Crisis in Session — Step-by-Step Clinical Flowchart
When a crisis happens in session, you need to know what to do and in what order. This flowchart covers every major in-session crisis type with step-by-step protocols and specific language.
What is in this flowchart
Seven crisis branches — suicidal ideation, self-harm, panic attack, acute dissociation, psychosis, homicidal ideation, and medical emergency. Each with its own assessment and response sequence.
Suicidal ideation assessment protocol — the full sequence: receive first, then assess. Ideation type, plan specificity, means, intent, timeline, protective factors, history. Risk stratification and what to do at each level.
Safety planning guide — a collaborative, step-by-step format for building a real safety plan in session: warning signs, internal coping, social contacts, crisis contacts, means restriction. Not a signature form — a working plan.
Self-harm protocol — function assessment, lethality evaluation, distinguishing self-harm from suicidal intent, and the language that keeps the client talking honestly.
Panic and dissociation protocols — what to do, what to say, and what not to do for both. How to use the moment clinically after the acute phase passes.
Post-crisis checklist — same-day documentation, supervisor consult, follow-up contact, self-care. What needs to happen before the session ends and before the next day.