No Harm Contract
A written or verbal agreement between a clinician and a patient in which the patient commits to not engaging in self-harm or suicidal behaviour for a specified period.
Full Definition
A no harm contract, also called a safety contract or no-suicide contract, is a therapeutic tool used in outpatient and crisis settings to reinforce a patient's commitment to safety. While once widely used, its clinical validity as a safety intervention has been questioned in the literature, and many facilities have replaced it with structured safety planning. Editors should be aware that the term appears in legacy documentation and may coexist with or be superseded by references to 'safety planning' in contemporary records. The document type varies from a formal signed form to a verbal agreement documented in a progress note. Editors must not alter the terminology retroactively in legal or clinical records.
Usage
Usage note: This term is considered outdated in evidence-based practice; editors should flag its presence in contemporary documents for clinician review without altering the text independently.
In Context
- "The therapist documented that a no harm contract was verbally established and that the patient agreed to call the crisis line before acting on suicidal ideation." — Outpatient therapy progress note
- "When editing older clinical records, retain 'no harm contract' as written; do not update to 'safety plan' without clinician instruction." — Retrospective chart review editorial note