Print or export as you go. Your responses are saved on this device only. Clearing your browser data or switching devices will erase your work. Use the Download PDF or Print button above to keep a permanent copy.

My Self-Harm Response Plan

Build a concrete response plan before you need it.

Week 8

Appendix H

Understanding the Function

What do you think self-harm does for your loved one? What need does it meet?

What is your typical reaction when you discover self-harm? (Be honest)

What would you like to change about your reaction?

My Response Protocol

Step 1 — Regulation: What will I do first to regulate myself?

Step 2 — Physical: What will I say to address the physical?

Step 3 — Mirror: What will I say to mirror their pain?

The signs I will watch for that indicate this may be shifting to suicidality:

If I see those signs, I will: