Building Your Own Wellness Toolkit: WRAP + DBT Diary Cards

One of the frustrating things about more traditional approaches to mental health is the emphasis on ‘working the program’ exactly as it’s prescribed. There is wisdom in many of the tools offered by the traditional mental health system. That said, most people who have been in recovery for a long time have necessarily experienced a lot of trial and error as they assemble a workable toolkit. Even those of us who steadfastly work a 12-Step program mix and match tools as needed. I think this sort of eclecticism is the natural result of adapting to shifting needs and challenges.

Some of us, however, are truly innovative. When I took my first continuing education classes after becoming a certified Recovery Support Specialist, I learned about the Wellness Recovery Action Plan, or WRAP. WRAP is an evidenced-based practice recognized by the United States Substance Abuse and Mental Health Administration (SAMHSA). It has been listed on the National Registry of Evidenced-Based Programs and Practices for over a decade. But it’s fairly unique in its origin:

This approach to wellness was developed in 1997 by several dozen people in recovery at an 8-day conference on mental health in Northern Vermont. Many attendees had been long-term residents in state psychiatric hospitals. Together, they discussed their practical strategies for coping with life’s struggles. Among them was Mary Ellen Copeland and Jane Winterling, who worked together to organize these strategies into a simple system: the WRAP. You can learn more about how to use a WRAP through continuing education courses at our parent organization, Advocacy Unlimited.

A key aspect of the WRAP is its daily maintenance checklist. Within the Daily Maintenance Checklist, participants first describe themselves when they are feeling all right. For example, I would describe myself as self-motivated, boisterous, resilient, and eloquent. They then make a list of things they need to do for themselves daily to keep feeling all right. My list includes things like brushing my teeth, leaving my room daily, sleeping 6-8 hours, and not eating within 2 hours of bedtime. Lastly, this list includes things a participant might choose to do to stay on track, but probably not daily. My list includes things like tidying up, going for a walk, and reading.

This is not the only such system that emphasizes daily maintenance. Dialectical Behavioral Therapy (DBT) is a tool frequently used by the traditional mental health system, often (but not exclusively) by people who have been diagnosed with Borderline Personality Disorder (BPD). DBT makes use of a data-driven process of self-reflection called a Diary Card. The Diary Card inventories symptoms or behaviors a person wants to work on and which skills, if any, they use to cope with those when difficulties arise. And interestingly, Dr. Marsha Linehan, the inventor of DBT, struggles with BPD herself.

Personally, I’m recommitting myself to a tool I used diligently at the beginning of this year: I combined my WRAP’s daily maintenance checklist with the form of DBT Diary Cards. This system I’ve created for myself works better for me than either does alone. It helps me track how my behavior, thoughts, and feelings are interrelated. It allows me to approach my life holistically, while appeasing my internal social scientist. I can see how behaviors like washing my face correlate with the degree of fatigue or anxiety I feel.

Some of the most impressive innovations in wellness and recovery have come from people reflecting on their own recovery. I want to encourage you to reflect on what does and does not serve you. Innovate. You have valuable insights.

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