RECOVERY ACTION PLANS FOR TEAMS

Introduction

Team WRAP sections

• Triggers
• A Triggers Action Plan
• Early Warning Signs
• Early Warning Signs Action Plan
• Crisis Planning
• Suggested Team Agreement

• WELLNESS TOOLBOX EXAMPLE
• WELLNESS TOOLBOX
• OUR DAILY MAINTAINANCE PLAN
• OUR TRIGGERS
• TRIGGERS ACTION PLAN
• OUR EARLY WARNING SIGNS
• OUR EARLY WARNING SIGNS ACTION PLAN
• WHAT ARE SIGNS OF THINGS GETTING WORSE / BREAKING DOWN?
• OUR ACTION PLAN WHEN THINGS ARE BREAKING DOWN

Over the last couple of years mental health workers from many disciplines have been introducing more and more people to using Wellness Recovery Action Plans (WRAP) and self-management techniques. This has gradually enabled people to become more able to look after themselves, rather than stay 'stuck' or rely on various professional staff.

One of the strengths of recovery-based work is that the same principles of wellness apply to staff and the people who use services alike. So, staff can use WRAP to maintain and improve their own wellbeing, just as much as 'service users' do.

In mental health, there is an acknowledgement that in order for a work team to do well, it needs to be well too, and that attending to the health and wellbeing of the team is an investment in its ability to offer a good service - "You cannot give it if you haven't got it".

Some mental health teams that use WRAP encourage service users to read it through themselves. This spreads ideas about wellness and further reduces barriers between 'the experts' (professionals) and the 'experts by experience' (service users). Producing a Team WRAP can in itself improve wellness, through more open and positive communication. As it develops, team members are encouraged to read the WRAP as often as needed. Sometimes this will mean daily, so that Team Members become more focused on actions and solutions. There is particular emphasis on using WRAP when there are times of difficulty. It is during and after these times that WRAPs are often improved and amended. In this way experiences can be a source to learn from - producing answers to the questions "what worked, what didn't, what we can do better for the future?"

A team WRAP is a living document. It is open to changes and new experiences. It is intended to be kept open as 'work in progress', to be continually updated as the team progresses with its work. It is intended to keep track with team life as it matures and changes, and to be a resource to turn to and use at times of difficulty. While developing the WRAP and incorporating Recovery principles in the work of the team, the team might consider how to embed the use of WRAP into its daily, weekly and monthly
practice, and set aside times for review and revision. So, the value of a WRAP is not just in creating it but in using it regularly and developing it on the basis of further experience, so that it increasingly becomes a well-shaped and working tool.

And even if WRAP proves not fit into a team's culture, it is likely to leave behind a commitment in individuals and in the team as a whole to looking after health and wellbeing. This in turn will affect morale, improve relationships and mental and physical wellness, reduce absence and improve performance.

TEAM WRAP SECTIONS

As with any WRAP this covers the following headings:

• The Wellness Toolbox
• What are we like when we are well?
• What are our wellness tools?
• What do we need to do each day to stay well? (Daily Maintenance Plan)
• What do we need to do from time to time to stay well?

Triggers

• What are our Triggers?

A Triggers Action plan

• What can we do about them?

Early Warning Signs

• What are early signs of something going wrong in the Team?

Early Warning Signs Action Plan

• What can we do to deal with these signs of difficulty?
• What are signs of things getting worse or things breaking down in the Team?
• What can we do to deal with things when they are breaking down?

Crisis Planning

• What can we do when we are beyond being able to resolve things ourselves?

In the following pages you will find an example WRAP. It is for a team with a particular role in an organisation. The ideas are from a real team that currently uses WRAP. Some of the Wellness Tools may fit your team experience, other may not. But it will give you a flavour of what Team WRAPs are about.

Suggested Team Agreement

This is how we will use our Team WRAP:

1. Our WRAP will be developed jointly, including all members of the staff group, as being equally important.
2. We will provide copies for all new staff including students.
3. We will have copies accessible in the workplace. Wellness tools and the daily maintenance plan will be clearly displayed in the office.
4. We will utilise WRAP as tool in supervision and in team and section meetings. It will also be used at times of increased need and pressure on staff team.
5. We will share our experience of developing this Team WRAP with others.
6. We will review the whole experience of putting a team WRAP into action on our development days.

• Low levels of friction and defensiveness
• Good cohesion
• Good communication
• Honest
• Effective
• 'We do our jobs'
• Things run smoothly
• Good humoured and fun to be with
• Low levels of sickness
• Open to challenge
• Resourceful
• Reflective and curious
• Constructively critical without fear of being stepped on
• Opinionated
• Trusting of each other
• Expressive
• Interested in learning
• Patient and tolerant of people who use our service, and one another
• Empathic
• Available
• Accepting of differences
• Innovative and creative
• Flexible
• Not judgemental
• Enthusiastic and energetic
• Supportive of one another personally and professionally
• Feel good to be in work at the start and at the end of the day
• Our communication works
• An affectionate appreciation of colleagues as, 'The oddest conglomerate of
• personalities I've ever come across'
• Lots of humour

• Supervision (with a degree of choice)
• Peer support
• Managerial support and guidance
• Family days
• Appreciation from one another and from the service
• Sensitivity to one another - consideration and care
• Being supported and valued by one another
• Knowing one another's preferences and skills
• Emotional atmosphere of the office
• Physical state of the environment
• Some freedom of movement
• Sound leadership
• Stability of staff group
• Hearing one another
• Everyone being able to all a meeting
• Permission and encouragement to learn
• An expectation of learning and growth
• Encouragement and time to bring back good ideas and practices to team
• Team development days
• Staff business meetings - with time and space to discuss issues
• Communication book
• Clear communication - in contrast to a load of old waffle
• Working together
• Peer group meetings each 3 months
• Have clear objectives
• Confidents and supporters - someone to turn to

• Communicate well
• Greet one another
• Share information
• Ensure good documentation to sustain communication for people not present
• Know what is going on
• Maintain the physical environment
• Replace milk in the fridge
• Be flexible and share domestic tasks
• Watch out for one another
• Deal with uncomfortable moods (in the team) sooner rather than later
• Be considerate and sensitive if someone is having a bad time personally or professionally
• Personally - get good nights sleep / be physically healthy / look after ourselves
• Sort things out as they arise
• Plan ahead - know what is coming
• Be prepared for the unexpected to happen
• Avoid too frequent changes

Things we need to do less frequently:

• Pay for the tea
• Annual review days
• Family days
• Review and discuss work in smaller work groups
• Do something different (spoil ourselves)

• Tension between our personal and professional life
• Sometimes people don't or can't deal with this openly and positively and this impacts on others
• Criticism that it unfounded or delivered brusquely
• Being given more work without proper consultation
• Too much paperwork
• Long meetings - being talked at from the front without time and space to discuss
• Too much time 'on the computer'
• When this gets more critical team relationships can be fractured
• When people reject support
• When the work or the workplace produces extended difficulty
• Staff shortages - particularly if they are unexpected or at short notice
• Staff being taken off to plug gaps elsewhere
• Feeling there is no end to a difficulty - no light at the end of the tunnel
• When cannot see any results from your efforts
• Machines breaking down and not mended
• Shortage of physical resources eg paper
• Too much change and uncertainty - about the future of the team
• People in bad moods who won't connect or deal with it
• Impact of changes elsewhere

• Make sure I/we stick to our daily maintenance plan
• Take a deep breath.
• Take some time out to deal with feelings rather than reacting
• Don't 'hide'
• Let concerns (and feelings) out
• Discuss things rationally
• Prioritise and make sure important things get done
• Anticipate challenges
• Prepare - forward plan
• Offer support and supervision
• Provide support... listen to others
• Accept support... expect to be listened to
• Share problems
• Call a meeting to discuss solutions
• Make a plan
• Do things that help getting to know people in the team better
• Actively respond to need
• Increase resources or find solutions to shortages
• Acknowledge difficulty, don't deny it
• Stop, think, and make a note
• Do what you can - refer what you can't
• Go out for a drink together

• Increased sickness / absence
• Lesser complaints eg colds, headaches increase
• Watching the duty rota book
• Reduced tolerance
• Reduced capacity to absorb or accept stuff
• Clock watching
• Avoiding and hiding
• Hostility, irritability, grumbling in corners
• Open back biting
• Increasing cynicism about the job
• Manner of challenging leadership decision - becomes more covert
• The leaving of notes and sending emails rather than more open communications
• Loss of perspective
• Stress reactions in individuals
• Concentration affected
• Emotional outbursts
• Physical signs - sweating, pacing, smoking, drinking
• Emotional signs - anxiety, anger, hopelessness, confidence dips
• Relationships strained
• Rushing around - not enough time to do things
• Tasks not being completed
• People isolating themselves

• Use our individual wellbeing WRAPs, if we have them
• Learn new stress management strategies and techniques
• Use supervision
• Get positive support from and with peers
• Get a different point of view
• Have a good informal 'do' with each other
• Spoil ourselves - Choccy biscuits or doughnuts?
• Sit down and talk
• Confide in someone
• Encourage healthy lifestyle and activity diet, exercise, stop smoking
• Work it out - make a plan
• Ask if you don't know what's going on or what something means
• Offer some help
• Try to understand the problem
• Get things back into perspective
• Take some leadership - we are all leaders
• Don't be dismissive
• Some things take time - don't knock yourself out

• Things disjointed and fractured (everything - communications and actions)
• Things don't get done or are just left
• Major mistakes
• Communication deteriorates
• Preoccupied with self rather than work tasks
• People inward turned, isolated - it's 'me' instead of 'us'
• Self preservation - need to look after me
• People preoccupied - (with the mess we are in?)
• Working without enthusiasm - doing the minimum
• Blaming others
• Bullying not checked or reported
• People complain of a 'blame culture'
• Expressions of hopelessness, even from the managers
• People talking positively about 'getting out'
• Team splits - the in-crowd and the out-crowd
• People feeling and showing signs of stress
• Poor and reduced functioning and effectiveness
• Low levels of trust - people guarded and suspicious
• Thinking and talking about getting out
• A sense of fear and apprehension

OUR ACTION PLAN WHEN THINGS ARE BREAKING DOWN

And what can we do about things breaking down?

• Acknowledging that we may need to take time to sort things
• Need compassion for one another and the situation
• A time for positive leadership
• Access helpful agency policies
• Cut back to basics - make time and energy to put into solving the problem or solving our own problems
• Talk to one another and not through third parties
• Get help from a variety of sources available in and outside the organisation
• Call a Team meeting - and consider an external facilitator