Safety Planning
Core Mechanism
Structured plan created collaboratively provides concrete steps to manage suicidal crisis; reduces impulsive action
Ontology
Suicidal crises are time-limited; having a concrete plan interrupts the narrowing of perceived options
Therapeutic Voice
"When you start to feel that way, who is the first person you could call? Let's write that down."
View of the Person
A being in acute crisis whose narrowed perception of options can be expanded by a concrete plan
Evidence
VA/DoD: recommended. Joint Commission: recommended
5+ RCTs (Stanley et al., 2018)
Included in suicide prevention reviews
Strong evidence. RCT showed 45% reduction in suicide attempts. Standard of care.
Conditions
Epistemology
Blind Spots
Intervention, not treatment — does not address underlying conditions; effectiveness depends on quality of therapeutic relationship
Contraindications
Not a standalone treatment — contraindicated as the sole intervention for complex clinical presentations requiring comprehensive therapy; also insufficient for actively psychotic clients unable to follow a plan
Training
Brief intervention from manual and brief training. Should be competency for all clinicians
No certification; free training available
2-4 hrs
Free-$100
Equity & Cultural Adaptations
Philosophical Roots
Shneidman (psychache — suicidal pain is psychological); means restriction research; crisis theory (time-limited states); pragmatism
Related Modalities
Test Yourself
Six steps of a safety plan?
Show answer
Warning signs, internal coping, social contacts, professionals to call, making environment safe, reasons for living.