Crisis Intervention and Safety Planning
What the candidate must know
Crisis work prioritizes safety and stabilization over insight. Know risk assessment domains: suicidal ideation, plan, intent, means, prior attempts, protective factors, substance use, and access to lethal means. Know that asking directly about suicide does not increase risk.
Understand the difference between a safety plan (collaborative, written, lists warning signs, coping strategies, supports, and crisis contacts) and a no-harm contract (not evidence-based and not a substitute for assessment). Safety planning is the preferred intervention.
Know the crisis continuum: mobile crisis, crisis lines, respite, and emergency evaluation. Know when emergency evaluation or involuntary hold criteria may apply, recognizing that statutes vary by jurisdiction.
Traps in questions
- Reassurance-seeking substituted for direct risk assessment.
- Relying on a no-harm contract as if it reduces risk.
- Failing to address means restriction when risk is elevated.
- Missing that a calm presentation does not equal low risk.
Rule of thumb
When risk is elevated, act: directly assess, restrict means where possible, involve supports, document, and arrange follow-up. Safety planning is collaborative and specific, not a generic list.
Worked example
A client discloses passive ideation with no plan and strong reasons for living. Appropriate response: complete a structured risk assessment, collaboratively build a safety plan, address means, schedule close follow-up, and document the reasoning.