The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning (WRAP) by comparing it with usual care. The primary outcome was reduction of psychiatric symptoms, with secondary outcomes of increased hopefulness, and enhanced quality of life (QOL). A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health settings in 6 Ohio communities and randomly assigned to the 8-week intervention or a wait-list control condition. Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed-effects random regression analysis. Compared to controls, at immediate postintervention and at 6-month follow-up, WRAP participants reported: (1) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total, (2) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness, and (3) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale. These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms, enhances participants' hopefulness, and improves their QOL over time. This confirms the importance of peer-led wellness management interventions, such as WRAP, as part of a group of evidence-based recovery-oriented services.

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Examined children's coping and involuntary responses to the stress of living with a depressed parent in relation to their symptoms of anxiety/depression and aggression. Sixty-six clinically depressed adults rated their children's (ages 7 to 17 years old; N = 101) coping and involuntary responses to parental stressors and anxiety/depressive and aggressive behavior symptoms. Based on parent report, children of depressed parents had high rates of symptoms of anxiety/depression and aggression, were exposed to moderate levels of parental stressors (parental intrusiveness, parental withdrawal), and responded to the stress of living with a depressed parent in ways that were associated with symptoms of psychopathology. Children's use of secondary control coping (e.g., positive thinking, acceptance, distraction) was associated with fewer anxiety/depression and aggression symptoms. In contrast, involuntary engagement responses (e.g., rumination, intrusive thoughts) were associated with more anxiety/depression and aggression symptoms. Path analyses revealed that a model in which secondary control coping and involuntary engagement stress responses mediated the relation between family stressors and child symptoms provided the best fit with the data. Implications of these findings for developing interventions for children to reduce the risk of psychopathology are discussed.

These promising early results suggest that further research on this intervention is warranted. Confirmation of the efficacy and effectiveness of peer-led self-management has the potential to enhance self-determination and promote recovery for people with psychiatric disabilities.

Training in mental illness self-management reduced depression and anxiety and improved participants' self-perceived recovery over time. Results confirmed the importance of WRAP as part of a group of evidence-based, recovery-oriented interventions.