Name that Letter
This part of FAST reminds patients to act in a way that aligns with their personal beliefs and recovery goals.
Stick to Values
While looking at themselves in the mirror, a patient thinks, “I’m disgusting if I eat this. I shouldn’t be here"
Stick to values – Focus on recovery and health, not ED thoughts.
Truthful – Acknowledge feelings without acting on the critical thought.
(No unnecessary) Apologies – Avoid blaming oneself for feeling this way.
“I notice this thought, but I am eating because I value my health and recovery.”
When teaching FAST, it’s important for patients to first understand this so the skill is meaningful
their personal values
Patients are encouraged to acknowledge both their own feelings and the staff’s role without blaming anyone.
Fair
Scenario 1: Meal Anxiety
A patient is sitting at the table and says, “I can’t eat this; it’s too much for me right now.”
Which FAST skill(s) would help?
Truthful – Honestly state feelings.
Stick to values – Acting in alignment with recovery values (still trying the meal).
"I am overwhelmed but I will try my best to get started with this meal"
A key teaching strategy is to help patients practice FAST in real situations, rather than only talking about it
in-the-moment practice / role-playing
This part of FAST helps patients avoid over-apologizing for having distress or needing support.
No Apologies
"They are pacing so much around unit, its unfair that they get to but I get redirected for it"
Fair – Acknowledge staff role and rules.
Truthful – Express feelings honestly.
Stick to values – Choose to follow the recovery plan despite frustration.
"Excessive movement does not align with my goals and I can find alternative activities even if my peers engage in that behavior"
When coaching patients, staff should model this to reinforce the FAST skill effectively.
calm, regulated behavior
Patients state what is true for them, even if it feels difficult, which helps build trust with staff and themselves.
Truthful
“If I eat this, I’ll gain weight and fail.”
Stick to values – Align actions with recovery, not ED thoughts.
Truthful – Acknowledge feelings and urges.
(No unnecessary) Apologies – Avoid blaming oneself for the thought
"I notice this thought, but I am still going to eat because I value recovery.”
Staff should prompt patients to identify which FAST skill applies before, during, or after a challenge. This helps with:
real-world application
Using FAST in a meal or treatment interaction helps patients:
A) Increase self-respect
B) Communicate effectively
C) Align with recovery values
D) All of the above
All of the above
A staff member says, “Try pacing your eating with mine,” and the patient feels pressured and frustrated
Fair – Acknowledge staff’s role and rules.
Truthful – Express feelings respectfully.
Stick to values – Continue following the recovery plan
“I feel a bit rushed, but I’m going to finish this bite as planned.”
When patients struggle with the skill in the moment, staff should focus on:
A) Validating feelings
B) Linking behavior to outcomes
C) Prompting self-respect language
D) All of the Above
A and C