Crisis Plan Development

Definition

Crisis Plan Development is the process of creating a clear, step-by-step guide to follow during a mental health crisis to help ensure safety, stability, and effective use of coping strategies.

Purpose

Used to:

• Prepare proactively for periods of severe distress.
• Reduce impulsive, harmful reactions.
• Ensure you have access to resources and support.
• Increase your sense of control during a crisis.

When to Use

Develop and use a crisis plan when:

• You experience recurring suicidal thoughts or self-harm urges.
• You are at high risk of emotional dysregulation.
• You have a history of crisis episodes.
• You want to feel prepared and supported.

When Not to Use

Avoid relying solely on a crisis plan if:

• You are in immediate danger (call emergency services instead).
• You are unwilling to consider any coping steps.
• You have not yet established basic safety.

How-To

1. Identify Early Warning Signs

• What signals that a crisis is developing?
• Examples: insomnia, racing thoughts, urges to self-harm.

2. List Helpful Coping Skills

• Include skills you have practiced successfully, such as:

  • Self-Soothing
  • TIPP
  • Wise Mind
  • Radical Acceptance

3. Identify Safe People to Contact

• List names and phone numbers of supportive contacts.

4. Create a Safe Environment

• Plan how to remove or limit access to harmful items.

5. Specify Emergency Steps

• When will you call your therapist or 911?
• Where will you go if you cannot stay safe at home?

6. Document the Plan

• Write it down in a clear format.
• Share it with trusted people.

7. Review Regularly

• Update as your needs and resources change.

Tips & Variations

• Keep a copy in your phone and another in your wallet.
• Practice using your plan during mild distress so it feels familiar.
• Include uplifting reminders (quotes, reasons for living).

Example

Scenario: Maria struggles with self-harm urges when overwhelmed.

Crisis Plan:

1. Early Signs: Feeling trapped, numbness, intrusive thoughts.

2. Skills: TIPP, calling a friend, taking a walk, Self-Soothing box.

3. Contacts: Therapist (555-123-4567), Partner (555-987-6543).

4. Environment: Lock away medications.

5. Emergency: Call 911 if safety cannot be maintained.

Inventor / Origin

Crisis planning is a staple of dialectical behavior therapy, designed by Marsha Linehan to reduce self-harm and hospitalization. It integrates concepts from safety planning and relapse prevention models.

Related Skills

• Self-Soothing
• TIPP
• Radical Acceptance
• Willingness
• DEAR MAN (to ask for help)

Limitations

May not be effective if:

• It is created in haste without genuine input.
• You don’t revisit or practice it.
• You avoid acknowledging your crisis patterns.

Evidence Base

Research shows:

• Crisis plans reduce emergency service use.
• Clients with plans are more likely to use coping skills before self-harming.
• They increase feelings of safety and agency.

Further Reading

• Linehan, M.M. (2015). DBT Skills Training Handouts and Worksheets.
• National Suicide Prevention Lifeline
• Stanley, B., & Brown, G.K. (2012). Safety Planning Intervention.

References

• Linehan, M.M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
• Stanley, B., & Brown, G.K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice.