Safety Plan FAQ: What It Is and How It Can Help High-Risk Clients

A safety plan is a clinical document that a mental health provider creates to help a client maintain safety. Some clients may never require a safety plan, but you should always be prepared to develop one if safety concerns arise. 
 

In this article, we’ll go over:

• What is a safety plan?
• Why is a safety plan important?
• What is included in a safety plan?
• When should I use a safety plan with a client?
• Free templates and resources

What is a safety plan?

A safety plan is a collaboration between a client and therapist. It is a clinical document that outlines strategies for helping a client maintain safety. Sometimes individuals such as a parent, guardian, or partner may participate in the development of the document, as they may play an active part in the plan. A copy of the plan should always be dated and given to the client. The original should be kept in your records.

Why is a safety plan important?

A safety plan is helpful for a client because it reminds them of their coping skills and support system when experiencing unsafe thoughts or behaviors. Examples of unsafe thoughts or behaviors can include:

• Urges to engage in self-harm
• Thoughts of hurting someone else
• Thoughts of suicide
• Experiencing internal voices telling a client to act in a dangerous manner
   

A safety plan acknowledges what risk factors a client is experiencing, what they can do on their own to maintain safety, who to contact for help, and where to go if they cannot be safe. It also provides a client with resources if they are unable to maintain safety on their own. 
 

If you are aware of a client experiencing unsafe thoughts or behaviors, and a client engages in such behaviors that cause injury or death, you could be held responsible. While a safety plan does not guarantee a client will be safe, it demonstrates that a provider has assessed for risk and addressed the concern to the best of their ability. This is helpful for a provider because it can protect you from potential legal action.

What is included in a safety plan?

✓ Triggers

Situations, people, or things that make a client feel upset, angry, sad, anxious, or uncomfortable.

✓ Warning signs

Thoughts, images, situations, behaviors that indicate a client is experiencing or about to experience unsafe thoughts or behaviors.

✓ Coping skills

Things a client has identified that they can do on their own to self-soothe.

✓ Support system

Someone a client has identified that they can ask for help.

✓ Professional support

Resources a client can use if they are unable to maintain their safety on their own.

✓ Acknowledgment 

A copy of the plan is dated and given to the client. The original is kept in your records.

When should I create a safety plan with a client?

Completing a safety plan for a client deemed as high-risk is a best clinical practice. Examples of a high-risk client include, but are not limited to:

• Your client expresses thoughts or feelings about harm to themselves or others
• Your client engages in potentially dangerous behaviors that may result in harm to self or others
• Your client steps down from a higher level of care to outpatient therapy care
• Your client’s response to PHQ-9 question #9, which asks about thoughts related to suicidal ideation

Free templates and resources

• Safety Plan Template: Adult
• Safety Plan Template: Child and adolescent‍
• Emergency resources‍
• National Suicide Prevention Lifeline: (800) 273-8255
• For SonderMind providers: CE Webinar: Helping Kids and Adolescents with Self-Harm and Suicidal Thoughts (1.5 CEs)

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