TY - JOUR
T1 - The No Harm Contract in the emergency assessment of suicidal risk
AU - Stanford, E. J.
AU - Goetz, R. R.
AU - Bloom, J. D.
PY - 1994
Y1 - 1994
N2 - Background: The No Harm Contract has been widely accepted in clinical practice, yet there is no broad consensus as to its value. This paper examines the contract and offers recommendations for its use as well as cautions about its misuse. Method: After a literature review, the No Harm Contract is examined from diagnostic, therapeutic, and medicolegal perspectives. Results: Diagnostically, the No Harm Contract can be used to assess the nature and severity of a patient's suicidality, uncover specific troubling issues precipitating suicidal thoughts, and evaluate the patient's competency to contract. Therapeutically, the contract affords an opportunity to initiate a therapeutic alliance, establish the limits of the psychotherapeutic framework, and reduce both patient and clinician anxiety. Medicolegally, the contract is not legally binding and grants no suicide malpractice suit protection. Conclusion: Although the No Harm Contract is a frequently used clinical tool that can provide diagnostic information and therapeutic advantage, it can also short-circuit comprehensive-suicidal assessment and disposition decisions.
AB - Background: The No Harm Contract has been widely accepted in clinical practice, yet there is no broad consensus as to its value. This paper examines the contract and offers recommendations for its use as well as cautions about its misuse. Method: After a literature review, the No Harm Contract is examined from diagnostic, therapeutic, and medicolegal perspectives. Results: Diagnostically, the No Harm Contract can be used to assess the nature and severity of a patient's suicidality, uncover specific troubling issues precipitating suicidal thoughts, and evaluate the patient's competency to contract. Therapeutically, the contract affords an opportunity to initiate a therapeutic alliance, establish the limits of the psychotherapeutic framework, and reduce both patient and clinician anxiety. Medicolegally, the contract is not legally binding and grants no suicide malpractice suit protection. Conclusion: Although the No Harm Contract is a frequently used clinical tool that can provide diagnostic information and therapeutic advantage, it can also short-circuit comprehensive-suicidal assessment and disposition decisions.
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M3 - Article
C2 - 8071303
AN - SCOPUS:0027980914
SN - 0160-6689
VL - 55
SP - 344
EP - 348
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 8
ER -