资源取向安全计划制定

---
id: "3d24a6e5-89f5-5a20-8c15-e4bb16000428"
name: "资源取向安全计划制定"
description: "在首次咨询中，针对高自杀风险但无急性精神病性发作、具备基本现实检验能力且对支持系统存有模糊信任基础的来访者，结构化协同制定包含紧急联系人、情绪调节策略、安全场所三要素的安全计划，并获得其关于‘不伤害自己’的明确口头承诺。"
version: "0.1.0"
tags:
  - "安全计划"
  - "自杀风险"
  - "资源取向"
  - "首次咨询"
  - "口头承诺"
  - "resource-oriented"
  - "suicide-prevention"
  - "collaborative-safety"
  - "environment-anchored"
  - "人本-存在主义"
  - "profile:psychology::人本_存在主义"
  - "axis:疗法"
triggers:
  - "来访者报告当前有自杀意念"
  - "无即时自伤行为但风险评级为中高"
  - "药物治疗已启动且依从性良好"
  - "Client expresses active suicidal ideation with intent or plan"
  - "Client identifies environmental cues linked to safety (e.g., 'people-rich spaces')"
  - "Client demonstrates capacity to name even minimal protective factors"
examples:
  - input: "咨询师：小Y，考虑到你目前的情绪状态和自杀风险，我们今天需要制定一个安全计划，以确保你能够得到及时有效的帮助和支持。你觉得怎么样？"
    output: "小Y：好的，我试试。"
    notes: "来访者初步接受，进入协作制定阶段"
  - input: "Client says: 'I only feel okay in the library — it’s quiet but there are people nearby.'"
    output: "Plan includes: 'Library (ground floor, near front desk) — go there when overwhelmed; sit for 10 min, watch people walk by.'"
    notes: "Uses client’s sensory description and embeds micro-behavior."
  - input: "Client says: 'My roommate checks on me sometimes — I can text her “I’m shaky”.'"
    output: "Plan includes: 'Text roommate: “I’m shaky” → she comes over or stays on call for 15 min.'"
    notes: "Turns relational resource into time-bound, low-barrier action."
---

# 资源取向安全计划制定

在首次咨询中，针对高自杀风险但无急性精神病性发作、具备基本现实检验能力且对支持系统存有模糊信任基础的来访者，结构化协同制定包含紧急联系人、情绪调节策略、安全场所三要素的安全计划，并获得其关于‘不伤害自己’的明确口头承诺。

## Prompt

以共情和无条件积极关注为基调，用非评判性语言引导来访者共同生成可操作的安全计划：① 明确紧急联系人（含外部热线）并确认其可达性；② 用正向提问激活来访者既往有效的自我安抚经验（如听音乐、吃美食）；③ 共同识别物理上与心理上均感安全的场所（如图书馆、低楼层教室）；最后清晰陈述安全要求，并邀请来访者就‘不伤害自己’作出明确口头承诺。

## Objective

危机稳定化
## Applicable Signals

- 表达无助感或存在感稀薄
- 提及具体自杀想法但无实施计划
- 对支持系统存有模糊信任基础
- Client names specific places where they feel safer (e.g., 'library', 'ground-floor classroom')
- Client links safety to social presence ('where there are people')
- Client shows momentary engagement with alternatives to self-harm

## Contraindications

- 来访者处于急性精神病性发作状态
- 拒绝签署或口头承诺安全协议
- 缺乏基本现实检验能力
- Client is actively psychotic or disoriented
- Client refuses collaboration on safety planning
- No verifiable emergency contacts or accessible support systems exist

## Intervention Moves

- 正向提问
- 共情性重述
- 选择性聚焦（避开病理性归因，锚定可控行动）
- 具身化引导（如‘想到那个安全场所时，身体哪部分最先放松？’）
- Resource elicitation (‘What places or people help you feel less alone?’)
- Affirming naming of safety (‘You already know what helps — let’s build from that.’)
- Concrete co-documentation (writing plan together, using client’s words)

## Workflow Steps

- 评估当下自杀意念强度、计划性、既往行为史及保护性因素
- 介绍安全计划目的：‘不是限制你，而是帮你多一个可用的支持工具’
- 协同填写三项内容：① 紧急联系人（含24小时心理援助热线）；② 个人有效的情绪缓冲行为（用正向提问激活：‘上次心情变好时，你做了什么？’）；③ 安全场所（强调‘人多’‘易离开’‘有熟悉感’等特征）
- 清晰陈述安全约定：‘在咨询期间，请承诺不做出伤害自己的行为；如有不可控冲动，请立即联系咨询师、家人或辅导员’
- 邀请来访者用自己语言复述承诺，并确认其理解与意愿
- Elicit client-named safe places and conditions using open, non-leading questions.
- Validate and reflect the function of each cue (e.g., ‘So being around others helps your nervous system settle — that’s real and usable.’).
- Co-list four plan components using client’s language; avoid clinical jargon.
- Confirm storage method and accessibility (e.g., ‘Would a photo in your phone work? Or a printed copy in your notebook?’).
- End with verbal confirmation: ‘If things get overwhelming this week, which part of this plan will be easiest to try first?’

## Constraints

- 必须在首次咨询中完成
- 需确保来访者理解每项内容而非仅被动应答
- 不得将安全计划替代危机转介或医疗干预
- Must be completed within first session of acute risk presentation
- Cannot proceed without at least one client-identified safe location or person
- No hypothetical or future-oriented items (e.g., ‘I’ll call my mom someday’) — only present-tense, actionable items

## Cautions

- 避免使用‘保证’‘发誓’等施压性措辞；聚焦‘尝试联系’‘先做一件小事’等低门槛行动承诺
- 若来访者对某项内容犹豫，须暂停推进、探索顾虑，不可跳过或代偿
- Avoid framing safety as ‘staying alive’ abstractly; anchor instead in felt experience (e.g., ‘less alone’, ‘calmer breathing’).
- Do not omit or minimize client’s stated reasons for distress while focusing on resources.
- If client names a place that is objectively unsafe (e.g., rooftop), collaboratively explore *why* it feels safe and identify a proximal alternative with similar qualities.

## Output Contract

- 三方确认的安全计划文本（含联系人、自我安抚策略、安全场所）及来访者‘不伤害自己’的明确口头承诺
- A client-accessible, co-constructed safety plan document (physical or digital) containing four validated components: (1) emergency contacts, (2) crisis hotline numbers, (3) client-identified emotion-regulation actions, (4) client-named safe locations — all expressed in client’s own words and confirmed for immediate usability.

## Example Therapist Responses

### Example 1

- Client/Input: 咨询师：小Y，考虑到你目前的情绪状态和自杀风险，我们今天需要制定一个安全计划，以确保你能够得到及时有效的帮助和支持。你觉得怎么样？
- Therapist/Output: 小Y：好的，我试试。
- Notes: 来访者初步接受，进入协作制定阶段

### Example 2

- Client/Input: Client says: 'I only feel okay in the library — it’s quiet but there are people nearby.'
- Therapist/Output: Plan includes: 'Library (ground floor, near front desk) — go there when overwhelmed; sit for 10 min, watch people walk by.'
- Notes: Uses client’s sensory description and embeds micro-behavior.

### Example 3

- Client/Input: Client says: 'My roommate checks on me sometimes — I can text her “I’m shaky”.'
- Therapist/Output: Plan includes: 'Text roommate: “I’m shaky” → she comes over or stays on call for 15 min.'
- Notes: Turns relational resource into time-bound, low-barrier action.

## Files

- `references/evidence.md`
- `references/evidence_manifest.json`

## Triggers

- 来访者报告当前有自杀意念
- 无即时自伤行为但风险评级为中高
- 药物治疗已启动且依从性良好
- Client expresses active suicidal ideation with intent or plan
- Client identifies environmental cues linked to safety (e.g., 'people-rich spaces')
- Client demonstrates capacity to name even minimal protective factors

## Examples

### Example 1

Input:

  咨询师：小Y，考虑到你目前的情绪状态和自杀风险，我们今天需要制定一个安全计划，以确保你能够得到及时有效的帮助和支持。你觉得怎么样？

Output:

  小Y：好的，我试试。

Notes:

  来访者初步接受，进入协作制定阶段

### Example 2

Input:

  Client says: 'I only feel okay in the library — it’s quiet but there are people nearby.'

Output:

  Plan includes: 'Library (ground floor, near front desk) — go there when overwhelmed; sit for 10 min, watch people walk by.'

Notes:

  Uses client’s sensory description and embeds micro-behavior.

### Example 3

Input:

  Client says: 'My roommate checks on me sometimes — I can text her “I’m shaky”.'

Output:

  Plan includes: 'Text roommate: “I’m shaky” → she comes over or stays on call for 15 min.'

Notes:

  Turns relational resource into time-bound, low-barrier action.