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The ABCs of Going to College

The ABCs of Going to College

By Victoria Freeman (MSW RSW), Kristen Anderson (LCSW), Dr. Gina Dimitropoulos (MSW, PhD)

The transition to college is hard and it can be even harder when you’ve struggled with an eating disorder. It’s easy to make comparisons when watching others take that next step if you aren’t ready; AND waiting until you are ready is the best next step for you. Studies show that students with active mental health challenges drop out of school at much higher rates than their peers1 and if you go before you’re ready, you may end up in a revolving door of starting and stopping that derails your college experience.  Working with your supports to think about your best next step is an important part of making a decision about college.

To recover, you built a support system – a scaffold – that allowed you to learn and grow and you no doubt gained a lot of skills along the way! In the transition to college you will face exciting challenges that will require you to use your skills in a new way. The ABCs of going to college are here to help you assess how ready you are for the transition and to help you build a plan for success.


College can be a very exciting and stressful time with many new responsibilities as well as new social, academic, and work experiences. The first step in assessing how ready you are for this next step is reflecting on what challenges may be ahead of you and your loved-ones.

Use the categories below to anticipate challenges you might face in your transition to college:

Making New Friends
Staying Connected with Family
Cafeteria Food
Recreational Activities Nights Out
Social Events
Eating Out
Staying Connected with Old Friends

Increased Academic Pressure and Difficulty
Working while in School

Build a Safety Plan

Now that you have reflected on the new challenges and experiences college will bring, the next step is making sure you are ready to manage your own recovery and what that entails. There are many predictable challenges to college, like the stress of final exams or eating more independently than you have before. However, there may be times when challenges you couldn’t expect complicate things! For example, how would you cope if you got the flu and got behind in your readings. What would you do if a tough social situation caused you extra stress?

Remember, it’s normal to experience slips. Slips can be part of the recovery process and learning how to manage them is an important skill.  Ensuring an awesome college experience means having your plan to get help lined up before you’re in crisis mode.

Use the following check-list with your supports to build your own safety plan.

College Check List

  • I can go grocery shopping independently
  • I can cook and prepare my own meals
  • I can consistently follow an appropriate meal plan for me
  • I can eat out with friends without symptoms
  • I know I need to prioritize sleep and good self-care to stay healthy and productive
  • I have signed up with counselling and/or accessibility services on campus just in case I need them
  • I know who will manage my medical care and I am familiar with medical services on campus
  • I have researched if there are local supports or groups
  • I have thought about how to talk about my eating disorder history (if and when I want to) with new friends, roommates, partners, etc.
  • I know who to call if I am struggling, and I know when to call them
    (ex: if I have symptoms __ times per week)

(ex: if my weight changes by __ amount)
(ex: if I experience: panic attack/insomnia/etc.)

  • Other:

Cope Healthfully

Eating disorders have very severe, long-term consequences on health and mental health and no one chooses to have one. Still, it is not uncommon over the course of the illness for eating disorder symptoms to begin serving a functional role in life.  Understanding how symptoms may have helped you in the past, can prevent you from engaging with them in the future.

Check off the items that reflect your experience and
identify alternative coping strategies that will be more supportive of long-term success




Functions of the Eating Disorder



Alternative, Healthy Coping Strategy

□      Helps me deal with strong emotions by distracting me or numbing out Ex: Build a self-care kit filled with distracting or soothing items like music and coloring


□      Helps me feel like I can fit-in, in a world filled with social pressures about shape and weight Ex: Look for a group or club on campus that aligns with my interests, and not the interests of the eating disorder
□      Helps me feel safe and that people in my life are going to stay close Ex: Talk to my loved ones when I’m struggling



□      Helps relieve pressure
(ex: “If I’m sick, I can put things on hold – I’m not sure I can cut it here”)
Ex: Get connected with accessibility services and create a step-by-step plan for completing homework on time.
□      Helps me to feel more in control Ex: Practice grounding strategies like deep breathing to help me feel in control
□      Helps me deal with boredom Ex: Practice urge surfing: When the urge to have symptoms comes up, try to find another activity for 30-minutes before giving in to the urge (ex: visiting a friend, mindful walk)
□      Other
□      Other



Anticipate, Build a Safety Plan + Cope Healthfully

Hopefully these exercises have helped you tackle the ABCs of assessing
if college is the right step for you, right now.

The last piece of guidance we will leave you with is to approach making these decisions with self-compassion2. It is easy to get caught up in external pressures, beliefs, expectations, or comparison making with our peers – but remember – being a young adult means being in a period of change, discomfort and self-discovery. Research shows that it’s way more normal to feel uncertain about just about everything than it is to have it all figured out3.
So with that in mind…

…We wish you luck in making your decision and we hope you challenge yourself to say NO to comparisons and to say YES

About the authors:

Victoria Freeman is a social worker at Southlake Regional Hospital’s Young Adult Eating Disorder Program and at her private practice in Toronto, Ontario, where she supports individuals and families.  Victoria is passionate about awareness, prevention, and treatment of eating disorders across the lifespan with a specific focus on the unique challenges of young adults. To learn more or to contact Victoria, visit

Kristen Anderson is co-founder of the Chicago Center for Evidence Based Treatment and a former therapist and Clinical Director of the University of Chicago Eating Disorders Program.  She earned her bachelor of arts degree in psychology from the Honors College at University of Michigan-Ann Arbor and obtained her masters degree in social service administration from the University of Chicago. Kristen has provided family-based treatment in her clinical practice as well as her role as a study therapist on four NIMH-funded multisite trials at the University of Chicago. She has published multiple scholarly articles and book chapters on the delivery of family based treatment and the use of telemedicine.  Kristen was most recently funded by NEDA’s Feeding Hope grant to investigate the use of telemedicine in delivering Family Based Treatment.  Kristen’s primary interests including family based treatment for adolescents and young adults as well as assessment and pre/post-operative guidance for bariatric surgery patients. Kristen is the Managing Director and a Faculty member consultant of the Training Institute for Child and Adolescent Eating Disorders.


1Hjorth, C. F., Bilgrav, L., Frandsen, L. S., Overgaard, C., Torp-Pedersen, C., Nielsen, B., & Bøggild, H. (2016). Mental health and school dropout across educational levels and genders: a 4.8-year follow-up study. BMC Public Health, 16, 976.




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