Safety Planning – Additional DBT Tool

Safety Planning

Definition

Safety Planning is the creation of a structured, prioritized list of actions, coping strategies, and support contacts to use when experiencing suicidal thoughts, urges to self-harm, or other high-risk crises. It is a proactive method to enhance safety and stabilize emotions before harm occurs.

Purpose

Used to:

  • Prevent suicide and self-harm.
  • Increase a sense of preparedness and control.
  • Clarify clear, actionable steps during crisis.
  • Reinforce commitment to staying safe.

When to Use

Use Safety Planning when:

  • You have a history of suicidal ideation or self-harm.
  • You experience frequent intense emotional distress.
  • You are transitioning out of inpatient care or emergency services.
  • You want a structured backup plan to support yourself.

When Not to Use

Avoid relying exclusively on safety planning if:

  • You are in immediate danger and require emergency intervention.
  • You have not yet identified any skills or supports you are willing to use.
  • You have limited motivation to participate in planning.

How-To

1. Recognize Warning Signs

  • List personal signals that crisis is approaching (e.g., hopelessness, isolation).

2. Use Internal Coping Strategies

  • Identify skills you can do alone:

    • Mindfulness
    • TIPP
    • Self-Soothing

3. Contact People for Distraction

  • List social supports you can call or spend time with.

4. Contact Supportive Professionals

  • Include therapist, psychiatrist, crisis hotline.

5. Restrict Access to Lethal Means

  • Remove or secure weapons, pills, sharp objects.

6. Emergency Contacts and Steps

  • When to call 911, go to ER, or contact crisis line.

7. Document and Share

  • Keep it visible and accessible.
  • Share with trusted people and professionals.

Tips & Variations

  • Use a wallet card or app (e.g., My3) for easy access.
  • Review and update every few months.
  • Practice using parts of the plan during mild distress.

Example

Scenario: Sam has chronic suicidal ideation.

Safety Plan:

  1. Warning Signs: Withdrawing from friends, giving away belongings.

  2. Coping Skills: Deep breathing, DBT Opposite Action, music.

  3. Distraction Contacts: Sister (555-111-2222).

  4. Professionals: Therapist (555-333-4444).

  5. Means Restriction: Partner holds medications.

  6. Emergency: Call 911 if unable to maintain safety.

Inventor / Origin

Safety Planning was popularized by Barbara Stanley, PhD, and Gregory Brown, PhD as part of suicide prevention protocols. It has been incorporated into DBT by Marsha Linehan as a key strategy in crisis management.

Related Skills

  • Crisis Plan Development
  • Radical Acceptance
  • Willingness
  • Opposite Action
  • Wise Mind

Limitations

May not be effective if:

  • The plan is superficial or not individualized.
  • It is never reviewed or practiced.
  • There is no commitment to use it in crisis.

Evidence Base

Research shows:

  • Safety Planning reduces suicidal behavior and hospital visits.
  • Increases coping skill use.
  • Enhances confidence in crisis management.

Further Reading

  • Stanley, B., & Brown, G.K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk.
  • Suicide Prevention Resource Center
  • Linehan, M.M. (2015). DBT Skills Training Handouts and Worksheets.

References

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

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