Crisis Plan/ Safety Plan
The purpose of a safety plan is to write down your plan to use when you need it to ensure you are safe and able to cope with the events.
Client Name
First Name
Last Name
Client Date of Birth
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1. Write 3 warning signs that a crisis may be developing. (State ways you know when you are not doing well such as sweaty palms, shaking, panic, crying, yelling, etc)
2. Write 3 internal coping strategies that can take your mind off your problems. (State things you do that help you cope with the crisis)
3. Who/What are 3 people or places that provide distraction? (What helps you take your mind off of the crisis?)
4. Who can you ask for help? (name and relationship)
5. Professionals or agencies you can contact during a crisis:
6. Write out a plan to make your environment safer. (What can you do to make yourself safe or calm when in a crisis or not doing well? Ex: walk outside, remove weapons, ask for support, separate from the situation)
Provider Name, Credentials
First Name
Last Name
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Submit
Should be Empty: