2 thoughts on “What Is A “Safety Plan” For Mental Health?

  • March 12, 2014 at 12:36 am

    My understanding is that behavioral contracts (sometimes known as no-harm contracts) have largely fallen out of favor. The concern, at least from what I’ve read, seems to be that these contracts establish that there was a safety concern about a client — and that the therapist did nothing more than accept the client’s word that they would not harm themselves or others. In the case of a client who breaks this contract and commits harm, the therapist could be found liable for not taking further steps to ensure safety. (I’m not a lawyer, so again, this is just based on what I’ve been reading.)

    Safety plans along the lines of what you’ve described here have been looked on much more favorably in what I’ve seen in recent literature. Are others seeing and hearing the same thing? Or are no-harm contracts still more in use than the literature would suggest?

    • March 12, 2014 at 9:49 am

      Hi Benjamin:
      Thank you for your comment.

      You are right, they have fallen out of favor. I myself, do not use behavior contracts because they are complicated, senseless most times, and not useful for someone who is incapable of comprehending the agreement or honoring it. However, if a safety-plan (a document that lists situations where coping may be difficult and ways to cope or people to reach out to), is used, it is most useful with younger clients such as children and teens who are in a cognitive state of awareness. I certainly would discourage the use of a behavioral contract or safety plan with someone who is suffering from delusions or hallucinations or even cognitive distortions. It can be difficult to comprehend the agreement or plan.

      But more to your point, I think you are correct about the safety plans and their more favorable reputation. They are more worthy of attention and, in my practice of psychotherapy, more useful. There are definitely risk management issues with all of these contracts/plans.

      We must keep in mind that the contract/plan is but a small piece of the strategic approach to counseling someone in need. Although dated, this article discusses them a bit.

      Again, thanks for your comment


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