Eating Disorder Relapse Prevention

EDIT™ Worksheets | Believe In Your Self
Success #3 | Relapse Prevention


“Green light!” she screamed. We all started to run towards the finish line. “Yellow light,” she said. We all slowed our runs to a jog. And just when I took off in a sprint, I heard the fatal sound, “Red light!” My body was still moving before it registered what it heard. I had to go all the way back to the beginning because I had kept moving when I heard “red light.”

Red Light, Green Light is a popular playground game. What seems like a silly kid’s game is actually a really important message for our clients. When you see a yellow light, slow down – because otherwise, the red light might suddenly appear – and then you’ll have to “start all over.” This Relapse Prevention worksheet is focused on helping clients recognize what the red, yellow and green lights are in terms of their recovery:

  • Green Lights are the indicators that all is going well in recovery

  • Yellow Lights are the warning signs that a relapse is possible

  • Red Lights are sure indication that a relapse is occurring

Although clients may not have to “start all over” if a full relapse occurs, it can be much harder to restore recovery practices once a relapse has occurred. In some cases, if the relapse persists and ED behaviors worsen – then clients may in fact need to “start all over” with intensive treatment. When clients are nearing the completion of their outpatient treatment with you as an EDIT™ Certified practitioner, this is an important time to use this worksheet. It’s best to do this worksheet in session.

Start with the Green Light section – which is likely where your client sees themselves in that moment. Guide them to make a list of the signs that their recovery is going well, for example: I’m not worried about my weight, I can eat all the foods I like without a binge/purge, I’m writing in my journal every day, I’m doing fun things with my friends.

Next, move on to the Yellow Light section. Your client might be feeling pretty confident in their recovery, especially after completing the Green Light list. Emphasize to your client that “complete recovery is possible” – and that they might never have a relapse. But one cause of relapse is being “overconfident” – almost “cocky” about recovery, with an attitude, “I’ve got this!” With that perspective, they might let some of their healthy recovery strategies begin to slip. And as recovery slips, ED can slip back into their life. Guide your client to be humble, and recognize their Yellow Light early warning signs, for example: Seeing something on social media that makes me want to lose weight, Eating dessert but feeling urges to binge/purge, Skipping days of journal writing, Canceling plans with friends and starting to isolate.

Finally, complete the Red Light section. After recognizing the Yellow Light warning signs, your client is likely recognizing how vulnerable they are to relapse. You don’t want your client to live in fear of relapse – but rather, to have a healthy respect for their recovery and to be diligent in realizing the early signs that relapse might occur. Next, guide your client to list the Red Light signs of full relapse, for example: Checking weight and starting on a weight loss plan, Binge/Purge episode has occurred, Quitting journal writing altogether, Lying to friends about how I’m really doing.

After completing all of the sections, guide your client to answer the question at the bottom of the page. What is their action plan for Yellow and Red Lights? What are they willing to commit to if they notice the waring sighs of the Yellow Light – perhaps a friend they will call and be honest with? How can they care for themselves if they get to a Red Light – perhaps a commitment to call you as their EDIT™ Certified practitioner, and ask for a session to address the relapse?

As you conclude the session, return back to the Green Light section. Encourage your client with all that he or she is doing well – Green Lights are a sure sign of healing and restoration. Red light, Green Light might just seem like a child’s game, but the message is true – if you see yellow, go-slow.