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Identify your personal early warning signs across thinking, mood, behaviour, and physical health, and create a stepped action plan for responding.
This worksheet helps you and the people around you recognise the early signs that your mental health may be deteriorating, and plan what to do at each stage. It's especially useful for conditions with a relapse pattern, such as bipolar disorder, psychosis, or recurrent depression. Complete it collaboratively with your therapist and share it with trusted supporters.
Use in the relapse prevention phase of treatment to help the client identify their personal early warning signs of depression recurrence and plan proactive responses. Essential for all depression treatment, given the high recurrence rate. Should be completed collaboratively as therapy moves toward ending.
Frame as future-proofing: 'One of the most important things we can do as therapy ends is prepare you for the future. Depression can come back, and the earlier you spot the warning signs and take action, the less likely it is to develop into a full episode. Let's create your personal early warning system.'
For clients with recurrent depression, draw on their history to identify personalised warning signs. For first-episode clients, use the pattern observed during treatment as a guide. Include input from trusted others who might notice changes before the client does. Create tiered responses: green (wellness), amber (early warning), red (crisis).
Avoid creating the plan too early in treatment before the client has sufficient understanding of their own patterns. Not a substitute for ongoing support if the client remains at high risk. Ensure the plan does not become a source of hypervigilance or anxiety about relapse.
Warning signs should be specific and behavioural rather than vague. 'Cancelling plans with friends' is more useful than 'feeling down.' Include cognitive, behavioural, emotional, and physical signs. Link each warning sign to a specific action step. Share the plan with the client's GP if they consent. Rehearse the plan in session to increase the likelihood of implementation.
Suitable for clients working with early warning signs, relapse prevention, action plan, bipolar, psychosis, cbt, staying well. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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