A nurse is caring for a client who has agreed to a verbal safety contract following a self-mutilation attempt. Which of the following behaviors indicates that the contract has been effective?

• A. The client displaces their feelings of self-harm until they talk to the provider.
• B. The client suppresses their feelings when they are angry.
• C. The client notifies the nurse when they want to harm themselves.
• D. The client goes to their room alone when they feel overwhelmed.

Answer: (C)

Verbal safety contracts hinge on the client actively engaging with supports when urges to self-harm arise. The best indicator here is the client notifying the nurse when they want to harm themselves. This shows the contract is being used as intended: the person reaches out for help, enabling timely risk assessment, access to support, and deployment of coping strategies or interventions to prevent self-injury. It also strengthens accountability and the therapeutic connection.

Noticing the other responses: displacing feelings until talking to the provider delays addressing the distress; suppressing feelings when angry means emotions aren’t being expressed or managed in real time; going to the room alone when overwhelmed signals isolation rather than using the safety plan to seek help, which can maintain or increase risk.