Emotional Safety Plan This is a safety plan to help you think through different steps that identify ways to cope and people who can support you when you are in emotional distress or crisis. Take time to sit with a staff person and think through each of these steps. When you are finished, keep a copy for yourself, so you can refer to the different things you identified. If you find that your distress continues to get worse, please find a staff person or emergency contact to talk to, so they can help. STEP 1: What are some of the things that are causing me distress and creating a crisis for me (thoughts, images, mood, situations, and behaviors)? 1.
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STEP 2: These are the things I can do on my own to take my mind off my problems (e.g. relaxation techniques, deep breathing, physical activity, journaling, cleaning, light reading). 1.
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STEP 3: These are situations and people I trust that I can talk to and keep my mind off my pain. 1.
Name _______________________________________________ Phone _________________________
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Name _______________________________________________ Phone _________________________
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Name _______________________________________________ Phone _________________________
STEP 4: These are professionals or agencies I can contact when I feel in crisis or overwhelmed. 1.
Clinician Name ___________________________________________ Phone _____________________ Clinician Pager or Emergency Contact #: _________________________________________________
2.
Psychiatrist or Dr. _________________________________________ Phone _____________________ Dr. Pager or Emergency # ______________________________________________________________
3.
Other Professional/ Service_____________________________________ Phone ____________________
4.
Suicide Prevention Lifeline Phone: 1-800-273-8255
STEP 5: These are things I can do to make my environment safe (e.g. remove medications, remove weapons, add a night light) 1.
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