In working with the Collaborative Assessment and Management of Suicidality (CAMS), I concentrate on what I call "Drivers," which are the specific areas or life circumstances that cause an individual to want to die (e.g., loss of a job, loss of family, etc.). To empower the Stabilization Plan from session to session, I have created a "Living Document" based on "near misses" that we update each week. This process is similar to a post-game analysis in sports. We also take a specialized approach to the Stabilization Plan: instead of identifying general coping skills, we use Implementation Intentions based on the "If-Then" model. For example, if someone is staring at the medicine cabinet (the trigger), then the Implementation Intention would be that they immediately go to the kitchen and drink a glass of ice water. One of my most successful additions to the Stabilization Plan is a "Red Flag Communication Protocol." We include a line stating that when a person feels their "Internal Agitation" has reached a Level 7, they will text a designated person the code word "ORANGE." This informs their support system that they are struggling without requiring a full explanation. This approach significantly reduces barriers to seeking help. Many chronically suicidal individuals feel like they would be a burden to those they reach out to and do not wish to initiate a "heavy-duty" conversation about their ideation. By utilizing an agreed-upon code word, the individual can reach their supportive people without the additional stress of explaining their situation.
Actionability can be enhanced when the plan is changed to containment that is not crisis but rather day to day. One particular addition which alters the subsequent steps to be followed is a written line which creates the firstest internal indication which will be taken to mean that the plan ought to be opened. Instead of waiting until one thinks about self harm the plan identifies a specific state, like two nights of poor sleep, skipping meals, or reenacting a particular story. This cue is self-identified by the clients. That timing matters. After the trigger being named, the second step is that of compressed. One of the actions identified in the plan can be accomplished in less than five minutes and is not dependent on motivation. As a sample, it may be sitting in a particular chair, texting one word to a respective contact, or opening a note with a grounding language that is written in a stable session. It focuses on initiation rather than relief. This change helps to cut the ambiguity between sessions. There is no longer a debate among clients on whether things are bad enough. The cue provides the response to that. Subsequently, follow-up sessions are followed by a review on whether the cue came and whether the first action was taken and not whether the client felt better. This adaptation helps in chronic ideation as it respects its permanency. The plan is turned into a day-to-day containment instrument instead of an emergency document. Coherence is enhanced as the initial step is concise and definite and it is pegged on observable experience.
When working with chronic suicidal ideation, I keep the Stanley-Brown or CAMS plan brutally practical between sessions. I add a single line under coping steps that says exactly who to text, what to say, and within how many minutes. We also tie each step to a time of day when urges spike. The biggest difference came from scheduling one low-friction action that happens before thoughts escalate, not after. That shift reduced crisis calls and increased plan use outside sessions.
As a technologist I don't create safety plans myself, but clinicians I collaborate with emphasise that the most effective Stanley-Brown Safety Plans are highly personalised and focus on connecting the individual to support rather than asking them to manage a crisis alone. In practice this means co-writing the plan in the client's own words and including simple, concrete steps they have rehearsed in session. For clients with chronic suicidality, therapists often start by listing personalised warning signs and coping strategies that have worked before - for example, listening to a favourite piece of music, going for a brisk walk, or practising a breathing exercise - and then move quickly to a section titled "Reasons for Living," where the client writes down people, values or future events that matter to them. Having the client articulate these reasons in their own handwriting makes the plan feel grounded and accessible when emotions are overwhelming. One modification that I've seen make a clear difference is including a proactive outreach commitment at the end of the plan. Instead of just listing crisis phone numbers, the plan might include a line like "If I notice I'm starting to feel hopeless, I will send a text message to [trusted person] and let them know I need support" or "I will call my therapist to schedule an extra check-in." This explicit permission to reach out, coupled with rehearsing the wording in session, helps clients feel less like they are burdening others. Clinicians also encourage clients to store the plan in a place they will actually use - such as a photo on their phone - and to review it at the start of each session to reinforce familiarity. It's essential to emphasise that safety planning should always be conducted with a qualified mental health professional. If you or someone you know is struggling with thoughts of self-harm, contact a crisis hotline or healthcare provider immediately. Customising a plan is about reinforcing connections and coping resources, but professional guidance is vital for managing chronic suicidality safely.