Improving Propensity for Patient Self-Advocacy Through Wellness Recovery Action Planning: Results of a Randomized Controlled Trial
- 1.7k Downloads
A fundamental aspect of successful illness self-management for people with serious mental illnesses is the ability to advocate for themselves in health and rehabilitation settings. This study reports findings from a randomized controlled trial comparing propensity for patient self-advocacy among those who received a peer-led mental illness self-management intervention called Wellness Recovery Action Planning (WRAP) and those who received usual care. Outcomes were self-reported engagement in self-advocacy with service providers, and the relationship between patient self-advocacy and other key recovery outcomes. In a multivariable analysis, at immediate post-intervention and 6-month follow-up, WRAP participants were significantly more likely than controls to report engaging in self-advocacy with their service providers. Higher self-advocacy also was associated with greater hopefulness, better environmental quality of life, and fewer psychiatric symptoms among the intervention group. These findings provide additional support for the positive impact of peer-led illness self-management on mental health recovery.
KeywordsMental illness self-management Patient self-advocacy Mental health recovery outcomes
This work was supported by the US Department of Education, National Institute on Disability and Rehabilitation Research; and the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (Cooperative Agreement #s: H133B050003, H133B100028). The views expressed do not reflect the policy or position of any Federal agency. The authors gratefully acknowledge the contribution of the WRAP instructors from the six Ohio study sites who gave so willingly of their time and expertise, as well as the Ohio Department of Mental Health and the Ohio county service boards who helped make this research possible, and the UIC Survey Research Laboratory.
- Adams, J. R., & Drake, R. E. (2006). Shared decision-making and evidence-based practice. Community Mental Health Journal, (42)1, 87–105.Google Scholar
- Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: W-H. Freeman and Company.Google Scholar
- Cook, J. A., Copeland, M. E., Corey, L., Buffington, E., Jonikas, J. A., Curtis, L. C., et al. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34(2), 113–120.PubMedCrossRefGoogle Scholar
- Cook, J. A., Copeland, M. E., Jonikas, J. A., Hamilton, M. M., Razzano, L. A., Grey, D. D., et al. (2011). Results of a randomized controlled trial of mental illness self-management using Wellness Recovery Action Planning. Schizophrenia Bulletin. doi: 10.1093/schbul/sbr012.
- Copeland, M. E. (2001). Wellness Recovery Action Plan: A system for monitoring, reducing and eliminating uncomfortable or dangerous physical symptoms and emotional feelings. Occupational Therapy in Mental Health, 77, 127–150.Google Scholar
- Copeland, M. E. (2002). Wellness recovery action plan (2nd ed.). Dummerston, VT: Peach Press.Google Scholar
- Derogatis, L. R. (Ed.). (1993). Brief symptom inventory: Administration scoring and procedures manual (3rd ed.). Minneapolis, MN: National Computer Systems.Google Scholar
- Epstein, J., Barker, P., Vorburger, M., & Murtha, C. (2002). Serious mental illness and its co-occurrence with substance use disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies (DHHS Publication No. SMA 04-3905, Analytic Series A-24).Google Scholar
- Giffort, D., Schmook, A., Woody, C., et al. (1995). Construction of a scale to measure consumer recovery. Springfield, IL: Illinois Department of Health and Human Services, Office of Mental Health.Google Scholar
- Kennedy, A., Reeves, D., Bower, P., Lee, V., Middleton, E., Richardson, G., et al. (2007). The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: A pragmatic randomised controlled trial. Journal of Epidemiology and Community Health, 61(3), 254–261.PubMedCrossRefGoogle Scholar
- Onken, S. J., Dumont, J. M., Ridgway, P., Dornan, D. H., & Ralph, R. O. (2002). Mental health recovery: What helps and what hinders? A national research project for the development of recovery facilitating system performance indicators. Alexandria, VA: National Association of State Mental Health Program Directors, National Technical Assistance Center for State Mental Health Planning.Google Scholar