A young male sitting with their father. He has created a self-harm safety plan and is connecting with someone he trusts.

How to Create a Self-Harm Safety Plan

September 13, 2023

6 min.

People often self-harm to process difficult feelings and painful memories. Charlie Health offers healthy alternatives to self-harm, including a five-part self-harm safety plan to navigate tough times going forward.

By: Alex Bachert, MPH

Clinically Reviewed By: Dr. Don Gasparini

Learn more about our Clinical Review Process


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Table of Contents

Trigger warning: Self-harm, suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

What is a self-harm safety plan?

A self-harm safety plan is a list of coping strategies, resources, and trusted individuals that someone can refer to when they feel the urge to self-harm—defined as intentionally hurting oneself. Self-harm, sometimes called self-injury or self-mutilation, is often a way to cope with difficult feelings, painful memories, or overwhelming situations. A self-harm safety plan outlines healthy alternatives for managing these painful emotions or feelings of distress. 

A comprehensive and effective self-harm safety plan should be written in your own words, be easy to read, and include actionable items. Below are five essential sections to include in a self-harm safety plan. 

1. Triggers and warning signs 

Thinking about why and when you self-harm can help you understand how to stop it from happening in the future. A self-harm safety plan should always include a list of triggers, meaning situations or thoughts that make you want to harm yourself. Triggers look different for everyone but can include specific situations, sensations, thoughts, emotions, or even people that cause the urge to self-harm. 

Spotting your triggers isn’t always obvious, but there are a few ways to understand your behavior patterns better. For example, you can try journaling each time you self-harm, including what happens before, during, and after. You can also look for physical warning signs, such as sensations like numbness, restlessness, and feelings of heaviness.

Here are a few questions to help you identify what causes you to self-harm and your self-harm triggers:

  • When did I first self-harm? What was going on in my life at that time?
  • How do I feel just before I self-harm? Do any of my habits or routines contribute to that feeling?
  • Am I always in the same place or with a particular person when I get the urge to self-harm?
  • Do I always feel the same emotions when I get the urge to self-harm?

2. Distraction techniques

Sometimes, you just need a distraction to help you resist the urge to self-harm. Here are a few ideas to get you started.

If you’re feeling angry, try substituting self-harm with:

  • Exercising 
  • Dancing
  • Banging pots and pans
  • Hitting a pillow against the wall 
  • Shouting
  • Ripping up a piece of paper

If you’re feeling sad, try substituting self-harm with:

  • A hot bath
  • Soothing music
  • A book or movie
  • Playing with a pet
  • Giving yourself a present
  • Hugging a loved one

If you’re feeling out of control, try substituting self-harm with:

  • A cold shower
  • Flicking an elastic band on your wrist
  • Holding ice cubes in your hand

If you’re feeling guilty, try substituting self-harm with:

  • Thinking about your positive qualities
  • Talking to someone who cares about you
  • Doing something nice for someone else
  • Thinking about something you’re proud of 
Young female with pink and brown hair. She is creating a self-harm safety plan.

3. Coping strategies 

A self-harm safety plan should also include healthy alternatives to self-harm for coping with distressing emotions and situations. If you’re already working with a therapist or mental health professional, you might have a list of tools to help you effectively manage your emotions. If not, here are a few examples to get you started:

  • Mindfulness techniques, such as slowly eating a piece of fruit and thinking about its taste, color, smell, weight, and texture
  • Deep breathing exercises, such as counting backward from 10
  • Physical activity, such as yoga or a walk around a local park
  • Positive affirmations, such as “I am strong enough to get through this”

4. Support system

If you’re struggling with painful emotions, one of the best things you can do is connect with someone you trust. Create a list of friends, family members, teachers, or other trusted adults you can rely on during tough moments as your support system.

Sharing your self-harm probably feels scary, but opening up to someone you trust is an important step in getting help. Not sure how to start the conversation with family and friends? Simply be honest and say something like: “I’m struggling to process some painful emotions right now, and I’m concerned that I won’t cope in a healthy way. I could use your support right now. Can you do that for me?

A comprehensive safety plan should include supportive people and places, such as:

  • People who can help you resist the urge to self-harm
  • Safe places where you can relax, such as a friend’s house or your favorite coffee shop 
  • Access to a support line, such as the Crisis Text Line. Text HOME to 741741 to connect with a real human to discuss healthy coping mechanisms to manage your emotions

5. Emergency support

If you or a loved one are experiencing suicidal thoughts, please immediately call the National Suicide Prevention Lifeline at 988 or dial 911. 

Additionally, here are several other suicide prevention resources:

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Why are self-harm safety plans important?

People self-harm for different reasons, but self-harm is often used to cope with painful emotions, escape traumatic memories, or gain control. Having a well-thought-out self-harm plan in place is important because it can proactively mitigate the risk of self-harm and present solutions for navigating moments of crisis more healthily.

Self-harm plans are also important because they can promote overall emotional well-being. Self-harm isn’t a mental illness, but research shows it is usually a warning sign of deeper mental health issues, such as depression, anxiety disorders, and bipolar disorder. And when left untreated, self-harm can lead to a toxic cycle of shame, guilt, and emotional suffering. Having a self-harm plan can empower people to take care of themselves and take control of their mental health. 

Self-harm safety plans, though, shouldn’t replace speaking with a mental health professional. In fact, a self-harm safety plan is more useful when used in conjunction with mental health treatment, such as cognitive behavioral therapy (CBT). A licensed mental health professional can help people understand the underlying factors contributing to self-harming behaviors and tailor a self-harm safety plan to address these specific triggers. A therapist can also teach and reinforce healthier coping skills and serve as someone who can offer consistent support and accountability when it comes to the self-harm safety plan.

Get support for self-harm with Charlie Health

Self-harm is usually a sign that someone is struggling with their mental health and would benefit from professional mental health support—which is where Charlie Health comes in. 

Charlie Health offers comprehensive mental health care for adolescents, young adults, and families who need more support than once-weekly therapy. Our virtual Intensive Outpatient Program (IOP) combines group sessions, individual therapy, and family therapy to create a customized treatment plan based on each person’s mental health needs—including support around self-harm.

No matter where you are in your mental health journey, we’re here to help you every step of the way. Our team of compassionate, experienced mental health professionals will help you understand your triggers, create a safety plan, and learn healthy ways to cope with difficult emotions. Fill out this short form to get started today.

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