Safety Plan Template

What Is a Safety Plan?

A safety plan is a collaborative, written document developed with a client who is at risk of harm — whether from suicidal ideation, self-harm, domestic violence, or other dangerous situations. Unlike a no-harm contract (which research has shown to be largely ineffective), a safety plan is a practical, step-by-step guide that helps the client recognize warning signs and take specific actions to stay safe during a crisis. Learn more about safety planning documentation.

The Stanley-Brown Safety Planning Intervention is the most widely researched model and forms the basis of the template below. Safety plans are used across social work settings including mental health clinics, hospitals, schools, domestic violence programs, and child welfare agencies.

A well-constructed safety plan is personalized, written in the client's own language, and reviewed regularly. It should be a living document that the client can actually use — not a form filed away in a chart.

Template

Client Information

• Client name
• Date of birth
• Date safety plan created
• Date(s) safety plan reviewed or updated
• Social worker name and credentials
• Reason for safety plan (suicidal ideation, domestic violence, self-harm, other)

Step 1: Warning Signs

Help the client identify the thoughts, feelings, images, moods, situations, or behaviors that signal a crisis may be developing.

Prompt the client: "What do you notice happening inside you or around you right before things start to feel really bad?"

Document the client's specific warning signs:

1. ---

2. ---

3. ---

Example responses:

• "I start thinking that nobody would care if I was gone"
• "I stop answering my phone and stay in bed all day"
• "I start drinking more than usual"
• "I feel a tightness in my chest and my thoughts start racing"

Step 2: Internal Coping Strategies

List activities the client can do on their own — without contacting another person — to distract from or manage the crisis.

Prompt the client: "What are things you can do by yourself to take your mind off your problems or help you feel even a little bit better?"

1. ---

2. ---

3. ---

Example responses:

• Go for a walk around the block
• Take a hot shower
• Listen to a specific playlist
• Do a breathing exercise (box breathing: inhale 4 counts, hold 4, exhale 4, hold 4)
• Write in a journal
• Play with pet

Step 3: People and Social Settings That Provide Distraction

Identify people the client can reach out to or places they can go for social contact and distraction — without necessarily disclosing the crisis.

Social settings that help:

• ---

• ---

Example responses:

• Call cousin Maria and talk about anything
• Go to the gym
• Visit the coffee shop on Main Street
• Attend a church service or community group meeting

Step 4: People the Client Can Ask for Help

Identify specific people the client trusts enough to tell they are struggling.

Prompt the client: "Who in your life could you tell that you're having a hard time and ask for help?"

Step 5: Professional and Agency Contacts

List professionals and agencies the client can contact during a crisis.

Step 6: Making the Environment Safe

Identify ways to reduce access to lethal means or remove immediate dangers from the client's environment.

For suicidal ideation:

• Secure or remove firearms (who can hold them? where can they be stored?)
• Remove or lock up medications (who can hold excess medication?)
• Remove or secure sharp objects, ropes, or other means

For domestic violence:

• Identify a safe place to go if the client needs to leave
• Pack an emergency bag (documents, medications, money, clothing, phone charger)
• Establish a code word with a trusted person that signals "call for help"
• Store important documents outside the home (at a friend's house, in a locker)

Document specific actions agreed upon:

1. ---

2. ---

3. ---

One Thing Worth Living For

Prompt the client: "What is one thing — even something small — that is worth staying alive for or worth being safe for?"

---

Example responses:

• "My daughter's smile when I pick her up from school"
• "I want to see my sister's wedding next year"
• "My dog needs me"

Signatures and Acknowledgment

• Client signature and date
• Social worker signature, credentials, and date
• Copy provided to client: Yes / No
• Copy placed in chart: Yes / No
• Copy sent to: _________________ (other providers if applicable)

When to Use This Template

Safety plans should be developed whenever a client presents with:

• Suicidal ideation — Active or passive thoughts of ending their life
• Self-harm urges — Desire to injure themselves without suicidal intent
• Domestic violence risk — Currently in or recently exiting an abusive relationship
• Homicidal ideation — Thoughts of harming others (requires additional duty-to-warn considerations)
• Substance use crises — Risk of relapse that could lead to overdose or dangerous behavior
• Child safety concerns — When a parent needs a concrete plan to maintain their child's safety

Tips for Creating Effective Safety Plans

1. Collaborate, do not dictate — The client must generate the coping strategies and contacts. A safety plan imposed by the clinician will not be used
2. Use the client's own words — Write exactly what the client says. If they say "call my mom," write that, not "contact maternal figure for support"
3. Be concrete and specific — "Exercise" is vague. "Walk two laps around Riverside Park" is actionable
4. Review and update regularly — A safety plan created six months ago may no longer reflect the client's current supports or warning signs. Review it at every session during high-risk periods
5. Make sure the client keeps a copy — The plan only works if the client can access it during a crisis. Offer a wallet card, a photo on their phone, or both
6. Practice the steps in session — Walk through the plan once with the client so they have rehearsed it before they need it
7. Address lethal means directly — Research consistently shows that reducing access to lethal means is one of the most effective suicide prevention strategies. Do not skip Step 6

Speed Up Safety Plan Documentation with NotuDocs

Creating safety plans is deeply personal work that requires your full attention on the client. NotuDocs helps you document the plan after the conversation by generating structured safety plan documents from your session notes, so you can stay present with your client during the moments that matter most. Try it free.