress and hardship for me. setting up appointments with my health care professional taking my daily medication attending a special event in my community buying healthy groceries paying my bills cleaning the apartment This list also includes good things I like to do for myself from time to time: spending time with my counselor or case worker checking my s from family and friends going for a walk watching a movie learning something on the internet Section 2: Triggers Page 3 of 24

4 Triggers: Things that happen that may worsen my mental health difficulties My triggers are external events or circumstances that, if they happen, produce feelings that are very uncomfortable. I feel like I am getting ill. These are normal reactions to events in our lives, but if we don t respond to them and deal with them in some way, I may notice that I am feeling worse and worse. If they happened, they might cause me to feel badly. They have triggered or increased problems in the past. The awareness of my susceptibility (triggers) and development of plans to deal with triggering events when they come up increases my ability to cope, and to avoid the development of an acute onset of more severe mental health problems. It is not important to project catastrophic things that might happen, such as war, natural disaster, or a huge personal loss. If those things were to occur, you would use the actions you describe in the triggers action plan more often and increase the length of time you use them. anniversary dates of losses or trauma traumatic news events being very over-tired work stress family friction relationship ending spending too much time alone being judged or criticized being teased or put-down financial problems physical illness sexual harassment hateful outbursts by others aggressive-sounding noises (sustained) being the scapegoat being condemned/shunned by other(s) being around an abuser, or someone who reminds me of a past abuser things that remind me of abandonment or deprivation intimacy excessive stress someone trying to tell me how to run my life self blame extreme guilt (from saying "No", etc.) Page 4 of 24

5 Triggers Action Plan: Things I can do to keep my triggers from having a more serious effect develop a plan of what you can do if your triggers come up to keep them from making you feel badly. Include things that have worked for you in the past and ideas you have learned from others. Use your Wellness Toolbox for ideas. The awareness of my susceptibility (triggers) and development of plans to deal with triggering events when they come up increases my ability to cope, and to avoid the development of an acute onset of more severe mental health problems. It is not important to project catastrophic things that might happen, such as war, natural disaster, or a huge personal loss. If those things were to occur, you would use the actions you describe in the triggers action plan more often and increase the length of time you use them. As I become more and more familiar with what my triggers are, I am able to respond quickly, doing things that will help me stay well. Including on this list things I could do in different situations. Like if I were on a bus and noticed a trigger I could take a few deep breaths but it wouldn t be a good place to start dancing or watch a favorite TV show. But these tools might be ones I could use if I were triggered and were at home. make sure I do everything on my daily maintenance program call a support person and ask them to listen while I talk through the situation do some deep breathing exercises remember that it's okay to take care of myself work on changing negative thoughts to positive ones get validation from someone I feel close to some form of spiritual communication such as prayer or meditation Section 3: Early Warning Signs Early Warning Signs: Internal signs that my mental health difficulties may be getting worse Early warning signs are internal and may be unrelated to reactions to stressful situations. In spite of our best efforts at reducing triggers and negative feelings, we may begin to experience early warning signs, subtle signs of change that indicate we may need to take some further action. Reviewing early warning signs regularly helps us to become more aware of them, allowing us to take action before they worsen. In identifying my early warning signs, I think back to times when I have felt badly, and to what I was feeling like before I started feeling this way. I notice more and more of them over time as my awareness level increases. anxiety nervousness forgetfulness inability to experience pleasure lack of motivation feeling slowed down or speeded up avoiding doing things on daily maintenance list being uncaring not answering the phone not buckling your seat belt not wanting to do things you usually enjoy Page 5 of 24

6 Early Warning Signs Action Plan: Responses to my early warning signs Early Warning Signs Action Plan Many people overlook their early warning signs and keep doing what they usually do. However, to avoid further difficulties, it is essential to take action at this time. The longer you wait the harder it gets. Using your Wellness Tools, you can respond quickly when you notice early warning signs, taking action before you feel worse and preventing more difficult times. Using my Wellness Tools, I can respond quickly when I notice early warning signs, taking action before I feel worse and preventing more difficult times. do the things on my daily maintenance plan whether I feel like it or not tell a supporter/counselor how I am feeling and ask for their advice. Ask them to help me figure out how to take the action they suggest. do exchange listening at least once a day do at least one focusing exercise a day do at least three 10 minute relaxation exercises each day Section 4: When Things Are Breaking Down When Things Are Breaking Down: Signs that tell me things are getting much worse When Things Are Breaking Down In spite of our best efforts, our mental health difficulties may progress to the point where they are very uncomfortable, serious and even dangerous, but we are still able to take some action on our own behalf. This is a very important time. It is necessary to take immediate action to prevent a crisis. Make a list of the signs which, for you, mean that things have worsened and are close to the crisis stage. This is my list of the signs which, for me, mean that things have worsened and are close to the crisis stage. I realize that signs vary from person to person. What may mean "things are breaking down" to one person may mean a "crisis" to another. anxiety feeling very oversensitive and fragile irrational responses to events and the actions of others feeling very needy unable to sleep for... increased pain headaches sleeping all the time avoiding eating wanting to be totally alone Page 6 of 24

7 Plan for When Things are Breaking Down: What I need to do to take care of myself Plan for When Things are Breaking Down Write a plan that you think will help reduce your mental health difficulties when they have progressed to this point. The plan now needs to be very directive with fewer choices and very clear instructions. This is my list of the signs which, for me, mean that things have worsened and are close to the crisis stage. I realize that signs vary from person to person. What may mean "things are breaking down" to one person may mean a "crisis" to another. The action plan for "When Things Are Breaking Down" needs to be very decisive. Taking good care of myself, and welcoming help and encouragement from supporters helps keep me safe from crisis. call my doctor or other health care professional, ask for and follow their instructions call and talk as long as I need to my supporters arrange for someone to stay with me around the clock until my signs subside take action so I cannot hurt myself if my signs get worse. Crisis Plan Part 1 What I'm Like When I'm Feeling Well Crisis Plan Writing a clear crisis plan when you are well, to instruct others about how to care for you when you are not well keeps you taking responsibility for your own care. It will keep your family members and friends from wasting time trying to figure out what to do for you that will be helpful. It relieves the guilt felt by family members and other care givers who may have wondered whether they were taking the right action. It also insures that your needs will be met and that you will get better as quickly as possible. A crisis plan needs to be developed when you are feeling well. However, you cannot do it quickly. Decisions like this take time, thought and often collaboration with health care providers, family members and other supporters. While you may have developed other plans rather quickly, this plan is likely to take more time. Don t rush the process. Work at it for a while, then leave it for several days and keep coming back to it until you have developed a crisis plan that you feel has the best chance of working for you. The next section of your WRAP is your Crisis Plan. This plan consists of several parts. Noticing and responding to signs early reduces the chances that you will find yourself in crisis. But it is important to confront the possibility of crisis, because in spite of your best planning and assertive action in your own behalf, you could find yourself in a situation where others will need to take over responsibility for your care. This is a difficult situation, one that no one likes to face. In a crisis you may feel like you are totally out of control. Over the next few steps, you will be given ideas that others have included on their crisis plan. It will help you in developing your crisis plan. By writing a clear crisis plan when I am well, to instruct others about how to care for me when I am not well helps me take responsibility for my own care. It spares my family members and friends from wasting time trying to figure out what to do for me that will be helpful. It relieves the guilt felt by family members and other care givers who may have wondered whether they were taking the right action. It also ensures that my needs will be met and that I will get better as quickly as possible. Page 7 of 24

8 My crisis plan is developed when I am feeling well. However, I cannot do it too quickly. Decisions like this take time, thought, and often collaboration with health care providers, family members and other supporters. While I may have developed other plans rather quickly, this plan is likely to take more time. No rushing the process. I work at it for a while, then leave it for several days, and keep coming back to it until I have developed a crisis plan that feels like it has the best chance of working for me. I have already developed a section on what I am like when Iam well, at the beginning of Wellness Recovery Action Plan. I can copy it from there, and insert it in the plan here if I choose to do it that way. In this section it can be brief. In the first section write words or phrases that describe what you are like when you well. Descriptive words might include: talkative quiet outgoing withdrawn adventurous cautious outspoken reserved ambitious laid back retiring intellectual humorous sensible practical energetic pale Crisis Plan Part 2 Page 8 of 24

9 Signs of Serious Mental Health Difficulties: When others need to take over my care Signs of Serious Mental Health Difficulties You may find that this is the most difficult part of developing your crisis plan. Describe those signs that would indicate to others that they need to take over responsibility for your care and make decisions in your behalf. This is hard for everyone. No one likes to think that anyone will ever have to take over responsibility for them or their care. And yet, through careful, well developed descriptions, you stay in control even when things seem to be out of control. the Crisis Plan or Advance Directive is titled Indicators that I Need Assistance from Others. Here you will clearly describe signs that you need others to assist you and perhaps make decisions on your behalf. These indicators must be described well, so it is clear to others that help is needed, even though you may not tell them you need help, or may even tell them you don t need help. This is not an easy task. It may bring up for you times in your life you would rather not think about. Be very clear in describing the symptom. Don t try to summarize. Use as many words as it takes to describe the behavior. Your signs might include: being unable to recognize or correctly identify family members and friends uncontrollable pacing, unable to stay still not combing my hair (for how many days?) not cooking or doing any housework (for how many days?) not understanding what people are saying thinking I am someone I am not thinking I have the ability to do something I can t do (like fly) abusive, destructive or violent behavior, toward self, others, or property shoplifting making sexual advances toward people I don t know spending large amounts of money (how much?) on things I don t need giving away money and possessions to people I don t know substance abuse not getting out of bed (for how long?), and refusing to eat or drink (for how long?) Crisis Plan Part 3 Supporters: People who can take over my care Page 9 of 24

10 Name Connection Phone Number Notes Page 10 of 24

11 . Supporters The next section of the crisis plan lists those people who you want to take over for you when the signs you list come up. They can be family members, friends or health care professionals. When you first develop this plan it may be mostly health care professionals. But as you work on developing your support system, try and change the list so you rely more heavily on family members and friends. In this section, list those people you want to take over for you when the signs you listed in the previous section come up. They can be family members, friends or health care providers. They should be people who can be counted on to follow the plans. When you first develop this plan, the list may be mostly health care providers. It is hoped that over time the list will rely more heavily on family members and friends, as they are most available. It s best to have at least five people on this list so it is more likely that someone will be available if help is needed. Peers can be very good supporters for each other. It is a good idea if, before listing someone in this part of the plan, that you talk with the prospective supporter about what is wanted and make sure they understand and agree to be in the plan. You, the person developing the plan, and only you, can decide who these people should be. Have at least five people on your list of supporters. If you have only one or two, they might not be available when you really need them eg. on vacation, sick. If you don t have that many supporters now, you may need to work on developing new and closer relationships with people by going to support groups, community activities and volunteering. Following are some examples of attributes people want from those who take over and make decisions for them: responsible, Page 11 of 24

12 . honest, sincere, calm, compassionate, and understanding. You may want to name some people for certain tasks like taking care of the children or paying the bills and others for tasks like staying with you and taking you to health care appointments. People I Do Not Want Involved Name Reason. People I Do Not Want Involved You will also want to include a list of those people you DO NOT want involved in your support system for whatever reason. There may be health care professionals or family members that have made decisions that were not according to your wishes in the past. Also include here a list of people who you do not want to be involved in any way if you are having a crisis. They may be people you like a lot but that don t do well in hard times. They may become agitated, controlling, judgmental, threatening or scared. They may try to make do things that are not in your plan, or that you know won t help. They may be people who have treated you badly in the past. They could inadvertently get involved in your care again if you don t include them in this list of people you do not want involved in any way in your care or treatment. Example: Person: Uncle Reason: I don't want him to know my problems. Settling Disputes Between Supporters: How I want it handled Settling Disputes Between Supporters Many people like to include a section that describes how they want possible disputes between supporters settled. For instance, you may want to say that a majority need to agree, or that a particular person or two people make the determination in that case. Or you may want some organization or agency to intervene on your behalf. I would like Tom Smith to resolve all disputes that might occur between my supporters Crisis Plan Part 4 My Health Care Providers Page 12 of 24

13 Name Type Phone Number Notes Modoc County Health Services Current Medications Other Key Contacts In this section of the plan, you will develop a complete listing that includes contact information for all health care providers and when they should be contacted. In this section you will want to be sure to include: Names, roles, and phone numbers of all care providers like doctors, counselors, case managers, vocational counselors, etc. and under what circumstances they should be contacted. Name of insurance provider and key numbers in case doctors, treatment facilities or pharmacies need them. Name and phone number of your pharmacy. To avoid medication interactions, use only one pharmacy for all your medications and make sure they have a complete listing of all the medications you are using on their computer. Check for possible negative interactions each time you get a new prescription or change doses. Medications you are taking, why you are taking them, dosage, time administered and how you take them. For Example: Name: Dr. James Phone: Notes: Call when medications need to be changed or refilled. Martha Cleary, Counselor Call her, explain the situation and ask for suggestions. Arrange for me to have an appointment with her if I am willing to go and if someone can take me. Page 13 of 24

14 Medication Dosage Prescriber Pharmacy Notes Wellbutrin Preferred Medications 100 MG tablet Crisis Plan Part 5 Dr. Genack Rite Aid Current Medications List the medications you are currently taking for any reason, the dosage, when these medications are taken and why you are taking them. Include the name of the prescribing doctor and the pharmacy where you get this prescription filled. List all medications, vitamins, or herbal supplements taken for any reason. Current Medications Medication Dosage Prescriber Pharmacy Notes Wellbutrin Acceptable Medications Medications to Avoid 100 Mg tablet Dr. Genack Rite Aid Preferred Medications List those medications you would prefer to take if medications or additional medications became necessary, and why you would choose those. Medication Dosage Prescriber Pharmacy Notes Wellbutrin Medication Acetaminophen 100 Mg tablet Notes Dr. Genack Rite Aid Acceptable Medications List those medications that would be acceptable to you if medications became necessary and why you would choose those. Gives me "restless leg syndrome" Medications to Avoid List those medications that must be avoided and give the reasons Page 14 of 24

15 Treatments Treatments Here you will list treatments you have found to be helpful like massage and acupuncture. In this section, list those treatments that have been helpful in the past, that could be used now, and how and when they could be used. Include the name of the person or people who provide this treatment. This could include things like a chiropractic visit and various kinds of whirlpool therapy. Which treatments and complimentary therapies have worked for you: massage acupuncture accupressure counseling Treatments to Avoid Treatments to Avoid List any treatments that you do not want. It is important that you are very specific about this. List those treatments you would not want. The one that comes up here most often is electroconvulsive therapy. Some people have found it to be very helpful while others do not want it under any circumstance. If you are not sure how you feel about a specific treatment, find out more about it before including it in your plan. Ask your health care providers and mental health organizations for information, look it up on the internet or your library, and ask other people who have had this treatment. Crisis Plan Part 6 Home/Community Care/Respite Center Crisis Plan Part 7 Page 15 of 24

16 Hospitals and Treatment Facilities Name Contact Phone Number Notes. Hospitals and Treatment Facilities In this section, list the treatment facilities you would like to use if family members and friends cannot provide you with care, or if your condition requires hospital care. In this section of your crisis plan, list the treatment facilities you would like to use if your home/community/respite plan cannot be implemented, family members and friends cannot provide you with care, or if your condition requires hospital care. You can also include a list of treatment facilities you would like to avoid such as places where you received poor care in the past. Also include the names of people you would like to take you home when you are released. Your options may be limited by the facilities that are available in the area and applicable insurance coverage. It may take some research, either through phoning, visiting or an Internet search to find out about treatment facilities in the area. Hospitals and Treatment Facilities To Avoid Name Notes. Hospitals and Treatment Facilities to Avoid List treatment facilities you would like to avoid such as places where you have received poor care in the past. Crisis Plan Part 8 Page 16 of 24

17 What Helps Things Others Can Do For Me That Would Help Me To Feel Better Section 8 is about what helps and what doesn't help. Here you will describe for your supporters what they can do that would help you to feel better. Many of these things may already be in the Wellness Toolbox. In this section you describe for your supporters what they can do that would be helpful. This is a new concept in crisis care. In the past, people did what they thought was best for the person they were caring for. Sometimes it was helpful. Often it was not helpful. Sometimes it was even harmful. The only options considered were medications, hospitalization, seclusion and restraint. (Medications may still be on your list of things that will help. Be specific about kinds and amounts.) Here you will describe for your supporters what they can do that would help you to feel better. Many of these things may already be in the Wellness Toolbox. Examples: Hold me; go for a walk with me; watch a funny video with me; listen to jazz with me; cook me good food; set me up so I can draw or paint. In addition this can also include a list of things that others might do that would not be helpful, and that might even make the situation worse. This part of the plan is very important and deserves careful attention. The list might include things like don t: threaten me, blame me, or force me to do things. What doesn t help or might even make things worse Things Others Can Do For Me That Would Help Me To Feel Better Section 8 is about what helps and what doesn't help. Here you will describe for your supporters what they can do that would help you to feel better. Many of these things may already be in the Wellness Toolbox. In this section you describe for your supporters what they can do that would be helpful. This is a new concept in crisis care. In the past, people did what they thought was best for the person they were caring for. Sometimes it was helpful. Often it was not helpful. Sometimes it was even harmful. The only options considered were medications, hospitalization, seclusion and restraint. (Medications may still be on your list of things that will help. Be specific about kinds and amounts.) Here you will describe for your supporters what they can do that would help you to feel better. Many of these things may already be in the Wellness Toolbox. Examples: Hold me; go for a walk with me; watch a funny video with me; listen to jazz with me; cook me good food; set me up so I can draw or paint. In addition this can also include a list of things that others might do that would not be helpful, and that might even make the situation worse. This part of the plan is very important and deserves careful attention. The list might include things like don t: threaten me, blame me, or force me to do things. Things you need others to take care of It should also include a list to things you need others to take care of for you during this time like getting the groceries, providing care for children or pets, watering plants, paying bills, cleaning the house. Crisis Plan Part 9 Page 17 of 24

18 When Supporters No Longer Need to Use This Plan When Supporters No Longer Need to Use This Plan In the last part of the Crisis Plan, you list signs that would let your supporters know you have recovered enough so that your supporters no longer need to use this plan. In the last part of the Advance Directive or Crisis Plan, you give your supporters information on how to recognize when you have recovered enough so that you can take care of yourself and to let them know that they no longer need to use this plan. Of course you don t want people caring for you when you can easily take care of yourself. List those signs that would tell others they you are feeling much better and that they no longer need to follow the directions in this Crisis Plan. Make sure it is clear as you would not want someone to stop caring for you when you still need care, but would want them to stop if you were feeling much better. While these indicators differ from person to person, some common ones include: when I am eating at least two meals a day when I am awake for six hours a day when I am taking care of my personal hygiene needs daily when I can carry on a good conversation when I can easily walk around the house Signing Your Crisis Plan I developed this plan on (date) with the help of Any plan with a more recent date supersedes this one. Signed Witness Witness Attorney Date Date Date Date Durable Power of Attorney (If you have one) Phone number Page 18 of 24

19 Post Crisis Plan Well Enough To Think About Recovery Finalizing and Signing Your Plan Now you have completed your Crisis Plan or Advance Directive. Review it and ask your supporters to review it several times before you finalize it. Have a discussion with your supporters. Ask them if there are parts of the plan that they don t understand, that could be stated more clearly, that might be hard to follow or that they think should not be included. Take their suggestions into consideration as you finalize your plan. Ask your state protection and advocacy for information on legalizing your plan. Post Crisis Plan That time after you have had a very difficult time and when you are working toward feeling good again can be very difficult. Others may assume you are still having difficulties and try to control you. You may not trust your own feelings and behaviors. You may be feeling very discouraged. Thinking about this possibility before you have any difficulties, when you are feeling all right, can make it easier for you to recover from a crisis. The Post Crisis Plan guides you through the process of addressing numerous issues that you may be addressing as you work on your recovery. You can answer some of the questions now and others when you are actually in this situation. Many people find that it is helpful to review the questions when they are feeling well, write some possible responses and then revise and add to it when they are actually recovering from a difficult time. Well Enough To Think About Recovery How will I know, and how will my supporters know, that I am doing well enough to think about my recovery? So that you and others are aware a crisis has passed, indicate characteristics about yourself that show this to be accurate. Such characteristics might include: eating three meals a day, having increased interest in self-care, and making plans to visit with family and friends. How I Would Like To Feel When I Have Recovered From This Crisis How I Would Like to Feel When I Have Recovered You may want to refer to the first section of your Wellness Recovery Action Plan - What I am Like When I am Well. However, this may be different from what you feel like when you are well - your perspective may have changed in this crisis. Post Recovery Supporters List Page 19 of 24

20 Name Connection Phone What I Need Them To Do. Post Recovery Supporters List List the people you would like to support you if possible during this post crisis time including people you would like to have stay with you during difficult times, take you to appointments and make other arrangements for you. Refer to your list of supporters in your Crisis Plan. Safe Comfortable Place Safe Places If you are being discharged from a treatment facility, do you have a place to go that is safe and comfortable? What do you need to do to insure that you have a safe comfortable place to go? What Will You Do To Insure You Will Feel Safe At Home? If you have been hospitalized, your first few hours at home are very important. Will you feel safe and be safe at home? What will you need to do to insure that you will feel and be safe at home? If The Following Things Were In Place, It Would Ease My Return Things To Do It would ease my return if my kitchen were clean - I can ask my sister to do that for me. I will pay any past due bills. I will have plenty of groceries on hand - Bill could take care of that. Someone to answer the phone for me. I will ask Tom to get me a stack of funny movies to watch Things I Must Take Care Of As Soon As I Can Things I Must Take Care Of As Soon As I Can Mow the lawn Call my family Clear out my s Go to a support group Things I Can Ask Someone Else To Do For Me Things I Can Ask Someone Else To Do For Me Pick up my medications Vacuum Get my car filled with gas Take me out for breakfast or lunch Pick up my mail Things That Can Wait Until I Feel Better Strenuous yard work Getting in touch my with brother Cleaning the closets Calling my employer Page 20 of 24

21 Things I Need To Do For Myself Every Day While I Am Recovering From Crisis Shower Take my medications and vitamins Get at least half an hour of outdoor exercise Eat three meals including breakfast Take time out to meditate Check in with my spouse Things I Might Need To Do Every Day While I Am Recovering From This Crisis Check in with a friend Go to a support group Contact a peer Go fishing Get out of my apartment Read Things and People I Need to Avoid While I Am Recovering From This Crisis The local bar Drinking buddies My oldest sister Alcohol Marijuana The center of town My ex-spouse Signs That I May Be Beginning to Feel Worse Nervousness Impatience Anxiety Unable to sleep Hungry all the time Irritable Wellness Tools I Will Use If I Am Starting To Feel Worse Peer counseling Relaxation exercises Exercise Eating out with a friend Cutting back on caffeine Working on art projects Things I Need to do to Prevent Further Repercussions From This Crisis - and When I Will do These Things Make payment arrangements on my bills - before the end of the month Arrange for visits with my children - as soon as I feel ready Make an appointment with my primary care physician for a check up - right away Find myself a new counselor - before the middle of the month Go to AA - within the next two weeks People To Thank, Apologize To, or Make Amends With Page 21 of 24

22 Name Action When How. Thank I owe my supporter a thank you for gathering my mail while I was getting better. When Medical, Legal, or Financial Issues That Need To Be Resolved Issue Medical, Legal, or Financial Issues To Resolve Resolution Things I Need to do to Prevent Further Loss Prevent Further Loss This could include such things as canceling credit cards, getting official leave from work if it was abandoned, cutting ties with destructive friends, etc. Signs That This Post Crisis Phase is Over I have my appetite back I feel comfortable walking to the post office alone I am cooking for myself I am having fewer flashbacks I sleep through the night Changes in the First 4 Sections of my WRAP That Might Help Prevent a Crisis in the Future Add half an hour of meditation time to my daily maintenance plan Add disagreements with family members and rainy days to my list of triggers and doing a diversionary activity like reading to triggers action plan Add lethargy to my list of early warning signs. Add an hour of daily exercise to my early warning signs action plan Add crying all the time to my list of signs that things are breaking down and getting out of the house to my when things are breaking down action plan Changes in My Crisis Plan That Might Ease My Recovery Change medications to ones I am now taking Include being unable to stop pacing as a sign that others need to step in and help Include making me popcorn on my list of things that others can do to help Take my mother and Dr. Chase off my list of supporters Changes I want to make in my lifestyle or life goals Get some vocational training or go back to college Change jobs Reconcile with my partner Move to a different area Move to the country Get a room mate Get a pet How I'll call the bank for some assistance on reconciling my account Page 22 of 24

23 What did I learn from this crisis? I cannot ever use alcohol How important my family is to me How important it is to use my WRAP I need to get my sleep I never want to overspend again Are there changes I want or need to make in my life as a result of what I have learned? Avoiding eating sugar Pay close attention to my diabetes regime Switch counselors Work on building my support system Stay away from drug dealers If so, when and how will I make these changes? I am going to start looking for a new job after I go back to work I am going to change my diet now I am going to start looking for a new counselor as soon as I feel ready I am going to start going back to the support group next month. Timetable for Resuming Responsibilities Responsibility Person Filling In Person Assisting Task Plan for Resuming. Timetable for Resuming Responsibilities It may help you to set up a timetable for resuming responsibilities that others had to take over or that did not get done while you were having a hard time. Page 23 of 24

24 . Using Your WRAP Now that your WRAP is as complete as you want to make it at this time, set up a system for daily review of the plan. Many people report that they like to review their plan first thing in the morning so it will keep them on track through the day. Then they refer back to it if needed. Remember that as you become familiar with the plan, you will find that the review process takes less time. Give copies of your crisis plan to the supporters you list on that plan. People who are using these plans regularly and updating them as necessary are finding that they have fewer difficult times, and that when they do have a hard time it is not as bad as it used to be and it doesn t last as long. Developing a WRAP is not easy. Now that you have completed yours, or even if you have completed some parts of it, plan a celebration for yourself. This is a great achievement. Page 24 of 24