> ## Documentation Index > Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt > Use this file to discover all available pages before exploring further. # Safety plan > A six-step crisis safety plan built collaboratively with the client — warning signs, internal coping, social distraction, social help, professional contacts, and means safety. The safety plan is Rivet's single crisis-category template. It's a collaborative, six-step plan you build with a client at elevated suicide risk — typically after an SI assessment that warrants intervention, after an ED discharge, or as part of ongoing risk management with a vulnerable client. The structure follows the Stanley-Brown Safety Planning Intervention (SPI), the most evidence-based brief crisis-management tool currently in use. **A safety plan is part of a clinical response, not a substitute for assessment.** Build a plan after you've assessed risk — not instead of it. Pair the plan with a screening tool like [C-SSRS](/clinical-templates/clinician-administered/c-ssrs) for ongoing monitoring. If the client is in acute crisis right now, the plan is built later, not now — current crisis means stabilization and immediate care first. ## What the template covers Six numbered steps, in order. The clinical theory is **stepped escalation**: the client exhausts internal coping (low-arousal) before involving others (higher-arousal social engagement), before involving professionals, before final means-safety steps. The ordering matters — it builds a ladder the client can climb in real time. | Step | What it captures | | ----------------------------------- | ------------------------------------------------------------------------------------------------------------- | | **1. Warning signs** | Three slots — internal cues the client uses to recognize a crisis is starting | | **2. Internal coping strategies** | Three slots — things the client can do alone to take their mind off the crisis | | **3. Social distraction** | Two people (name + phone) and two places that take the client's mind off the crisis — without asking for help | | **4. Social help** | Three people (name + phone) the client can ask for help during a crisis | | **5. Professionals and agencies** | Clinician, other professional, ED, crisis line | | **6. Making the environment safer** | Two means-safety action fields (large text) | Total: 33 items across the six steps. ## When to use it * **After an SI assessment that warrants intervention** — the C-SSRS flags an actionable concern (items 4, 5, or 6), and the conversation moves from assessment to plan. * **Post-ED discharge** — the safety plan is part of standard discharge practice after a suicide-related ED visit. * **After a self-harm event** — the conversation about what to do next time. * **As part of ongoing risk management** — for a client whose presentation puts them at elevated risk over time. Build the plan **collaboratively** in a single session (20–45 minutes). Build it during a stable period, not during acute crisis. The client retains a copy (phone or paper); you keep a copy in their record. ## The evidence The Stanley-Brown SPI is the most rigorously studied brief crisis intervention currently in widespread use. The 2018 JAMA Psychiatry RCT (Stanley et al.) compared SPI plus structured follow-up against usual care for suicidal patients treated in ED settings, and reported: > **A 45% reduction in suicidal behavior in the SPI arm over the > six-month follow-up period.** The largest single component of the effect is attributed to **Step 6 (means safety)** — the conversation about reducing access to a chosen method during the elevated-risk period. ## How to launch it Open the templates picker and search "safety plan" — the template lives in the Crisis category. Build the plan with the client on screen. Read each step aloud, write together. The clinical value is in the conversation, not the form fields — the form is the durable record. When you finish, **save a copy where the client can find it during a crisis**. Phone screenshot, lock-screen note, wallet card, printed copy. A safety plan that lives in an EHR the client can't access during a crisis is not a safety plan. ## Step-by-step ### Step 1 — Warning signs Three string slots. Internal cues — thoughts, feelings, body sensations, behavioral changes, situations — that signal the client that a crisis is starting. The client is recognizing themselves in advance. Be concrete. "Lying awake past 2 a.m. thinking about being a burden" beats "feeling bad." ### Step 2 — Internal coping strategies Three string slots. Things the client can do alone, without engaging anyone else, to step away from the crisis trajectory. Walking, music, a specific show, a specific game, a shower. The lower the activation energy required, the better — the client picks these in a moment when activation is high. ### Step 3 — Social distraction (without asking for help) Two people (name + phone) and two places. **The key clinical detail is "without asking for help."** The client calls these people for casual contact — not to tell them they're in crisis. The contact itself is the regulation. Places are the same — a coffee shop, a library, a gym, a friend's apartment when they're around. Somewhere the client goes to be among people without needing to disclose. ### Step 4 — Social help Three people (name + phone) the client can ask for help during a crisis — specifically asking. Different list from Step 3. These are people who know the client well, who can hold the disclosure, who can be reached. Check the phone numbers are current. Update the plan if a relationship changes. ### Step 5 — Professionals and agencies * **Clinician — name and phone** (you, in most cases) * **Other professional — name and phone** (psychiatrist, family doctor, prior therapist) * **Local emergency department — name and phone** * **Crisis line** — pre-populated default: **9-8-8 (call or text)** · **Talk Suicide Canada 1-833-456-4566** · **911** · plus space for a local line specific to the client's region. 9-8-8 is the Canadian three-digit crisis number, live since November 2023\. It accepts calls and texts. Include it on every plan. ### Step 6 — Making the environment safer Two large text fields for means-safety actions. **This is the highest- evidence component of the plan.** Means restriction is a hard conversation. What the client uses, what they keep at home, what they can put out of reach for a defined period. Locking medications, giving a key to someone, removing firearms from the home, leaving them with someone, having someone else hold them. The 2018 RCT effect is largely attributable to this step. Specifics, not generalities. "I will give my Tylenol to my partner and keep only one day's supply in the bathroom" beats "I will be careful with medication." ## Reading the plan later When you re-open a saved plan — for a review session, before a known high-risk window, or as part of ongoing care — the structured fields let you see at a glance what's there. * **Step 1–3 capture self-management capability.** Strong content here is protective. * **Step 4–5 capture social and professional support.** Gaps here are clinical concern — the client doesn't have a ladder above the second rung. Address with practitioner intervention. * **Step 6 (means safety) is the highest-evidence component.** If Step 6 is thin, that's where the next conversation goes. ## When to review the plan * **At every visit during an elevated-risk period.** * **Every 3–6 months during ongoing care.** * **After any near-miss, self-harm event, or ED visit.** * **When relationships, employment, or living situation change** — old contacts may be out of date. ## What the template doesn't do * It doesn't replace the C-SSRS or other ongoing risk monitoring. Build the plan, keep screening. * It doesn't dial the phone numbers for the client. The crisis line number is a string, not a tap-to-call button. The client dials. * It doesn't auto-remind the client to review. You schedule the review. ## Naming and licensing Rivet's template uses the six-step Stanley-Brown method with original field labels. It is titled **"Safety plan"** — not "Stanley-Brown Safety Plan." If your practice prefers the licensed Stanley-Brown form specifically (with their wording and branding), contact suicidesafetyplan.com for the licensed PDF. ## Citation * **Stanley, B., & Brown, G. K.** (2012). "Safety planning intervention: A brief intervention to mitigate suicide risk." *Cognitive and Behavioral Practice,* 19(2): 256–264. * **Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L.** (2018). "Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department." *JAMA Psychiatry,* 75(9): 894–900. **45% reduction in suicidal behavior in the SPI arm.** The six-step clinical method is published peer-reviewed work and in widespread use. The Stanley-Brown form itself carries usage restrictions; Rivet's template uses the underlying method with original wording. ## Related articles The screening tool that typically precedes the safety plan conversation. Use the two together — assessment first, plan second. Item 9 (passive death ideation) is one of the most common triggers for a follow-up risk conversation that leads to a safety plan.