Safety planning is one of the most vital clinical tools for supporting clients who are navigating risk, whether due to thoughts of suicide, self-harm, substance use, or other safety concerns. It’s not just a form to fill out- it’s a relational, clinical conversation about what helps a client stay safe during moments of overwhelm.
When done well, a safety plan is:
- Collaborative: Created with—not for—the client.
- Concrete: Easy to understand and access during crisis.
- Dynamic: Reviewed and updated as the client’s needs evolve.
Every client can benefit from safety planning. Life is unpredictable: we all experience distress at times, and having a clear plan for how to cope—who to reach out to, what to do, and what keeps us going—can be a powerful act of self-support.
This guide will help you confidently and compassionately engage clients in building a plan that supports their safety- and integrates into your clinical care and documentation.
What Is a Safety Plan?
Once you’ve completed a risk assessment, the next clinical step is safety planning. A risk assessment helps identify potential dangers, while a safety plan provides a clear, proactive roadmap for the client to navigate and manage those risks effectively. When done collaboratively, the safety plan becomes an extension of the therapeutic relationship.
Whether a client is experiencing thoughts of suicide, urges to self-harm, substance use, or emotional dysregulation, safety planning transforms your clinical insight into a usable, real-world tool that can help them get through the hardest moments.
“Let’s figure out what helps when it gets really hard—so you’re not alone, and you don’t have to guess what to do in those moments.”
A safety plan is essentially a coping-with-distress plan—a set of personalized strategies and supports a client can use to navigate moments when their emotional pain feels unbearable.
These moments are often short in duration, but intense, like a wave cresting in the ocean. The goal is not to eliminate distress altogether, but to help the client survive the peak of the wave. Over time, therapy helps make the waves smaller, less frequent, and easier to ride out. But safety planning helps clients manage this wave, right now, with tools that are meaningful to them.
When to Use Safety Planning:
- As a proactive tool for clients with emotional dysregulation difficulties
- After identifying risk in session
- When risk is chronic or may fluctuate
- After discharge from a higher level of care
How to Introduce and Frame Safety Planning to Clients
Not every client responds well to the phrase “safety plan”. For some, it might feel clinical, stigmatizing, or suggest they’re “in trouble.” What matters most is how you frame the purpose of the plan: to help them feel more supported and less overwhelmed when things are hard.
To introduce safety planning as a supportive, collaborative process, try:
“When things feel really tough, it can help to have a plan- something we create together- to guide you through it.”
- Letting clients name the plan in their own language (e.g., Distress Plan, Emergency Kit, Get-Through-It Guide). This increases ownership and usability.
- Asking permission: “Would it be okay if we built something together for those hard moments?”
- Avoiding jargon: Use phrases like “making things feel less risky” instead of “means safety.”
- Building on strengths: Highlight what the client already does to cope- and make it more intentional.
The more personalized the plan feels, the more likely the client is to use it when they need it most.
How to Collaboratively Build a Safety Plan
The best safety plans are co-created. Use the client’s own words and experiences, and draw from the pain and protective factors explored in your risk conversation.
| Step | What It Supports Clinically | What to Ask the Client |
| 1. Warning Signs | Recognize early signs of escalating risk | “What do you notice first when things are getting worse?” |
| 2. Internal Coping Strategies | Build distress tolerance without relying on others | “What helps you calm down or distract yourself when you’re alone?” |
| 3. Social Supports (non-clinical) | Reduce isolation and increase emotional connection | “Who helps you feel grounded, even a little?” |
| 4. Crisis Resources (professional) | Increase access to emergency care | “What services or professionals would you reach out to in a crisis?” |
| 5. Means Safety | Reduce access to potential tools of harm | “Are there items or environments that feel unsafe for you right now?” |
| 6. Reasons for Living | Reinforce protective factors and meaning | “What keeps you going, even when it’s hard?” |
Frame each step as a shared task:
“Let’s figure this out together so you feel more prepared next time.”
Tips for Effective Safety Planning
- Use Their Language: Replace clinical terms with their words. “Shutting down” may mean more than “dysregulated.”
- Normalize It: Safety planning isn’t a sign of crisis- it’s a skill for resilience.
- Practice Together: Walk through how the plan might work in real time.
- Make It Accessible: Save it in a shared file, email, printout, or on their phone.
- Revisit Often: Update it after any changes in risk or protective factors.
What If Risk Is Chronic?
Clients with long-term suicidal ideation or emotional dysregulation often already have coping strategies- they just may not recognize them. Safety planning:
- Puts those tools into a structured format
- Creates shared language for future risk conversations
- Offers consistency across moments of instability
Even if the client isn’t in an acute crisis, safety planning supports ongoing outpatient care and helps them feel more in control of their distress- and contributes to increasing self-efficacy and empowerment.
Documenting Safety Planning
Your documentation should show how safety planning flows from risk assessment.
Always document:
- Date of safety plan creation or update
- Context of risk that led to planning
- Protective factors identified
- Client engagement in the planning process
- Barriers and how they were addressed
- How and where the plan was shared
- Follow-up plan (e.g., “Will review in next session”)
Example Note:
“Following risk assessment (chronic suicidal ideation, no acute plan), collaborated with client to develop a safety plan. Client identified internal strategies (journaling, grounding), support contacts (sister, sponsor), and plan for accessing Rula Crisis Line and therapist in moments of risk. Discussed locking medications and removing sharp objects. Plan emailed to client. Will review and revise next week.”
Safety Planning = Hope in Action
A safety plan is more than a clinical task—it’s a tool for surviving the worst moments with dignity and support. It’s a compassionate, collaborative act that helps clients feel prepared, supported, and connected when distress peaks. By grounding the plan in the client’s own language and strengths, you’re not just reducing risk- you’re reinforcing hope, agency, and the belief that getting through the hard moments is possible.
Need consultation on a complex case with a client at risk?
Rula’s Patient Safety Team is here to support you. Schedule a consultation anytime!
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