Sample Safety Plan
18 Aug 2023[Note that all our new online clients will need to complete a PDF version of the below during their first session. In-person clients will only need to complete if there is either indication during first or subsequent sessions that it will be required of if there is a client history of suicide attempts or ideation.]
Sample Safety Plan for New Clients
Client’s Name: [your name]
Date: [today’s date]
Introduction
Welcome to our therapy sessions. Your safety and well-being are of utmost importance to us. This safety plan is designed to provide you with practical strategies and resources to manage difficult moments and enhance your emotional well-being. It is important to remember that this plan is not a substitute for professional help; if you are in immediate danger, please seek help immediately.
Warning Signs
Identify signs that indicate you might be at risk. These can include changes in thoughts, feelings, behaviours, or circumstances. Examples may include increased sadness, social withdrawal, overwhelming anxiety, hopelessness, or isolation.
Warning signs: [provide list]
Coping Strategies
List healthy coping strategies that you can use to manage distressing situations. These could include deep breathing exercises, mindfulness techniques, engaging in hobbies, talking to a friend, or engaging in physical activities you enjoy.
Coping strategies: [provide list]
Social Contacts
Compile a list of people you can reach out to for support. This might include family members, friends, colleagues, or support group members. Make sure to include their names, contact numbers, and a brief note on how they can help.
Social contacts: [provide list]
Professional Contacts
Include the contact information of mental health professionals you can reach out to, such as your therapist, psychiatrist, or counsellor. Include their names, contact numbers, and any emergency after-hours contacts if applicable.
Professional contacts: [provide list]
Personal Network
List places or activities that provide you comfort and solace. This could be a favourite park, a relaxing playlist, or a comforting book. Having these options readily available can provide a positive distraction during challenging times.
Personal network: [provide list]
Emergency Plan
If you find yourself in a crisis and need immediate help, these steps are some options (but not an exhaustive list):
- Call Emergency Services: Dial your country’s emergency number for immediate assistance.
- Contact a Trusted Person: Reach out to someone on your social contacts list who can support you.
- Use a Helpline: Reach out to a helpline.
Emergency plan: [write the steps you will follow]
Commitment to Safety
We are committed to your safety and well-being. During our sessions, we can work together to refine and adapt this safety plan to best suit your needs. Remember that there is no shame in seeking help; reaching out for support is a sign of strength.
Disclaimer
This safety plan is designed to offer guidance and support, but it is not a substitute for professional mental health care. If you are in immediate danger or require urgent assistance, please contact emergency services or a mental health professional. Your safety is a priority, and we are here to support you on your journey towards healing and well-being.
Please sign below to indicate that you have read and understood this safety plan.
Client’s Signature:
Date:
(Note: This sample safety plan is provided for illustrative purposes and should be adapted to the specific needs and preferences of the client. It is not a replacement for personalised mental health care.)
More about planning: https://sprc.org/effective-prevention/strategic-planning/