Free Self Harm Safety Plan Template
Self-Harm Safety Plan
I. Introduction
Welcome to the Self-Harm Safety Plan, designed to provide support and guidance for individuals struggling with self-harm behaviors. This personalized document outlines strategies and steps to prevent and manage self-harm effectively.
A. Purpose
The purpose of this Self-Harm Safety Plan is to:
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Provide individuals with practical tools and resources to cope with self-harm urges.
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Assist in the identification of warning signs and triggers.
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Facilitate crisis management and access to professional support.
B. Scope
This Self-Harm Safety Plan encompasses:
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Personalized coping strategies and techniques.
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Emergency contacts for immediate assistance.
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Steps for implementing the safety plan during crises.
II. Personal Information
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Name: [Your Name]
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Date: [Current Date]
Emergency Contacts:
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Primary Contact:
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Name: [Primary Contact Name]
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Relationship: [Relationship]
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Phone Number: [Primary Contact Number]
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Secondary Contact:
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Name: [Secondary Contact Name]
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Relationship: [Relationship]
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Phone Number: [Secondary Contact Number]
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III. Warning Signs
1. Emotional Signs:
Feeling overwhelmed: Sensation of being inundated or unable to cope with stressors, leading to feeling emotionally swamped.
Extreme sadness or depression: Intense feelings of sorrow or despair, often accompanied by a lack of interest in activities, changes in appetite or sleep patterns, and persistent negative thoughts.
Intense anger: Overwhelming feelings of rage or fury, often leading to outbursts, irritability, and difficulty controlling impulses.
2. Physical Signs:
Increased heart rate: Noticeable elevation in heart rate, indicating heightened physiological arousal often associated with anxiety, stress, or agitation.
Clenching fists: Tightening the hand muscles into a fist-like position, indicative of tension, frustration, or anger.
Pacing: Restless or repetitive walking back and forth, reflecting inner turmoil, agitation, or needing to release excess energy.
IV. Components of the Self-Harm Safety Plan
A. Personal Triggers and Warning Signs
Identify personal triggers and warning signs that may precede self-harm behaviors.
B. Coping Strategies
Positive Distractions: Engage in activities that provide a sense of calm and distraction.
Self-Soothing Techniques: Practice relaxation exercises such as deep breathing or mindfulness.
Social Support: Reach out to trusted friends, family members, or support groups for emotional support.
Professional Support: Contact mental health professionals or crisis hotlines for immediate assistance.
C. Professional Resources
1. Therapist/Counselor
Name: [Therapist Name]
Phone Number: [Therapist Contact Number]
2. Crisis Hotlines
List emergency contact numbers for immediate assistance:
National Suicide Prevention Lifeline: 1-800-273-8255
Crisis Text Line: Text "HELLO" to 741741
D. Safety Plan Implementation
Step-by-Step Guide: Provide a step-by-step guide on implementing the safety plan during a crisis.
Practice Scenarios: Role-play potential crises to prepare for real-life emergencies.
V. Review and Updates
Regularly review and update the Self-Harm Safety Plan to:
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Reflect changes in triggers, coping strategies, or support networks.
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Incorporate feedback from the individual and their support network.
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Ensure the plan remains relevant and effective in managing self-harm behaviors.
VI. Conclusion
The Self-Harm Safety Plan serves as a valuable tool in preventing and managing self-harm behaviors. By identifying triggers, implementing coping strategies, and accessing support networks, individuals can navigate through moments of crisis with resilience and strength. Remember, you are not alone, and help is always available.
For queries or further information, please contact:
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Company: [Your Company Name]
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Phone Number: [Your Phone Number]
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Email: [Your Email]
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Address: [Your Company Address]
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Website: [Your Company Website]
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Social Media: [Your Company Social Media]
