Safety & Crisis Planning

source image: http://taolifestudio.com/page/2/
source image: http://taolifestudio.com/page/2/

You know the old adage…Hope for the best, plan for the worst. Often times when clients come to me, they’ve been stuck in crisis mode for themselves or a loved one. When safety is a concern, I address it as early as possible in therapy. This post will walk you through the process of creating a safety and crisis plan, so that everyone involved will know what to do when a situation escalates. Hopefully, planning ahead and increasing awareness will prevent harm and minimize the frequency of crises.

First, identify the top two or three risk behaviors. Examples include running away, physical altercations, self-harm, and property destruction. Keep the focus on the most threatening behaviors. Avoid behaviors that do not pose a threat to physical safety for now; these can be addressed at a later time.

Once everyone is on the same page regarding the behavior they’d like to prevent, spend some time thinking about what has triggered the behavior in the past. Often times with teens, feeling rejected or being yelled at have been triggers for a physical altercation. Other common triggers include being disrespected, not getting his/her way, crowded spaces, people getting in his/her personal space, or others messing with personal belongings. This is not a time to be judgmental or argue about what triggers the behavior. Accept that it is what it is and write it down. The point at this time is to be aware of what triggers unwanted behavior so that you can be ready to respond proactively.

After the behaviors and triggers have been identified, the next step is to brainstorm a few strategies to employ when triggers are likely to appear. For example, if the behavior is running away, triggered by feeling disrespected, then maybe caregivers and the teen agree on a safe place that the teen can retreat to – be it a friend’s house, a relative’s home, a church, or similar. For physical aggression, consider what would help calm the person. Some people get more irritated by a demanding voice and would prefer direction from someone speaking with a calm, clear voice. Sometimes a hug or a gentle pat on the shoulder from a loved one works to deescalate the situation, while close physical contact of any kind might exacerbate the issue. List several coping skills that can be used in a variety of contexts (reading, drawing, specific exercise, talk to a friend, play basketball, etc).

Then brainstorm strategies to put in place that will immediately follow if the risky behavior transpires. In keeping with the physical aggression scenario, consider everyone who might be involved. Make a plan for how to handle this at home, at school, and in the community. The steps might vary depending on where you are. Within the home, consider how to keep everyone safe before a fight breaks out. Are there younger children or other vulnerable individuals in the home? Identify one person who will take the others to another area of the house, possibly even a neighbor’s house if necessary. Separate the individuals involved in the fight if you are able. Designate a space to go cool down. Make a list, complete with phone numbers, of the people in your support network whom you can call for help and the order in which to reach out. Decide when it will be necessary to call the police if physical safety is at immediate risk. If it is your child who struggles, allow him to designate a person he trusts who he can talk to. This could be a friend, a relative, teacher, coach, therapist, etc. Similarly, you will likely need a healthy outlet following an event, as well. Include who you will reach out to on the safety plan, too.

Finally, make a plan for how to address the incident once everyone has calmed down. Will a family meeting in the living room be appropriate? Will it be later that day or a couple days later? Would everyone feel safer addressing it in a therapist’s office? Maybe writing letters to each other would help to process the event and share ideas about how to make a change for the future. How can the individual make amends to others who were affected by the situation?

Make sure you are talking through these considerations when tempers are cool and everyone involved is willing to agree on the plan. It will not do any good to force a plan on someone who hasn’t bought into it. Sometimes these conversations can be tricky and intimidating, but if you can meet in a safe place with an open mind, creating a plan ahead of potential crisis can make a world of difference for you and your loved ones. Contact me for a phone consultation if you have questions about therapy. Below is a list of national and local resources, if you are so inclined.

National Alliance on Mental Illness (NAMI): (800) 950-6264

Georgia Crisis and Access Line:             (800) 715-4225

National Suicide Prevention Lifeline: (800) 273-8255

Teen Helpline: (800) 400-0900

Adolescent Suicide Hotline: (800) 621-4000

Adolescent Crisis Intervention & Counseling Nineline: (800) 999-9999

Domestic Violence Hotline: (800) 799-7233

Child Abuse Hotline: (800) 422-4453

Drug & Alcohol Treatment Hotline: (800) 662-4357

Eating Disorders Center: (888) 236-1188

Panic Disorder Information Hotline: (800) 647-2642

Rape, Abuse, Incest, National Network (RAINN): (800) 656-4673

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems. Use of this website in no way constitutes professional service or advice.

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