As a clinical social worker, I often worry about my clients. Besides working with a higher-risk population that have had hospitalizions in the past year, I’m a human being and I care about my clients. I especially have a soft spot for people suffering with hopelessness, feelings of worthlessness, and depression. It’s a hell I’m familiar with.
When a client has self-harming or suicidal behavior (thoughts, plan, gesture, or attempt), no matter how meticulously I dot my i’s and cross my t’s to keep them safe, I worry. I worry even though I’m licensed now, and I’m trained in crisis management, suicide prevention, and safety planning. Even though I’ve done a hundred safety plans. Even when we write a comprehensive safety plan that identifies signs of a crisis, supportive people, and all the behaviors and coping skills that can redirect a client to consider alternative behaviors. I worry even though, ultimately, it is their decision to stay safe or not.
Plans are better than contracts. There is research that suggests that safety contracts are ineffective to reducing risk. When you turn a therapeutic tool into a legal document, I’m not quite sure how you would enforce it, God forbid anything terrible were to happen.
Safety planning helps me to feel better about giving clients identifiable tools to make healthy choices. My worry is not a buzzing static anymore like it was when I was green… it’s more like hoping that clients do what we want them to… to stay safe. I do the best that I can and hope that the client makes the best decisions for themselves.
The Old Way
A safety plan that I often do with clients is one which identifies the signs of a crisis, internal coping mechanisms, external distractions, identifying whom the person can call for help, and phone numbers two important places (i.e. crisis line).
It’s comprehensive, informative, but its boring. Not that it should be fun, but still… it just looks like a bland medical document. I like using handouts with my clients… things like my self-care plan or self-assessment… something tangible that they can take home, reflect on, even hang up. So I made a new one.
The New Way
I’ve reimagined the traditional safety plan to be something that a trained professional can work on collaterally with a client, and hopefully their support system, while creating something that they can hang up somewhere prominently, whether it is a refrigerator, dorm furniture, or bedroom mirror. As you can see, the formatting looks very familiar. It’s bold but hopefully, not boring.
