Objective:The Wellness Recovery Action Plan (WRAP) is a structured approach to illness self-management that is widely used within mental health services. This systematic review identifies, appraises, and metaanalyzes quantitative evidence from experimental or quasi-experimental comparison group designs for effects of WRAP on measures reflecting personal recovery and clinical symptomatology. Method: A systematic strategy was used to search 6 electronic reference databases (Medline, CINAHL, EMBASE, PsycINFO, PsycARTICLES, The Cochrane Library) using full-text, keywords, and Medical Subject Headings (MeSh)/ Thesaurus headings terms. Unpublished research was identified using the same strategy in the EThOS database. Controlled trials of WRAP were selected and assessed for quality. Meta-analyses were applied to quantitative data to establish the effects of WRAP on outcomes of interest. Results: Of 253 studies initially identified, 5 quantitative studies (reported in 6 papers) reporting controlled trials were included in the review. Meta-analyses revealed that, relative to inactive control conditions, WRAP was (a) superior for promoting self-perceived recovery outcomes (demonstrating a small-but-significant pooled effect), but (b) not superior for reducing clinical symptomatology-although restriction to randomized-controlled trials revealed 1 small effect favoring WRAP for reducing depression. Conclusions and Implications for Practice: Participation in WRAP has positive outcomes for participants, quantifiable using comprehensive measures of self-perceived recovery. Improvements were not sustained over time. Future research could explore this, as well as potential effects of follow-up WRAP sessions. The results support a move to broader measurement of outcomes within mental health, away from a reliance on clinical outcome measures. Recommendations for further research are made. Impact and ImplicationsThe current article pooled data from studies into the effectiveness of the Wellness Recovery Action Plan in adult mental health settings. The findings provide support for a broader conceptualization of outcomes than clinical symptom measurement: demonstrating significant growth in self-identified personal recovery in the absence of significant symptom reduction.

Purpose The purpose of this systematic review was to address two questions: what is the qualitative evidence for the effects of the Wellness Recovery Action Plan (WRAP) training, as perceived by adults with mental health difficulties using it? What is the quality of qualitative literature evaluating WRAP? Design/methodology/approach Five electronic reference databases and the EThOS database for unpublished research were systematically searched, as well as two pertinent journals. Study quality was assessed using Critical Appraisal Skills Programme criteria and results analysed using thematic synthesis. Findings Of 73 studies, 12 qualitative papers met inclusion criteria and were generally good quality. Analyses demonstrated expected findings, such as increased understanding and active management of mental health in the context of group processes. Results also highlighted that WRAP training promoted acceptance and improved communication with professionals. Peer delivery of WRAP was highly valued, with contrasting perceptions of peers and professionals evident. Some cultural considerations were raised by participants from ethnic minorities. Research limitations/implications WRAP training participation has positive self-perceived effects beyond those captured by measures of recovery. Broader implications are suggested regarding earlier access to WRAP, professional support and communication between professionals and service users. Recommendations for further research include the relationship between social support and illness self-management and peer-delivered acceptance-based approaches. Multiple time-point qualitative studies could offer insights into WRAP training processes and whether changes are sustained. Originality/value As the first review of qualitative evidence regarding WRAP training, value is offered both through increased understanding of outcomes and also guidance for future research.