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7: Crisis Response Planning and Safety Planning

Risk Management and Treatment » Non-pharmacologic Interventions
7: Crisis Response Planning and Safety Planning

There is insufficient evidence to recommend for or against completing a crisis response plan or safety planning intervention to reduce the risk of suicide attempts in patients with recent suicidal ideation, a lifetime history of suicide attempts, or both.

Strength:

Neither for or against

Category:

ReviewedNew-replaced

Grades and Definitions

Strong for
or "We recommend offering this option …"
Weak for
or "We suggest offering this option …"
No recommendation
or "There is insufficient evidence …"
Weak against
or "We suggest not offering this option …"
Strong against
or "We recommend against offering this option …"

Categories and Definitions

Evidence Reviewed* Recommendation Category* Definition*
Reviewed New-added New recommendation following review of the evidence
New-replaced Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence
Not changed Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed based on review of the evidence
Not reviewed Not changed Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG
*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.

Recommendation Resources

Crisis Response Plans (CRP) and Safety Planning (SPI) both include step-by-step instructions to use prior to or during a suicidal crisis. They are developed in a collaborative, patient-centered manner. Key components shared by CRP and SPI include identifying warning signs, self-management or internal coping strategies, social support networks and professional/crisis services. CRP and SPI are considered routine care by multiple accreditation bodies and are recommended over "no harm contracts," which have no research support.

Training and Clinical Resources

This section includes recommended trainings and/or clinical resources about Crisis Response Planning and Safety Planning.

Crisis Response Planning Training Options
Stanley-Brown logoStanley-Brown Safety Planning Intervention Training
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Manuals

This section includes recommended manuals about Crisis Response Planning and Safety Planning.

Crisis Response Plan Overview
Stanley-Brown Safety Planning Intervention
Safety Plan Quick Guide Cover ImageVA Safety Planning Quick Guide for Clinicians
Center of Deployment Psychology Safety Planning Infographic
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Videos

This section includes recommended videos about Crisis Response Planning and Safety Planning.

What is a Crisis Response Plan (CRP)?
Implementing the Suicide Safety Plan Intervention
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Webinars

This section includes recommended webinars about Crisis Response Planning and Safety Planning.

SRM Lecture Series graphic Challenging Barriers to Safety Planning: Considering Context and Clinical Complexity Presented by Dr. Colleen Becket-Davenport and Georgia Gerard, LCSW
CPG Webinar graphic Empowering Veterans through Crisis Response Planning & The Safety Planning Intervention Presented by Drs. Craig Bryan & Wendy Batdorf
CPG Webinar graphic Safety Planning — Basics and Beyond Presented by Drs. Megan Harvey & Suzanne McGarity
CPG Webinar graphic Safety Planning in the Emergency Department Presented by Dr. Bridget Matarazzo
CPG Webinar Suicide Prevention 2.0 Clinical Telehealth Program Presented by Dr. Jessica A Walker
Webinar Icon The Safety Planning Intervention to Reduce Suicide Risk Presented by Drs. Barbara Stanley and Gregory Brown
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Mobile Apps

This section includes recommended mobile apps about Safety Planning.

Screenshot of VA Safety Plan appThe Safety Plan app
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Podcasts

This section includes recommended podcast episodes about Crisis Response Planning and Safety Planning.

Short Takes on Suicide Prevention logo Rocky Mountain Short Takes on Suicide Prevention: A Mobile Safety Planning App with Dr. Pearl McGee-Vincent
Short Takes on Suicide Prevention logo Rocky Mountain Short Takes on Suicide Prevention: Collaborative Safety Planning for Older Adults with Drs. Elizabeth Conti and Ali Abbas Asghar-Ali
Short Takes on Suicide Prevention logo Rocky Mountain Short Takes on Suicide Prevention: Safety Planning in the Emergency Room (It Works!) with Drs. Barbara Stanley, Greg Brown and Lisa Brenner
Podcast icon What if Suicide Prevention is Simple? Crisis Response Planning Interview with Dr. Craig Bryan
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Articles

This section includes recommended articles about Crisis Response Planning and the Safety Planning.

Bryan, C. J., Mintz, J., Clemans, T. A., Leeson, B., Burch, T. S., Williams, S. R., Maney, E., & Rudd, M. D. (2017). Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers: A randomized clinical trial. Journal of affective disorders, 212, 64-72. https://doi.org/10.1016/j.jad.2017.01.028
Green, J. D., Kearns, J. C., Rosen, R. C., Keane, T. M., & Marx, B. P. (2018). Evaluating the Effectiveness of Safety Plans for Military Veterans: Do Safety Plans Tailored to Veteran Characteristics Decrease Suicide Risk?. Behavior therapy, 49(6), 931-938. https://doi.org/10.1016/j.beth.2017.11.005
Rozek, D. C., & Bryan, C. J. (2020). Integrating crisis response planning for suicide prevention into trauma-focused treatments: A military case example. Journal of clinical psychology, 76(5), 852-864. https://doi.org/10.1002/jclp.22920
Stanley, B. & Brown, G. K. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001
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 Safety Planning With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department. JAMA psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776
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