Crisis Intervention in Social Work – Psychosocial Crises and Suicidality

Course content

This self-study course provides professional knowledge for practice. It does not replace legal advice in an individual case or any mandatory induction or instruction, and it does not fulfil any statutory or contractual training obligation; whether it can be taken into account is for your employer to decide. The applicable laws in their current version, as well as the policies and procedures of your organisation, take precedence.

A client turns up at the counselling centre remarkably composed the day after being evicted from his flat. A young woman withdraws more and more after finishing her degree. A mother can hardly think clearly after her child’s serious diagnosis. However different these situations are, they have something in common: people are thrown off balance because what is happening to them exceeds their usual ways of coping. Social work professionals meet such moments every day – in counselling, in child and youth welfare services, in integration assistance for persons with disabilities, in homelessness services and in hospital social services. This first module lays the conceptual and theoretical foundation for the whole course. It is not yet about specific intervention techniques, but about the question of what a crisis actually is, how it can develop and how you can recognise it in everyday practice.

PART 1 – Introduction and definition: what is a psychosocial crisis?

Why a clear concept of crisis matters

In everyday speech the word ‘crisis’ is used far too loosely: from a relationship crisis to a crisis of meaning to the crisis of a football club, almost anything seems to qualify. For professional practice this vagueness is a problem. Anyone who calls every strain a crisis risks overlooking genuine escalations or, conversely, dramatising everyday difficulties. A precise professional concept, by contrast, helps to place situations in context, to find a shared language in the team and to decide what kind of support is appropriate. It also guards against prematurely pathologising people who are reacting, in an entirely understandable way, to exceptional strain.

The crisis according to Sonneck: loss of emotional balance

In German-speaking countries, a definition has become established that goes back to the Viennese crisis intervention approach. Sonneck et al. (2016) understand a psychosocial crisis, in essence, as the loss of emotional balance that a person experiences when confronted with events or life circumstances that they cannot cope with at that moment. Three elements of this definition are particularly revealing for practice. First, it refers to a balance in the sense that people normally have established ways of dealing with demands. The crisis begins where this structure starts to waver. Second, the definition stresses the confrontation with events and life circumstances – so the crisis has a trigger that comes from outside or arises from the life situation. Third, it refers to the moment: being overwhelmed is tied to the present point in time and is not to be understood as a lasting characteristic of the person.

This time-boundedness is central to social work. It means that the same person who sees no way out today may well be able to act at another time and with different support. Crises are therefore fundamentally changeable and – this is the hopeful message of the concept – in principle can be overcome. At the same time, the definition makes clear that the event alone does not decide whether a crisis exists; what matters is the relationship between the strain and the coping resources available. A house move can be a welcome change for one person and, for another who loses their social network, trigger a deep shock (Sonneck et al., 2016).

A crisis is not an illness – distinguishing it from mental illness and from an emergency

A psychosocial crisis is not a diagnosis and not a mental illness. It describes a state of acute overload that can affect anyone – regardless of previous illness, education or social status. This distinction has considerable consequences for the stance of professionals: those who understand a crisis as a normal human reaction to exceptional strain do not approach those affected as ‘sick people’ but as people in a difficult situation who need support for a while. That said, crises and mental illness can coincide. An existing illness can increase vulnerability to crises, and a crisis can develop into an illness or make an existing one worse. Judging whether a mental illness is present, however, is a matter for doctors or psychotherapists. Social workers do not make diagnoses; they observe, describe and, where needed, refer on (Sonneck et al., 2016).

Distinguishing a crisis from an emergency is just as important. An emergency exists when there is immediate danger to life or health and immediate action is required – for example in a life-threatening injury or acute danger to oneself or others. A crisis can turn into an emergency, but does not have to. The following comparison illustrates the differences.

The mind map summarises the building blocks developed in this module: the concept, the two types of crisis, the phases, typical triggers and the resources on which support can build.

PART 2 – Theoretical foundations: types of crisis and crisis models

The roots of the crisis concept

The modern understanding of psychosocial crises goes back largely to the psychiatrist Gerald Caplan, regarded as the founder of the crisis concept in preventive psychiatry. His basic idea – that in a crisis people lose a previous balance and in this phase are particularly in need of support but also particularly open to change – still shapes the standard literature today. In the German-language professional discussion this concept is taken up above all in the account by Sonneck et al. (2016) and linked to the distinction between two types of crisis: the traumatic crisis and the crisis of change.

Traumatic crisis and crisis of change

A traumatic crisis is triggered by a sudden, usually unexpected event that changes the life situation abruptly: the unexpected death of someone close, a serious diagnosis, an accident, an experience of violence or the loss of one’s home through eviction. The event hits the person unprepared and fundamentally calls into question their familiar view of themselves and the world. The term ‘traumatic’ here refers to the quality of the event as an emotional shock and is not to be equated with a clinical trauma-related disorder (Sonneck et al., 2016).

A crisis of change by contrast arises from life changes that are in themselves part of human life: transitions such as leaving the parental home, entering working life, the birth of a child or retirement, but also upheavals such as a separation or release from prison. Such changes become a crisis when the usual coping resources are no longer enough to meet the new demands. The change is often foreseeable or even wanted, and yet it can shake a person’s balance lastingly. In these cases the build-up is rather gradual: tension and helplessness increase, attempts at solutions fail, and at some point the overwhelm becomes noticeable to the person and those around them (Sonneck et al., 2016).

Cullberg’s phase model of the traumatic crisis

For the traumatic crisis, the Swedish psychiatrist Johan Cullberg described a model of its course that is still widely used in crisis intervention today (Cullberg, 1978). It distinguishes four phases, which are to be understood not as a rigid sequence but as fluid transitions. In the shock phase those affected often appear astonishingly calm and composed to the outside world, or seem to function normally, while inside there is a chaos of unreality, numbness and disorientation. It is precisely this outward lack of visible distress that can mislead professionals. In the reaction phase the person is confronted with the reality of what has happened. Strong, changing feelings arise – grief, anger, fear, guilt, despair – and previous certainties collapse. This is often when the strain is greatest. In the processing phase the person begins to detach from the event and gradually turns back towards everyday life and the future. The last phase is reorientation – the phase in which what has been experienced is integrated into the person’s own life story; new relationships, tasks or perspectives gain importance. Sonneck et al. (2016) also take up this model in their account of the traumatic crisis.

It is important what the model does not say: it sets no fixed duration for the individual phases, and it does not describe an automatic process in which every person passes through all stages in the same order. People can move back and forth between phases, individual phases can overlap, and a new source of strain can throw someone who had already reorientated back into an earlier phase. The model is therefore above all a framework for orientation that helps professionals to understand reactions as comprehensible and to tailor their own support accordingly.

PART 3 – Triggers of crisis and resources in the fields of social work

Typical triggers at a glance

Social work is concerned with crises in a particular way, because the people it supports are often in life situations in which strains accumulate and resources are scarce. Some triggers come up again and again for professionals. The loss of one’s home – through eviction, notice to quit or separation – means not only losing a roof over one’s head but also privacy, security, routines and often social contacts. Separation and divorce shake relationships, finances and future plans all at once. The death of someone close can trigger a traumatic crisis, especially if it occurs suddenly. A serious diagnosis – one’s own or that of a relative – calls life plans into question and is a frequent trigger of crisis in hospital social services. The release from prison is a transition that promises freedom but can also bring the search for housing, dealings with authorities, unemployment and stigma. And young people moving out of the parental home or a youth welfare setting face the task of organising an independent life, often without a reliable family network in the background.

These triggers cannot always be assigned clearly to one type of crisis. A separation can happen suddenly and unexpectedly and then proceed like a traumatic crisis; but it can also be the end point of a long process and take the form of a crisis of change. Several strains also often overlap: the separation leads to loss of home, the loss of home endangers the job, and the threat of job loss deepens the shame. For professionals, what matters is therefore less the exact categorisation than understanding how the person affected experiences the event.

Keeping resources and protective factors in view

Because a crisis arises from a mismatch between strain and coping resources, a key to overcoming it lies in the resources of the person affected. These include personal resources such as earlier experiences of coping, abilities, humour, faith or values, social resources such as family, friends, neighbourhood, colleagues or peer groups, and structural resources such as an accessible support system, financial security and safe housing. In crises, resources have often not disappeared but are temporarily out of reach: the person does not remember having come through a hard time before, or does not dare to ask relatives for help. A resource-oriented stance therefore asks not only ‘What happened?’ but also ‘What has helped you in the past?’ and ‘Who could be at your side now?’. According to Sonneck et al. (2016), involving the person’s surroundings is one of the cornerstones of crisis intervention, which is covered in detail in the next module.

PART 4 – Recognising and placing crises in everyday practice

Observing and describing rather than diagnosing

In everyday practice, crises rarely announce themselves with a clear statement from the person. More often they show up in changes: a normally reliable client misses appointments, a young person reacts irritably to small things, a resident withdraws from group activities, someone seems unusually exhausted or unusually quiet. Such observations are not yet evidence of a crisis, but they are a reason to ask attentively. It helps to separate observation from interpretation: ‘I notice you’ve been coming less often lately’ is a description that opens an invitation to talk; ‘You are depressed’ would be a diagnosis that neither fits the role of social work nor does justice to the person.

A few guiding questions have proved useful for placing a possible crisis in context, and professionals can keep them in mind: Is there a recognisable trigger, and how long ago was it? Is it more of a sudden event or a transition? How does the person themselves experience the situation? Which previous ways of coping no longer work? Which resources are still available or could be reactivated? And are there signs that the crisis is escalating – such as hopelessness or remarks about death? The answers do not replace a professional evaluation in the team, but they give orientation about how urgent the situation is and what support fits.

What follows from this for action

Distinguishing the type and phase of a crisis is not an end in itself. It has direct consequences for the kind of support offered. In the shock phase of a traumatic crisis, people need above all stability, safety and simple, clear information; lengthy conversations about feelings or complex planning usually overwhelm them. In the reaction phase, by contrast, it is important to allow and bear intense feelings rather than to soothe them too quickly. In crises of change, the focus is often on sorting out the demands together: What exactly is overwhelming? Which small steps are possible now? Where can the person’s surroundings offer relief? How this support looks concretely in conversation is explored further in the modules on conducting conversations and on the basic principles of crisis intervention (Sonneck et al., 2016).

From understanding crises to suicidality – a preview

Not every crisis involves suicidal thoughts, and the great majority of crises are overcome without suicidal escalation. Even so, the link between crisis and suicidality is of great importance for social work. When people see no way out, experience their situation as unbearable and unchangeable, and feel cut off from others, the thought of death can appear as an apparent solution. In its National Suicide Prevention Strategy, the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) stresses that, in particular, members of the professions who come into contact with people in suicidal crises should be made even more aware and trained in dealing with people at risk (Bundesministerium für Gesundheit [BMG], 2024). In the field of action ‘health literacy and empowerment’, the strategy also highlights early recognition of the need for help and onward referral (BMG, 2024). Social work professionals are in a key position here: they often have earlier and lower-threshold contact with people in crises than medical services do. A sound understanding of crises is therefore the prerequisite for noticing warning signs and acting in good time. Modules 4 and 5 explore in depth how suicidality can be recognised, raised and evaluated.

PART 5 – Critical perspective: limits, tensions and consequences

Limits of phase models

Phase models such as Cullberg’s (1978) are valuable for teaching because they bring complex experience into a comprehensible order. But that is precisely where their limit lies. People process distressing events in very different ways, and not every reaction can be assigned to a phase. Anyone who misreads the model as a norm risks measuring those affected against an ideal course: ‘By now she really ought to be in the processing phase.’ Such expectations can create pressure and devalue individual courses. It is professionally appropriate to use the model as a heuristic that makes understanding easier, not as a yardstick against which progress is measured. The phases do not necessarily run in a straight line, setbacks are part of the process, and no generally valid statement can be made about their duration.

Crisis and living situation: the social perspective

Crisis models mostly come from the psychiatric and psychological tradition and focus on the experience of the individual. Social work adds to this perspective a view of living situations. Whether an event becomes a crisis depends not only on personal coping abilities but also on material means, housing conditions, legal status, access to support and experiences of exclusion or discrimination. People living in poverty, without secure housing or with an insecure residence status often have less of a buffer to absorb strain. A purely individualising view that interprets crises solely as personal overload would leave out these structural factors. Crisis support grounded in human rights therefore takes both seriously: the subjective experience and the social conditions that make crises more likely or make it harder to overcome them.

A tension: de-pathologising and staying alert

Stressing that a crisis is not an illness has a de-stigmatising effect and strengthens a resource-oriented stance. But it carries a risk: if every strain is interpreted as a ‘normal crisis’, serious mental illness or suicidal escalation can be overlooked. Conversely, premature pathologising leaves people feeling not taken seriously or labelled. Professionals therefore work within a tension that cannot be resolved but can be handled reflectively: open and de-pathologising in approach, alert to warning signs and ready to involve medical or psychiatric help when there are signs of illness or acute danger. This balance works best in a team and in line with the procedures of the organisation concerned.

Open questions in care provision

An understanding of crises is only useful if people in crisis can actually reach help. Here an open issue shows itself: the National Suicide Prevention Strategy recommends developing a concept for a central, round-the-clock crisis service emergency number with forwarding to the state crisis services; no such nationwide number exists so far (BMG, 2024). An act to strengthen national suicide prevention exists only as a ministerial draft; among other things it provides for a concept for a nationwide uniform number for people in crisis, but is not in force (BMG, 2026). For practice this means: professionals need to know the services available in their region and record in their organisation whom to contact in which situation.

Consequences for practice

Several consequences can be drawn from the considerations in this module. First, a professional understanding of crises demands an accurate, open-minded look: outward calm can mean shock, anger can be an expression of despair, and withdrawal can point to an escalation. Second, professionals should use crisis models for orientation without forcing people into schemes. Third, the question of resources belongs from the start, because overcoming a crisis depends largely on whether coping resources become accessible again. Fourth, working with people in crisis requires clarity about one’s role: social work supports, relieves, connects and refers on – it does not make diagnoses and does not replace treatment. And fifth, crisis work is teamwork: evaluations should be shared, approaches agreed and one’s own strain noticed (Sonneck et al., 2016).

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

The first module was about what a psychosocial crisis is and how it can develop. This module changes perspective: what should social work professionals do when a person in an acute crisis is sitting opposite them, in despair on the phone or collapsing in the ward corridor? The answer is not a rigid programme but a stance guided by a few well-founded principles – and by a simple structure that stays available even under pressure.

PART 1 – Introduction: what crisis intervention is – and what it is not

Starting point: the crisis as lost balance

Crisis intervention builds on an understanding of crises. In the standard German-language literature, the psychosocial crisis is described, in essence, as the loss of emotional balance that a person experiences when confronted with events and life circumstances that they cannot cope with at the moment (Sonneck et al., 2016). Two features of this definition are decisive: first, the crisis is not a term for illness but describes a mismatch between strain and the coping resources currently available. Second, it is tied to the moment – the balance is lost, but not permanently destroyed. This is exactly where the task of crisis intervention comes from: it is meant to help restore a sustainable balance, ideally before the situation becomes entrenched or escalates.

The crisis concept on which this view rests goes back to Caplan. Sonneck et al. (2016) distinguish traumatic crises, triggered by sudden, serious events, from crises of change, which arise from life transitions and upheavals. For the traumatic crisis, Cullberg (1978) describes a course with shock, reaction, processing and reorientation phases whose transitions are fluid. This matters for action because the same intervention works differently in different phases: a person in shock first needs orientation and stability, not problem-solving steps.

Definition: crisis intervention

Here, crisis intervention is understood as time-limited, goal-directed support that starts directly from the current crisis, relieves and stabilises the person affected, makes their own coping resources accessible again and – where necessary – arranges further help. This working definition draws on the understanding developed by Sonneck et al. (2016) in their standard work, but is this course’s own summary. It sets crisis intervention apart in three directions: from everyday counselling, which works without acute pressure to act, from emergency medicine, which averts physical danger to life, and from psychotherapy, which works over a longer period on mental disorders and patterns.

Crisis intervention is therefore not ‘mini-therapy’ and does not replace treatment. It is a bridge: from a state of overload to a state in which the person can again decide for themselves which help they need and accept. This bridging function makes it a natural fit for social work, whose core competence is in any case to assess living situations, open up resources and connect people with suitable help.

Why social work is called upon

Professionals in counselling centres, residential groups, emergency shelters, workshops or hospital social services are often the first to notice a crisis – often long before doctors or therapists are involved. The National Suicide Prevention Strategy of the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) therefore stresses that, in particular, members of professions who come into contact with people in suicidal crises should be made even more aware and trained in dealing with people at risk (Bundesministerium für Gesundheit [BMG], 2024). Skills in crisis work are thus not a specialism for a few experts but part of the basic professional repertoire. This course can contribute knowledge and occasions for reflection; it neither replaces induction into the procedures of your organisation nor confers any special authority.

PART 2 – Professional foundations: five basic principles

A didactic synthesis, not a canon

The professional literature contains different lists of principles of crisis intervention. The following five basic principles are a didactic synthesis for this course: they bring together ideas found in the standard literature (Sonneck et al., 2016) and in the National Suicide Prevention Strategy (BMG, 2024), but in this form they come from no single source. They are intended as a framework for orientation, not as a checklist. The mind map shows how principles, structure for action, role, network and limits fit together.

Principle 1: prompt, low-threshold help

Crises have their own timeline. The balance has just been lost, the usual ways of coping are not holding, and at the same time openness to support is often particularly great. Help that only becomes available after weeks often comes too late – either the crisis has by then ‘resolved’ itself without support, sometimes at the price of withdrawal, substance use or broken relationships, or it has escalated. Low-threshold means that barriers are deliberately lowered: no application before the first conversation, appointments at short notice, contact by phone or outreach, plain language and a setting that does not increase shame. The National Suicide Prevention Strategy expressly counts telephone and online counselling and crisis services among the building blocks of psychosocial support (BMG, 2024).

Principle 2: relationship as the foundation

Without reliable contact, any further intervention is ineffective. People in crisis often experience themselves as powerless, alone and misunderstood. A calm, attentive counterpart who listens, takes feelings seriously and does not judge is therefore already an intervention. In this context, relationship does not mean closeness at any price but dependable presence: the professional stays available, explains what they are doing and keeps agreements. This strengthens trust that help is possible – an experience that is often lost in a crisis.

Principle 3: focusing on the current trigger

Crisis intervention works in the here and now. Guiding questions are: What has happened? Why now? What is most urgent at the moment? Life history, earlier strains or fundamental conflicts can be significant, but are brought in only as far as they help to understand the current situation. Focusing guards against two typical mistakes: trying to solve ‘everything’ in one conversation, and overloading the person with too many topics at once. A clear focus also provides structure – and structure is a relief when everything inside is in disarray.

Principle 4: activating resources and surroundings

A crisis narrows the view. Those affected often see only the problem and no longer the abilities, relationships and experiences that helped them before. Crisis intervention therefore asks specifically: What has helped you in difficult times before? Who could be there for you now? Involving relatives, friends or trusted people is in principle done with the person’s consent. Activating resources is not sugar-coating but an expression of a human-rights- and resource-oriented stance that takes those affected seriously as active subjects and does not reduce them to their crisis.

Principle 5: safety takes priority

The fifth principle runs through all the others: where life or health is at risk – through suicidality, violence or an acute medical situation – safety takes priority over all other goals. This concerns the person affected, other people such as children in the household, and the professional themselves. In acute danger to life, the emergency number 112 is to be called (Land Niedersachsen, 2025). How suicidality is recognised, raised and evaluated is explored in Modules 4 and 5; the legal questions around confidentiality and involuntary admission are covered in Module 6.

PART 3 – Putting it into practice: the BELLA mnemonic as a structure for action

Five steps that stay available under pressure

Sonneck et al. (2016) structure crisis intervention with the German mnemonic BELLA. It stands for: Beziehung aufbauen (building the relationship), Erfassen der Situation (assessing the situation), Linderung von Symptomen (relieving symptoms), Leute einbeziehen (involving people) and Ansatz zur Problembewältigung (finding an approach to coping with the problem). The value of the mnemonic lies in its simplicity. In an acute situation in which professionals too are under stress, a manageable structure helps to forget nothing essential and later to explain one’s own approach in a traceable way.

The steps in detail

Building the relationship deliberately comes first. This includes introducing yourself, creating as calm a place as possible, signalling that you have time and, to begin with, simply acknowledging the person’s experience. Assessing the situation means taking stock together: What is the trigger? How is the person doing physically and emotionally? Are there signs of danger, such as thoughts of not wanting to live any more? Which people and which sources of help are already there? Assessing is not diagnosis – social workers do not make diagnoses – but a structured understanding of the situation as a basis for the next decisions.

Relieving symptoms aims at immediate relief: being allowed to speak, naming feelings, seeing to sleep, food, warmth or a safe place to sleep. Where physical or severe emotional complaints are in the foreground, this also includes bringing in medical help – drug treatment is expressly not a task of social work. Involving people means activating the social network and the professional support system, always with regard to the person’s consent. Approach to coping with the problem finally looks forward: Which first, realistic steps are possible in the next hours and days? Who takes on what? When is the next contact?

It is important to note that BELLA is not a strictly linear scheme. In practice, conversations jump back and forth between the steps, and building the relationship runs alongside the whole process. The order nevertheless offers helpful orientation: anyone who starts with proposed solutions before contact and understanding have been established often meets resistance. The following table summarises aims, typical actions and common pitfalls.

PART 4 – Practice: clarity of role and the chain of care

What social work contributes in a crisis – and what it does not

Clarity of role is an underrated principle of crisis intervention. Those who know their own role act more safely, overload themselves less and can involve other professions more specifically. Social work brings to the crisis its view of the whole living situation: housing, income, work, family, residence status, access to support. It can stabilise, structure, refer on and create continuity. Psychotherapy and psychiatry have different mandates and powers. The following comparison cards illustrate the differences in simplified form.

Clarity of role does not mean drawing boundaries in the sense of ‘that’s not my job’. On the contrary: precisely because social work does not provide therapy, it can actively support the transition into therapy or treatment – for example by phoning together, accompanying the person to the first appointment or bridging waiting times with supportive contacts. Crisis intervention therefore does not replace therapy, but it often creates the very precondition for people to seek it out.

Crisis help as part of a chain of care

No organisation can cope with crises alone. Effective crisis help arises in a chain in which different services interlock: counselling centres and social work organisations, telephone and online counselling such as the telephone counselling service (TelefonSeelsorge) (TelefonSeelsorge Deutschland, n.d.), doctors in private practice and psychiatric hospitals, the ambulance service and police and – in some states – specialised psychosocial crisis services. The National Suicide Prevention Strategy describes this interplay in several fields of action: health literacy and empowerment, with awareness-raising, early recognition of the need for help and onward referral; psychosocial counselling and support, with crisis services and handover into support services; and networking and coordination (BMG, 2024).

What the chain looks like locally varies greatly by region. Bavaria provides an example of a statutory basis: under Art. 1 of the Bavarian Act on Help for People with Mental Illness (BayPsychKHG), the districts (Bezirke) establish and run crisis services consisting of control centres and mobile professionals; the control centres can be reached around the clock on a single uniform number. This provision applies only to Bavaria and cannot be transferred to other states. There is so far no nationwide uniform crisis service number; the National Suicide Prevention Strategy recommends developing a concept for a central, round-the-clock crisis service emergency number with forwarding to the state crisis services (BMG, 2024).

Early recognition and onward referral as core tasks

For social work this results in a twofold task. First, early recognition: crises often announce themselves through changes – withdrawal, cancelled appointments, declining self-care, striking remarks, increasing substance use. Those who regularly support clients often notice such changes first and can raise them before the situation escalates. Second, onward referral: it works better when it is active and personal. A phone number on a slip of paper is rarely enough in a crisis; it is more helpful to phone together, to agree an appointment concretely and to fix your own next contact. This requires up-to-date knowledge of the local support landscape – ideally gathered in an overview kept by the organisation and updated regularly.

PART 5 – Critical perspective: limits, tensions, open questions

Limits of crisis intervention

Crisis intervention is effective, but it has limits. It cannot remove structural causes of crises – poverty, housing shortage, discrimination, lack of participation – but at most ease their consequences and open paths to further help. It is time-limited and must not permanently take the place of treatment or long-term support. And it reaches its limits where the situation exceeds the competence and powers of social work: in acute medical danger, in questions of involuntary admission or in violence that requires police action. Recognising these limits is itself a professional skill.

Tensions in practice

The clearest tension lies between autonomy and protection. Crisis intervention relies on voluntariness, consent and the person’s self-determination. At the same time, the safety principle requires acting in acute danger even against the person’s wishes at that moment – for example by calling in medical help or the ambulance service. This balancing is legally and ethically demanding and never belongs in the hands of a single professional alone; Module 6 shows which legal standards apply. A second tension exists between speed and relationship: acting quickly may be necessary, but must not bypass contact, because otherwise willingness to accept help falls. A third concerns the individual case and structure: someone working in a region without an accessible crisis service carries in practice more responsibility than a professional in a well-developed network – a problem that cannot be solved by individual effort.

Open questions

At the level of the care system, too, questions remain open. The National Suicide Prevention Strategy sets out goals and fields of action but is not itself a law (BMG, 2024). The ministerial draft for a suicide prevention act would, among other things, create a federal specialist office and a concept for a phone number, but is not yet in force (BMG, 2026). Whether and in what form a nationwide uniform crisis number will come is therefore open. For practice this means: professionals still need to know the services in their region and must not rely on a central solution. It is also open how skills in crisis work can be reliably built into the everyday life of organisations – through guidelines, case discussions and training – without responsibility being shifted onto individual staff.

Consequences for practice

Several practical consequences can be drawn from the basic principles. Organisations benefit from a written crisis guideline that names responsibilities, contact details and local points of contact. Professionals should know the support landscape in their region and refresh that knowledge regularly. Difficult decisions are made in the team and documented in a traceable way – a topic explored in Module 8. And last but not least: anyone who stands by others in crisis needs relief, exchange and permission to reach their own limits. Crisis intervention is teamwork, even when only one professional is in the room at the decisive moment.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

A phone call in the late afternoon, a client standing distraught in the corridor, a young person who has stopped speaking after an argument: crises rarely announce themselves, and they require social work professionals to find the right word at the right moment. This module applies the basic principles of crisis intervention to the situation in which they have to prove their worth – the conversation. It shows how you make contact when a person has been thrown off emotional balance, how you make relief possible without losing yourself in the flood of feelings, and how you find, together with the person affected, a focus that allows small, workable next steps. This is not about a technique that you ‘apply’, but about a professional stance expressed in language, pace and structure.

PART 1 – Introduction: what makes a crisis conversation

The conversation as the central tool

In most fields of social work there are neither medicines nor equipment for acute crises – there is the conversation. Whether in family counselling, hospital social services, homelessness services or a residential group in child and youth welfare: professionals often meet people in crisis first, frequently unprepared and without the chance to plan the situation calmly. For exactly this reason it is worth seeing conversation in a crisis as a professional task in its own right. The National Suicide Prevention Strategy stresses that members of professions who come into contact with people in suicidal crises should be made even more aware and trained in dealing with people at risk (Bundesministerium für Gesundheit [BMG], 2024). Safe conversation is one building block of this awareness – but it replaces neither medical nor psychotherapeutic help, and it is always carried out within the procedures of your own organisation and in a team.

Definition: crisis and crisis conversation

The starting point is the concept of crisis covered in detail in Module 1. Sonneck and colleagues describe the psychosocial crisis, in essence, as the loss of emotional balance that a person experiences when confronted with events or life circumstances that they cannot cope with at the moment (Sonneck et al., 2016). The decisive phrase is ‘at the moment’: a crisis is neither an illness nor a character trait but a state in which the usual coping resources are temporarily not enough. A distinction is made between traumatic crises, triggered by sudden, painful events, and crises of change, which arise from transitions and upheavals in the course of life (Sonneck et al., 2016).

In this module, a crisis conversation means a goal-directed, time-limited conversation held in an acute situation of strain that combines three tasks: it is meant to establish a reliable relationship, relieve the person affected emotionally and help them, out of the feeling of being overwhelmed, to see a manageable part of their situation again. This working definition is a didactic summary; it draws on the principles of crisis intervention as presented in the standard literature (Sonneck et al., 2016) but is not a definition taken over word for word.

Contact, relief, focus – three movements

The title of this module names three movements that run through every crisis conversation. Contact means the offer of a relationship: the person should sense that someone is there who listens, does not judge and can bear the situation. Relief means the space in which feelings and thoughts may be spoken – often the first moment when the inner pressure noticeably eases. Focus finally means clarifying together what is most urgent now and agreeing on first, manageable steps. These movements are not a rigid scheme to be worked through one after another. They interlock: if you notice that a person is flooded by feelings again while talking about concrete steps, you return to relief; if you sense that contact is breaking off, you first work on the relationship again.

PART 2 – Professional foundations: relationship, phases of crisis and structure

Relationship as the precondition for every intervention

The BELLA mnemonic introduced in Module 2 does not begin with the relationship by chance: Sonneck et al. (2016) structure crisis intervention into the steps of building the relationship, assessing the situation, relieving symptoms, involving people and finding an approach to coping with the problem. For conversation this means: before a situation can be meaningfully assessed, let alone an approach to a solution developed, a minimum of trust is needed. People in crisis often experience loss of control, shame or the feeling that they must not be a burden to anyone. A counterpart who stays calm, shows genuine interest and takes the distress seriously without dramatising it cannot dissolve this state, but can offer a first stable point to which the person can hold on.

In a crisis, a relationship forms more quickly than in longer counselling processes, but it is also more fragile. Even small signals – a glance at the clock, premature advice, an offhand ‘It’ll be fine’ – can be taken as rejection. Conversely, a single sentence that aptly picks up the person’s experience can clearly strengthen contact. Relationship work in a crisis is therefore less a matter of particular wording than of attention to what the person needs right now.

The phase of the crisis determines the tone of the conversation

For traumatic crises, Cullberg (1978) described a course in phases: a shock phase, in which those affected often appear astonishingly unremarkable outwardly while experiencing chaos inwardly, is followed by a reaction phase, in which the reality of the event reaches awareness with changing, often intense feelings; a processing phase and a phase of reorientation follow later. The phases merge fluidly into one another and do not run the same way for everyone (Cullberg, 1978). For conversation, this model is useful above all as an aid to orientation: it helps to place a person’s current state and to adapt one’s own approach accordingly.

In the shock phase the ability to take things in is limited. Long explanations, complex questions or too much information hardly reach the person. Orientation, safety and simplicity help here: short sentences, clear information about what is happening now, concrete support with immediate needs. In the reaction phase by contrast, the emphasis is on allowing feelings. Grief, anger, guilt or despair may show themselves without the professional having to calm or reinterpret them straight away. The following comparison cards summarise the differences.

In crises of change, whose concept goes back to Caplan and is described in detail in the standard literature (Sonneck et al., 2016), the build-up is often more gradual. Here, conversation often calls less for orientation amid chaos than for the shared insight that earlier attempts to cope no longer hold – and for the careful search for the point at which change can begin.

Structure as support

People in acute crises often experience their situation as unmanageable and confusing. A professional who comes across as calm and structured offers a counterweight: they signal that it is possible to look at the situation step by step. Structure shows itself in conversation at several levels – in the outer framework (an undisturbed room, clarified time, phone switched off, as far as possible), in the build-up of the conversation and in your own language. Making clear at the start how much time is available and what is possible in that time creates reliability. Structure does not mean control: it is an offer the person can use for orientation, and it stays flexible enough to respond to unexpected turns. The mind map summarises the building blocks of the crisis conversation.

PART 3 – Practice I: making contact and enabling relief

The first minutes

The first minutes of a crisis conversation shape whether a person can open up. It helps to introduce yourself briefly and clearly, to name your role and to ask openly about the person’s concern: ‘I’m Ms K. from the social service. I’ve heard you’re having a very hard time right now. I have time for you now – would you like to tell me what happened?’ An opening like this combines transparency with an offer of a relationship. It leaves the person the choice of where to begin and at the same time signals that the professional is ready to engage with what has happened.

Just as important as the words is the non-verbal level: a sitting position that is attentive but not crowding, a calm pace of speech, a lowered voice if the person is loud or agitated. Your own calm is often passed on to the other person – not as a technique, but because it conveys safety. If you are inwardly restless yourself, you may take a moment to breathe out consciously before the conversation begins. On the phone, where eye contact and body language are missing, voice, pauses and short responses such as ‘I’m still here’ take over this function.

Active listening, naming feelings and bearing them

Active listening means visibly following the other person: through short summaries, through questions that check understanding and by picking up emotional messages. In a crisis, naming feelings is particularly effective, because those affected often perceive their own state only vaguely. A sentence like ‘It sounds as if you are very afraid right now of how things will go on’ helps to order the inner confusion and shows that the professional has understood not only the content but also the experience. A tentative, questioning form matters here: the person should have the chance to correct.

Bearing feelings is often harder than naming them. Crying, silence, anger or despair trigger in many professionals the impulse to comfort quickly, to distract or to offer a solution. This impulse is human, but it can convey the message that the person’s feelings are too much. Bearing them means letting pauses stand, staying present and acknowledging feelings as an understandable reaction to a distressing situation. Sonneck et al. (2016) count relieving distressing symptoms among the core steps of crisis intervention; in conversation this relief often happens precisely because feelings are given a place instead of being suppressed.

Relief through speaking out

Many people already experience it as a relief simply to be able to tell what has happened in a coherent way. This telling orders what was experienced, makes it communicable and breaks through the isolation that often accompanies crises. Professionals support this process by not interrupting, inviting the person to continue with open questions and not pressing for details that the person (as yet) does not wish to share. Relief is, however, not an end in itself: if the telling goes round in ever new loops and the person visibly becomes exhausted or even more agitated, it makes sense to structure gently and move on to the question of what is most pressing now. The following table compares typical responses.

PART 4 – Practice II: finding focus, making agreements, closing the conversation

Clarifying the trigger and the most urgent concern

Crises often bundle several strains: a separation brings financial worries, housing questions and conflicts about the children; losing a home affects health, work and social relationships. Anyone who tries to discuss everything at once reinforces the feeling of being overwhelmed. Focusing on the current trigger is therefore a core principle of crisis intervention (Sonneck et al., 2016). In conversation it helps to clarify together what set off the crisis, what has happened since and what is weighing on the person most right now. Questions such as ‘What has happened since yesterday?’ or ‘What of all this is hardest for you at the moment?’ invite the person to pick a manageable part out of the whole picture.

Focusing does not mean declaring other topics unimportant. It can be a relief to ‘park’ them explicitly: ‘The question of maintenance is important, we’ll take it up at the next appointment. Today it’s about how you can get through the next few days well.’ In this way the person is not turned away but experiences that their concerns are seen and put in order. At the same time, the professional keeps in view whether the stated trigger hides signs of acute danger, which must take priority.

Small, concrete next steps

The experience of being able to do something yourself again is particularly valuable in a crisis. Agreements in a crisis conversation therefore aim at small, concrete and realistically achievable steps: phoning a trusted person this evening, coming to the agreed appointment tomorrow morning, spending a night at your sister’s, looking out a particular document. Big solutions – such as a new flat or sorting out custody – usually overwhelm in this phase. Sonneck et al. (2016) describe finding an approach to coping with the problem as the last step of their BELLA mnemonic; in conversation this means searching together with the person for ways of coping that they can carry themselves, instead of giving them ready-made solutions. It helps to sum up the agreed step once more at the end in the person’s own words.

Involving people close to the person – with consent

Social support is one of the most important resources in crises; it is no coincidence that involving other people is part of the BELLA mnemonic (Sonneck et al., 2016). In conversation you can ask who is around, who has helped in similar situations before and whom the person would like at their side now. Whether and how people close to them are involved is in principle decided by the person affected. Professionals can offer to phone together or think with the person about what they would like to say to the other person. They pass on information from the conversation only with the person’s consent.

Closing the conversation and leading on to safety planning

The end of a crisis conversation deserves particular care, because afterwards the person is on their own again. A good close sums up what was discussed, names the agreed steps, clarifies when and how the next contact will take place and makes clear whom the person can turn to if they feel worse before then. This is where safety planning starts: Stanley and Brown (2012) describe the safety plan as a written, prioritised list drawn up together with the person affected and in their own words – from personal warning signs through their own coping strategies and supportive people to professional points of contact. It is expressly not a no-suicide contract (Stanley & Brown, 2012). First elements of such a plan often become visible in the crisis conversation itself; Module 5 shows how it is developed in detail. The following step sequence summarises the course of a crisis conversation.

Conversations under difficult conditions

Not every crisis conversation takes place in a quiet counselling room. Language barriers make understanding harder on both sides. Simple, short sentences, checking understanding and – where possible – professional interpreting help here. Using children or relatives as interpreters is particularly problematic in crises, because they are distressed themselves and confidentiality suffers. In cases of intoxication through alcohol or other substances, the ability to converse is limited; exploring things in depth is then usually not sensible. Immediate safety takes priority, as does, where appropriate, a medical check and agreeing a follow-up contact. In acute danger to life or health, the ambulance service is to be called on 112.

Aggression in crises is often an expression of powerlessness, fear or hurt. Taking it seriously without taking it personally is a demanding task. A calm tone, naming the anger, avoiding power struggles and sufficient physical distance have a de-escalating effect. Self-protection always takes priority: professionals make sure they have a clear way to the door, inform colleagues, do not hold conversations alone where the risk is known to be raised and may end a conversation if they feel threatened. In acute threat the police are called on 110. The organisation should have clear agreements and emergency procedures for this – protecting staff is not an individual but an organisational task.

PART 5 – Critical perspective: limits, tensions and consequences

Clarity of role: conversation is not therapy

Crisis conversations in social work are effective forms of support, but they have clear limits. They are neither psychotherapy nor diagnosis. Social work professionals make no diagnoses and use no therapeutic procedures; their task is to stabilise, to orient and – where necessary – to refer on to further help. This clarity of role protects both sides: the person affected receives the help they need, and the professional does not overload themselves with demands that their mandate does not include. The conversational stances presented in this module are, moreover, not techniques with a guaranteed effect. Whether a sentence is helpful depends on the person, the situation and the relationship. The literature describes principles and experiential knowledge (Sonneck et al., 2016); it provides no script that works equally in every crisis.

Tensions in the crisis conversation

Several tensions cannot be resolved, only handled consciously. The first concerns structure and openness: too much structure can constrain the person and give the feeling of being dealt with; too little structure leaves them alone in the chaos. The second concerns pace: the crisis demands quick action, but the person needs time to sort out their feelings. The third, and perhaps most important, tension lies between autonomy and protection. In principle, the person affected decides what they tell, whom they involve and which steps they take. If, however, signs of acute danger appear, the professional may be called upon to take responsibility more clearly – always in the team, according to the organisation’s procedures and within the legal framework covered in Module 6.

The phase model also calls for a critical approach. Cullberg (1978) describes fluid transitions, not fixed stages. Anyone who assigns people to a phase too quickly risks overlooking their individual experience – for example when an outwardly calm person is taken to be ‘stable’ although they are in the shock phase. The model is an aid to perception, not a yardstick for how someone ought to react.

Open questions and consequences for practice

In many organisations it remains open how crisis conversations are secured organisationally: Is there a crisis guideline? Is it clarified who can be reached in the background if a conversation escalates or onward referral becomes necessary? Are rooms available in which an undisturbed and at the same time safe conversation is possible? The National Suicide Prevention Strategy points to the importance of early recognition, onward referral and the networking of support services (BMG, 2024) – requirements that can only be met if individual professionals are not left alone. For practice, it follows that conversational skill develops through practice, reflection and peer consultation. Noticing your own limits, seeking support after distressing conversations and reviewing experiences in the team is not a sign of weakness but part of professional practice. How aftercare, documentation and self-care can succeed is shown in Module 8.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

‘Sometimes I think it would be better if I just wasn’t here any more.’ A sentence like this is often dropped casually in counselling, at the end of an appointment, half in jest or with eyes turned away. Many social work professionals know the moment when they sense that there may be more behind a remark – and with it the uncertainty about whether they may ask, whether they might ‘set something off’ by doing so and what to do if the answer is yes. This module starts at exactly this threshold. It shows how you notice signs of suicidality, how you place them in a professional context without making diagnoses, and how you raise suicidal thoughts openly, calmly and directly. What happens after raising it – the joint risk evaluation, the safety plan and the onward referral – is the subject of the next module.

PART 1 – Introduction: suicidality as a topic for social work

Extent and social significance

Suicidality is not a marginal phenomenon that occurs only in psychiatric hospitals. In 2024, 10 372 people in Germany died by suicide, around 71.5 per cent of them men (Statistisches Bundesamt [Destatis], 2025). Behind each of these figures are relatives, friends, colleagues and not infrequently professionals who were in contact with the person who died. The National Suicide Prevention Strategy of the Federal Ministry of Health also refers to estimates of at least 100 000 suicide attempts per year; this is expressly an estimate and not an official count (Bundesministerium für Gesundheit [BMG], 2024). This order of magnitude alone makes clear that many people in a suicidal crisis turn up not in specialised services but in entirely everyday support settings: in debt counselling, in homelessness services, in residential groups in child and youth welfare, in hospital social services or in integration assistance for persons with disabilities.

The National Suicide Prevention Strategy stresses that, in particular, members of the professions that come into contact with people in suicidal crises should be made even more aware and trained in dealing with people at risk; it names men, among others, as a key target group for prevention (BMG, 2024). For social work this is a twofold mandate. On the one hand, social workers often reach men in precisely those life situations in which they otherwise hardly seek help – in over-indebtedness, job loss, separation, release from prison or loss of home. On the other hand, in many men strain shows itself not in tears or complaints but in irritability, withdrawal, increased alcohol use or a sober-sounding ‘I’ll sort that out myself’. Anyone who looks only for openly shown sadness easily overlooks what is going on behind such facades.

Terms: suicide, suicide attempt, suicidality

The term suicide refers to the ending of one’s own life by one’s own act; a suicide attempt is an act with this aim that does not lead to death. The term suicidality is broader: it denotes the whole of the thoughts, feelings, impulses and acts directed towards one’s own death – from a diffuse wish for rest to a concrete intention. In the standard literature on crisis intervention, suicidality is understood not as an illness in its own right but as a possible escalation of a psychosocial crisis in which a person sees no other way out (Sonneck et al., 2016). As a rule, suicidal people do not want to be ‘dead’ in the abstract sense; they want an unbearable state to stop. This distinction is central for practice because it directs attention to the suffering behind the thoughts, and with it to possible starting points for relief.

Language also deserves attention. Terms such as the German ‘Selbstmord’ (‘self-murder’) link the event to a criminal category; ‘Freitod’ (‘free death’) suggests a free, considered decision where narrowing and despair usually prevail. In professional use, the value-neutral terms are ‘suicide’, ‘suicide attempt’ and ‘suicidal thoughts’. In conversation with clients you may nevertheless pick up their own words – what matters is that you yourself name clearly and without euphemism what is at issue.

PART 2 – Professional foundations: continuum and pre-suicidal syndrome

Suicidality as a continuum

Suicidality is not an either-or but can be described as a continuum on which people move – and in both directions. At one end is the wish for rest or a break (‘I just want to sleep and not wake up’), which does not yet include any thought of an act of one’s own. Next come wishes to die, then suicidal thoughts, which can at first force themselves on a person involuntarily and later take up more and more space. As the thoughts become more concrete, considerations about how and when arise, finally an intention and, in the most extreme case, preparations and an act. This continuum is an aid to thinking, not a scale with fixed steps: people do not necessarily pass through it in a straight line; they can move quickly from a wish for rest into an acute escalation, or gain considerable distance again after relief.

Two things follow for social work. First, even a supposedly ‘harmless’ wish to die is a reason to talk, because it shows that a person has reached the limit of what they can bear. Second, any self-reassurance of the kind ‘Anyone who talks about it won’t do it’ is ruled out. Not infrequently, people in a suicidal crisis hint at their thoughts beforehand in some form – directly or in coded form. These remarks are offers of communication that need to be taken seriously. The continuum helps you to understand in conversation more precisely where a person stands at the moment; the professional evaluation of the consequences is made in the team and, where appropriate, together with medical or psychiatric help.

Ringel’s pre-suicidal syndrome

A classic model for understanding the inner situation before a suicidal act is Ringel’s pre-suicidal syndrome, which Sonneck et al. (2016) present in the standard literature on crisis intervention. It comprises three interconnected features:

Narrowing. A person’s perception, thinking, feelings and relationships become increasingly narrow. Options for action that are still visible from outside seem closed to the person affected; the situation is experienced as hopeless. This narrowing can arise situationally – for example through an impending eviction or a dismissal – but it can also show itself in the dynamics of feelings and relationships: contacts become less frequent, interests disappear, life shrinks to a few distressing topics.

Inhibited aggression directed against oneself. Anger, hurt and disappointment cannot be directed outwards or expressed. Instead they are turned against the person themselves – in self-devaluation, feelings of guilt and the feeling of being a burden to others.

Suicide fantasies. Thoughts of one’s own death first appear more as an idea, then become more frequent and finally force themselves on the person without their being able to control them any more (Sonneck et al., 2016).

The model is valuable for social work above all because it makes understandable why well-meant pointers to ‘all the positive things in life’ often do not get through: in narrowing, access to these resources is blocked. It also explains why relationship and contact matter so much – every encounter in which a person feels seen can open up the narrowing a little. At the same time, the pre-suicidal syndrome is not a diagnostic instrument that social workers could ‘tick off’. It offers a language for ordering observations and describing them in a traceable way in the team or to medical colleagues.

Crisis and suicidality: a fluid transition

From the previous modules you know the psychosocial crisis as a loss of emotional balance that arises when a person is confronted with events they cannot cope with at the moment (Sonneck et al., 2016). Suicidality can occur in any crisis, but it is not its inevitable consequence. Professionals should be especially attentive when experiences of loss and hurt coincide – such as the loss of a relationship, a home, a job or a social role, combined with shame, humiliation or the feeling of having failed. Such experiences often hit a person at a sensitive point in their self-worth and can reinforce the narrowing that Ringel describes. The field of action ‘psychosocial counselling and support’ in the National Suicide Prevention Strategy also underlines that early recognition of the need for help and onward referral are closely linked with low-threshold counselling services (BMG, 2024).

PART 3 – Practice I: noticing and placing warning signs

What professionals can watch for

Warning signs are observations that may indicate that a person is preoccupied with thoughts of their own death. They are not proof and do not allow prediction – but they are a good reason to ask. These include, first, remarks about meaninglessness, hopelessness or death, whether direct (‘I don’t want to live any more’) or indirect (‘Soon all this won’t be my problem any more’). A second area concerns withdrawal: appointments are cancelled, friendships neglected, hobbies given up, the person seems absent or closed off. Third, farewell behaviour may occur, such as giving away personally significant items, putting affairs in order, unusual parting words or letters. Fourth, sudden calm after a phase of great tension deserves attention: if a person who was in despair a moment ago seems relaxed and composed for no apparent reason, this can mean relief – but it can also mean that an inner decision has been made. Fifth, experiences of loss and hurt are themselves a sign worth talking about, especially when they are linked with shame or feelings of guilt.

None of these signs is unambiguous in itself. A young person who clears out their room may simply be developing new interests; a client who suddenly seems relaxed may really have found a solution. The professional skill does not lie in ‘interpreting’ signs but in understanding them as an invitation to talk. Anyone who raises an observation in an appreciative and concrete way gives the person the chance to explain for themselves what is going on. This is exactly the difference from checklist thinking, which sorts people by features instead of talking with them.

PART 4 – Practice II: raising suicidality directly

The worry about ‘setting something off’

Probably the most common inhibition among professionals is the fear that, by asking about suicidal thoughts, they will put an idea into someone’s head that was not there before. This worry is understandable but not professionally justified. A review of 13 studies found no statistically significant increase in suicidal thoughts as a result of people being asked about suicidality (Dazzi et al., 2014). This does not mean, conversely, that asking reliably prevents a suicide – but it does mean that fear of asking is no reason to stay silent. For many of those affected, an open question can even be a relief: at last someone says out loud what they themselves did not dare to say, and the subject loses some of its secrecy and shame.

Silence, by contrast, carries a message, even when well meant. Anyone who ignores hints or quickly steers the conversation towards ‘positive things’ easily conveys that this subject has no place here. Sonneck et al. (2016) therefore stress that raising suicidality openly is among the core tasks of crisis intervention and must be embedded in a reliable relationship. It is not the question itself that is risky but the way it is asked – for instance accusingly, casually on the way out of the door, or in a way that makes only a ‘no’ seem an acceptable answer.

How raising it can succeed

A helpful conversation about suicidality follows no rigid sequence, but it can be organised into recurring movements. It begins with noticing: you name what you have noticed and show your concern. Then you create a protected setting – a quiet place, enough time, no one listening in. You ask the actual question directly and without detours, using the word ‘suicide’ or ‘taking your own life’. After that you listen, bear silence, ask gently and acknowledge the person’s openness. The conversation never ends with leaving the person alone, but with a next step that you take together and within your organisation’s procedures.

When wording the question, it is worth observing a few principles. Ask openly and at the same time unambiguously: ‘Are you thinking of taking your own life?’ is clearer than ‘You’re not doing anything silly, are you?’. The second wording already suggests the desired answer and judges suicidal thoughts as ‘silliness’ – an additional obstacle for a person who is already ashamed. It also helps to use a normalising introduction: ‘People who have lost as much as you sometimes think about not wanting to live any more. Do you feel that way too?’ A bridge like this signals that suicidal thoughts are understandable in a crisis and may be spoken. If the answer is yes, the first thing is to stay calm and ask further: How long have the thoughts been there? How often and how pressing are they? What has helped so far to bear them? What is keeping the person holding on to life? These questions serve understanding and relief; the structured joint risk evaluation that follows is the subject of Module 5.

The request for confidentiality deserves special attention. Many people open up only on condition that ‘this stays between us’. Do not promise that. Instead, say honestly that the person matters to you, that you must not be left alone with this worry and that you would like to think together about whom to involve. The legal questions of confidentiality and its limits are covered in Module 6; for this module it is enough to take the stance of being transparent from the start and making no promises that you cannot keep in an emergency.

Dealing with your own uncertainty

Raising suicidality also touches the professional. Many experience fear of getting something wrong, helplessness because they cannot ‘solve’ the suffering, or unconscious defensiveness that shows itself in reassurance or hasty referral elsewhere. Some professionals carry their own experiences of suicide in their personal surroundings. These reactions are human and not a sign of lack of professionalism. What is professional is to notice them and not to carry them alone. Procedures clarified in advance in the organisation, a crisis guideline, the possibility of calling in colleagues or the manager at any time, and room for debriefing all help. The National Suicide Prevention Strategy sees raising awareness and training among professional groups that come into contact with people at risk as an important building block of prevention (BMG, 2024) – practice in wording, knowledge of warning signs and certainty that asking does not harm contribute considerably to staying able to act at the decisive moment.

A further aspect is the question of responsibility. Social work professionals bear responsibility for taking signs seriously, raising them and initiating appropriate help. They do not, however, bear sole responsibility for another person’s life. This distinction is important so that worry does not turn into overload and overload into avoidance.

PART 5 – Critical perspective: limits, tensions, consequences

Suicides cannot be predicted

However important knowledge of warning signs is, one limit must be stated clearly: suicides cannot be predicted in the individual case. Warning signs also occur in many people who do not take their own lives, and conversely there are suicides that were preceded by no recognisable signs. A professional who discovers afterwards signs that they ‘should have seen’ is often subject to hindsight bias: what seems unambiguous in retrospect was ambiguous in the situation and embedded in a multitude of other impressions. The aim of suicide prevention in social work is therefore not certain prediction but a stance of attentive, open asking that makes it easier for people to accept help.

Checklists and professional evaluation

Many organisations have leaflets or lists of warning signs. They can raise awareness and help to develop a shared language in the team. It becomes problematic when they are understood as a substitute for conversation and professional evaluation – for example on the pattern: ‘Only two features apply, so there is no need to act.’ Suicidality arises from the interplay of life history, current crisis, relationships and inner appraisals; no catalogue of features can capture that completely. Social work, moreover, makes no diagnoses. Its strength lies in relationship, in knowledge of living situations and in access to people whom other support systems do not reach. Where a further evaluation is needed, it brings in medical or psychiatric expertise and acts in a team.

Tensions: self-determination, protection and stigma

Raising suicidality takes place in a tension between respect for a person’s self-determination and the mandate to protect life. It would be too narrow to treat suicidal thoughts only as a ‘danger’ that must be handed on to other services as quickly as possible. People who open up expect, first of all, to be heard and taken seriously. A reflexive referral on can be experienced as rejection and reinforce the narrowing. Conversely, respect for autonomy must not lead to passive waiting when acute danger becomes apparent. The balance is most likely to succeed through transparency: the professional says what they notice, what they fear and which steps they consider necessary – and involves the person in the decisions as far as possible.

Added to this is the question of stigmatisation. Suicidality is still associated with shame and taboos, especially in men, in older people and in some cultural or religious contexts. Language that acknowledges suicidal thoughts as an understandable reaction to an unbearable situation, without playing them down, helps to loosen this taboo. That the National Suicide Prevention Strategy expressly names health literacy, empowerment and early recognition as a field of action (BMG, 2024) underlines that suicide prevention is not only a task for specialist services but also a question of openness in society, to which social work can contribute in its fields of work.

Consequences for practice

Several conclusions follow for everyday work in counselling, child and youth welfare services, integration assistance for persons with disabilities, homelessness services and hospital social services. Professionals should not interpret signs of suicidality but raise them; they should ask directly and without euphemism, knowing that a review found no statistically significant increase in suicidal thoughts as a result of asking (Dazzi et al., 2014). Organisations should clarify who is called in in an emergency, how information is passed on and how staff are supported after distressing conversations. And last but not least, professionalism includes the willingness to reflect repeatedly on your own stance towards life and death, failure and responsibility. The figures of the Federal Statistical Office (Destatis, 2025) make clear that suicide is a topic that social work professionals will very probably encounter in their careers – the question is not whether, but how well prepared.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

The question has been asked, and the answer has come: yes, the person is thinking of taking their own life. For many social work professionals, this is the moment when uncertainty is greatest. What happens now? Does the emergency number have to be called straight away, or is a follow-up appointment enough? How can the conversation continue so that the person feels taken seriously and, at the same time, more safety is created? This module follows directly on from raising suicidality openly and shows what comes next: a shared, structured evaluation of the current situation, the development of a written safety plan and a reliable onward referral to medical help, crisis services and counselling services. What matters here is not a technique but a professional stance: you act together with the person concerned, as part of a team and in line with your organisation’s procedures – and you know the limits of your role.

PART 1 – Introduction: the shared work begins after the subject has been raised

From noticing to acting

The previous module showed that suicidality can be noticed and raised openly – calmly, directly and without hesitation. But raising it is not an end in itself. It opens up a space in which you can work out together how pressing the thoughts are at the moment, what has kept the person alive so far and what support is within reach. The next steps follow from this clarification: sometimes a carefully developed plan with an agreed follow-up contact is enough, sometimes a prompt medical or psychiatric evaluation is needed, and in an acute situation of danger the emergency medical service must be called immediately. These three tasks – evaluating, planning and referring on – form the core of this module. They are closely interlinked and in practice are rarely dealt with one after another but usually within the same conversation.

The National Suicide Prevention Strategy underlines that these tasks matter particularly for social work. It stresses that, above all, members of professions who come into contact with people in suicidal crises should be made even more aware of the issue and trained in dealing with people at risk (Bundesministerium für Gesundheit [BMG; Federal Ministry of Health], 2024). Professionals in counselling services, in child and youth welfare services, in integration assistance for persons with disabilities (Eingliederungshilfe), in homelessness services or in hospital social services are often the first people someone turns to – not because they take over treatment, but because they are trusted and can build bridges into the support system.

Definitions

In this module, evaluation means a shared process of mutual understanding in which the professional and the person concerned look at the current situation in a structured way: How concrete are the thoughts of death? What protects and sustains the person? Who can be reached? The evaluation provides the basis for deciding whether, and how quickly, medical or psychiatric help is brought in. It is expressly not a diagnosis and not a measuring procedure – social workers do not make diagnoses and do not work with risk scales, but with their professional perception, the conversation and the team.

The safety plan is, according to Stanley and Brown (2012), a written, prioritised list of coping steps and sources of support that a person can draw on when a suicidal crisis intensifies. It is developed together, phrased in the person’s own words and is expressly not a promise not to harm oneself. The authors designed it as a brief intervention that can be fitted into a range of care settings (Stanley & Brown, 2012).

Onward referral means actively guiding a person to suitable support – medical care, crisis services, counselling and pastoral services. The National Suicide Prevention Strategy places early recognition of the need for help and onward referral in the field of action on health literacy and empowerment, and names crisis services and referral to support services as part of psychosocial counselling and support (BMG, 2024). This means more than handing over a telephone number: good onward referral makes sure that contact is actually made.

PART 2 – Professional and legal fundamentals

Evaluation as part of the relationship, not as a finding

Evaluation in social work differs fundamentally from medical or psychotherapeutic diagnostics. It is not based on standardised instruments but on an open, respectful conversation in which the person remains the expert on their own situation. There is a professional and an ethical reason for this. Professionally: suicidal crises are dynamic, and thoughts can grow or fade in intensity within a short time. A snapshot can therefore never be a reliable prediction. Ethically: people in suicidal crises often experience themselves as powerless and controlled by others. When the evaluation is carried out together, the person is addressed as an acting subject – an experience that can in itself bring relief.

From a social work perspective, evaluation is therefore more of a joint review of the situation than a judgement. It leads to a decision that is ideally made together with the person and backed up within the team: is joint planning with a binding follow-up contact enough, is a prompt medical evaluation necessary, or is there an acute danger that calls for immediate action? Those who do not have to make this decision alone act more calmly and clearly. Organisations are therefore well advised to provide fixed routes for consulting the manager or experienced colleagues, including outside regular working hours.

The concept of the safety plan

The safety plan according to Stanley and Brown (2012) follows a simple logic: in an acute crisis, people find it hard to think clearly and find solutions. What was worked out and written down together in calmer moments can then serve as orientation. The plan is built in six steps that lead from the inside outwards: first, personal warning signs; then one’s own coping strategies; then people and social settings that offer distraction; then people who can be asked for help; then professional services and crisis services; and finally making the environment safer (Stanley & Brown, 2012). The order is deliberate: the person should first be able to draw on their own resources and, where necessary, bring in further support step by step. In an acute situation of danger, however, the emergency number is always the right way to go – the plan is not a staircase that has to be climbed in full before help is sought.

Of particular importance is the distinction from the so-called no-suicide contract, in which a person promises not to harm themselves. Stanley and Brown (2012) expressly emphasise that the safety plan is not such a contract. The difference is not merely formal: a promise can create pressure, tempt people to keep thoughts to themselves and give professionals a false sense of security. The safety plan, by contrast, does not ask for a promise but for possibilities – it widens the room for action rather than narrowing it through an obligation.

The landscape of provision: crisis services, pastoral support, emergency number

Onward referral requires professionals to know the regional support system. In Germany this is diverse but inconsistent. The TelefonSeelsorge can be reached around the clock across the country: it is free of charge and anonymous, day and night, on 0800 1110111, 0800 1110222 and 116 123, also offers counselling by chat and email, and is run under the responsibility of the Protestant and Catholic churches (TelefonSeelsorge Deutschland, n.d.). In an acute threat to life, the emergency number 112 for the fire service and emergency medical service is to be called; it is free of charge and valid across Europe; the police can be reached on 110 (Land Niedersachsen, 2025).

Psychiatric crisis services, by contrast, are a matter for the individual states (Länder) and are developed to varying degrees. One example of a statutory basis is Bavaria: under Article 1 of the Bavarian Act on Help for People with Mental Illness (BayPsychKHG), the districts (Bezirke) set up and run crisis services consisting of control centres and mobile professionals; the control centres can be reached around the clock on a single, uniform telephone number (BayPsychKHG). This model cannot be transferred to other states – professionals therefore need to find out for themselves which crisis services exist in their region and when they can be reached. There is as yet no nationwide crisis service emergency number. The National Suicide Prevention Strategy recommends developing a concept for a central crisis service emergency number, available around the clock, with forwarding to the crisis services of the states (BMG, 2024). The ministerial draft bill for an act to strengthen national suicide prevention takes this up and provides, among other things, for a time-limited federal agency for suicide prevention, a concept for a central, free-of-charge and nationally uniform telephone number for people in crisis, a digital directory of support services and an expert advisory board (BMG, 2026). However, this draft is not in force.

PART 3 – Practice I: the shared evaluation

Three guiding questions for the conversation

In practice, it has proved useful to base the evaluation on three guiding questions that can be fitted into a conversation without standardised instruments. The first guiding question concerns the concreteness of the thoughts: Is it a general wish not to be here any more, or have the thoughts already taken a direction, for instance in the form of preparations or an intention? The purpose of this question is not to ask for details but to understand how close the person is to acting. The second guiding question concerns the protective factors: What has kept the person from following their thoughts so far? People are often named, along with responsibility for children or pets, beliefs, plans or simply the hope that things might get better again. These reasons are valuable because they can be taken up later in the safety plan. The third guiding question concerns the availability of support: Who can actually be reached today, tonight and at the weekend? Is there a family doctor, a friend, a neighbour, treatment already under way?

These three questions do not produce a scoring system or a classification into levels. They create a shared picture on the basis of which the next steps are agreed. Open, calm wording is helpful, for example: ‘You said that sometimes you don’t want to live any more. How is that today?’, ‘What has helped you so far to bear these thoughts?’ or ‘Who would know if things got worse for you this evening?’ It is important to give the person time, to bear silence and not to gloss over contradictions. If someone stresses that ‘it’s not all that bad’ but has previously described very concrete thoughts, it is appropriate to address this gently.

When medical or psychiatric help is brought in

The shared evaluation leads to the decision on whether medical or psychiatric help is brought in. Professionals do not make this decision on gut feeling alone, but in consultation with the team and in line with their organisation’s procedures. As a guide: the more concrete the thoughts, the less robust the protective factors and the harder it is to reach support, the more urgent a medical evaluation is. If clear uncertainty remains after the conversation, this too is a reason to bring in medical or psychiatric expertise – uncertainty is not a sign of lack of competence but a professional signal to be taken seriously. Where possible, this is done with the person’s agreement, for example by making an appointment together, by a telephone call made together or by accompanying the person in person.

Situations in which there is an acute threat to life are a special case, for example when a person announces an imminent act and can no longer engage with agreements. Then protecting life comes first: the emergency number 112 is called (Land Niedersachsen, 2025), the professional stays in contact with the person where possible and informs the manager. Decisions on involuntary admission are not made by social workers but by the bodies and courts responsible, in accordance with the legal requirements – this too is looked at in more depth in Module 6.

PART 4 – Practice II: creating a safety plan and referring on

The six steps at a glance

The following figure summarises the six steps of the safety plan. They are discussed one after another in the conversation and recorded in a form that is easily accessible to the person – on paper, as a card in a wallet or as a note on a mobile phone.

How the plan comes about: together and in the person’s own words

The value of a safety plan lies less in the completed sheet than in the process of creating it. Stanley and Brown (2012) emphasise that it is developed together and recorded in the words of the person concerned. In practice, this means: the professional asks questions, summarises and – if wished – writes things down, but does not dictate the wording. Instead of ‘do relaxation exercises when tense’, the plan might then say ‘go to the river with the dog’ or ‘listen to Sabine’s playlist’. Concrete, personal wording like this is easier to recall in a crisis than general recommendations.

For the warning signs (step 1), it helps to ask how the person themselves or the people around them notice that things are getting worse – for example sleeplessness, brooding in certain situations, social withdrawal or particular times of day. The own strategies (step 2) are about activities that the person can carry out without others. Steps 3 and 4 deliberately distinguish between contacts that simply offer company and distraction and people to whom the person can speak openly about their crisis. Both matter, because not every person close to someone is the right person to turn to in a crisis. For step 5, the professional services are entered together with when they can be reached: treating doctors, regional crisis services, the TelefonSeelsorge with its free telephone numbers (TelefonSeelsorge Deutschland, n.d.) and the emergency number 112 for an acute threat to life (Land Niedersachsen, 2025). Step 6 consists of thinking together about how the environment can be made safer in times of crisis – for example by involving a trusted person. No details about possible means are asked for or discussed; it is enough to clarify with the person what would help them feel safer in their surroundings.

At the end of the conversation, you discuss where the plan will be kept, who may know about it and when it will be looked at and adjusted together. If relatives or friends are involved, this happens only with the person’s agreement. A binding follow-up contact – an appointment, an agreed phone call – is an integral part of this. The plan is a living document, and reviewing and developing it is taken up in Module 8.

Onward referral that actually reaches its goal

People in suicidal crises often find it hard to get in touch with a new service on their own. A telephone number on a slip of paper is therefore often not enough. An accompanied transition is more effective: making the first call together, arranging an appointment while the person is still in the room, accompanying the person to the doctor’s practice or the hospital outpatient clinic or – with their agreement – involving a trusted person. The following table matches typical example situations with suitable actions and points of contact. It does not describe risk levels but is meant to aid orientation; the specific decision is always made case by case and within the team.

PART 5 – Critical perspective: limits, areas of tension, open questions

The limits of any evaluation

However carefully an evaluation is carried out: suicides cannot be predicted with certainty. People can conceal their thoughts, crises can intensify rapidly after an apparently stable conversation, and an effective safety plan does not guarantee that nothing will happen. For professionals, this insight is both a relief and a burden. A relief, because it makes clear that nobody can be expected to know everything; a burden, because it makes one aware of one’s own powerlessness. Professional practice therefore means acting to the best of one’s professional knowledge, coordinating within the team, documenting decisions in a traceable way and acknowledging one’s own limits. Those who are aware that responsibility for a person’s life does not rest with the professional alone can stay clearer and more attentive in crises.

The tension between self-determination and protection

Onward referral touches a fundamental area of tension in social work: respect for self-determination on the one hand and the protection of life on the other. Many people in crisis do not want relatives, doctors or authorities to learn of their thoughts – out of shame, fear of being admitted to hospital or because of bad experiences. Treating these fears with respect is a precondition for people opening up at all. At the same time, there are situations in which protecting life takes precedence. There is no simple rule between these poles. It helps to decide as much as possible together, to make transparent what the professional will do and why, and to limit steps taken against the person’s will to genuine emergencies – with consultation in the team and with regard to the legal limits explained in Module 6.

Gaps in provision and open questions

Another area of tension concerns the provision landscape itself. Good onward referral presupposes that services are available. In some regions there are well-developed crisis services, while elsewhere professionals depend largely on the emergency number, the out-of-hours medical structures and the TelefonSeelsorge at night and at weekends. The National Suicide Prevention Strategy names networking and coordination as a separate field of action and recommends developing a central crisis service emergency number (BMG, 2024). Whether and when such a number will come is an open question: the ministerial draft bill to strengthen national suicide prevention does contain a telephone number concept and a digital directory of support services, but it is not in force (BMG, 2026). For practice, this means not relying on future structures but knowing precisely the services available locally today.

Finally, there is the question of role clarity. Social workers can carry out evaluations, develop safety plans and build bridges – but they do not diagnose, do not treat and do not order involuntary admission. Particularly in fields of work where professionals are the only reliable contact people, the temptation can arise to take on more responsibility than the role can bear. A clear division of tasks with medical and psychiatric services protects clients and professionals alike.

Consequences for practice

Several practical consequences follow from these considerations. Organisations should have a written crisis protocol that names responsibilities, consultation routes and points of contact and is updated regularly. An up-to-date overview of regional crisis services and when they can be reached belongs in every team. Templates for safety plans can help, but should be designed so that there is room for the person’s own words. And finally, a culture is needed in which uncertainty may be voiced – because the willingness to bring in medical help or ask colleagues for advice in case of doubt is one of the most important safety resources an organisation has.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

The previous modules have shown how professionals understand crises, conduct conversations, raise suicidality openly and develop a safety plan together with the people concerned. In almost every one of these situations, a legal question arises sooner or later: May I inform the doctor even though my client does not want me to? Do I have to call the relatives? What happens when someone is ‘sectioned’ – and who decides? Questions like these leave many professionals uncertain, sometimes even afraid of doing something wrong. This uncertainty is understandable, because in acute crises two protected interests meet, both of which carry great weight: the person’s trust and self-determination on the one hand, their life and health on the other.

This module gives a structured overview of the legal framework within which crisis intervention operates. It explains professional confidentiality, justifying necessity and the two forms of involuntary admission – and it shows where the limits of your own role lie. An important point in advance: this module provides orientation knowledge. It does not replace legal advice in an individual case, and in practice your organisation’s procedures and consultation with your manager and team always take precedence over going it alone.

PART 1 – Introduction: why the law matters in a crisis

Two protective duties, one area of tension

Social work depends on trust. People tell professionals about debt, addiction, violence, shame and despair because they rely on this information not being passed on without their say. Without this confidentiality, many people seeking help would not come at all – or they would keep quiet about precisely the most important things. At the same time, the professional mandate requires professionals to protect people from serious harm when they can no longer protect themselves. In an acute suicidal crisis, this area of tension becomes especially clear: the person confides in someone, perhaps expressly asks for silence, and at the same time there is a serious danger to their life.

The law does not resolve this tension with a simple rule. But it does provide a graduated system: as a matter of principle, confidentiality applies; with the consent of the person concerned, disclosure is possible; without consent, it can exceptionally be justified if a present danger cannot be averted in any other way. And for the extreme case in which a person is in acute danger of harming themselves because of a mental illness and refuses help, federal and state law provide for the possibility of involuntary admission – with strict requirements and under judicial oversight. Those who know this system in outline can act more calmly and with better reasons in a crisis.

Key terms

Some terms come up again and again in this module and should be clear from the outset. By professional confidentiality we mean the duty of certain professional groups not to disclose without authorisation other people’s secrets that have been entrusted to them or have otherwise come to their knowledge; for social work professionals – for the group of persons named there – it is backed by criminal law in Section 203 StGB. Disclosing means making another person’s secret accessible to someone who did not previously know it – orally, in writing or electronically. Authorised is a disclosure in particular when the person concerned has consented or a ground of justification applies.

The justifying necessity under Section 34 StGB is one such ground of justification: it exceptionally permits an act that is in itself prohibited if that is the only way to avert a present danger to an important legal interest. Finally, by involuntary admission we mean a deprivation of liberty in which a person is held, against or without their will, in a closed facility, usually a psychiatric hospital. A distinction is made between civil-law involuntary admission by a legal custodian under the German Civil Code and public-law involuntary admission under the laws of the states (Arbeitsgruppe Psychiatrie der Arbeitsgemeinschaft der Obersten Landesgesundheitsbehörden [AG Psychiatrie der AOLG; Psychiatry Working Group of the Working Group of the Supreme State Health Authorities], 2023).

PART 2 – Legal fundamentals: confidentiality, necessity, involuntary admission

Professional confidentiality under Section 203 StGB

In Germany, breach of private secrets is a criminal offence for certain professional groups. For social work, Section 203(1) no. 6 StGB is the relevant provision. It states – reproduced here with omissions –: ‘Whoever without authorisation discloses another person’s secret […] that was entrusted to them or otherwise became known to them as […] a state-approved social worker or state-approved social education worker […] shall be liable to imprisonment of up to one year or a fine.’ The provision makes clear how much weight the legislator attaches to the relationship of trust in social work: it is protected by criminal law, as in other helping professions.

Three elements of the provision deserve particular attention. First, it concerns another person’s secret, that is, facts from another person’s sphere of life that are not generally known and whose secrecy the person has an interest in maintaining. Statements about suicidal thoughts, mental distress or family conflicts typically belong here. Second, the provision covers not only what was expressly entrusted, but also what has otherwise become known to the professional – for example through observations during a home visit. Third, only unauthorised disclosure is punishable. The decisive question in practice is therefore not ‘May I never say anything?’ but ‘When am I authorised to pass something on?’

Regardless of whether a professional falls within the scope of the criminal provision in an individual case, it is advisable to treat confidentiality as a professional standard. Employment contracts and the rules of provider organisations (Träger) as a rule also provide for confidentiality. For clients it makes no difference on what basis confidentiality rests – they rightly expect that their openness will not be used against them.

Consent as the first route

The simplest, legally safest and at the same time professionally best route to disclosing information is the consent of the person concerned. A person who consents remains the subject of events: they have a say in who learns what, and they experience that their self-determination is respected even in a crisis. This strengthens the working relationship rather than endangering it. Justifying necessity too presupposes, in principle, that an attempt is first made to obtain consent, because disclosure without consent comes into question only if the danger cannot be averted in any other way (Section 34 StGB).

In practice this means: in the crisis conversation, professionals should say openly why they consider it important to involve another service, and clarify together with the person who is to be informed, what information is passed on and how this happens. A graduated solution can often be found: the person calls the medical service themselves while the professional sits next to them; or they agree that a particular trusted person is informed, but not the family. Consent should be as specific as possible and documented in a traceable way. It is also important that the person knows they can withdraw their consent.

Justifying necessity under Section 34 StGB

But what if the person refuses any disclosure and at the same time there is an acute threat to life? This is where Section 34 StGB comes in. Under this provision, a person does not act unlawfully who, in the face of a present danger to life, limb, liberty or another legal interest that cannot be averted in any other way, commits an act in order to avert the danger from themselves or another – provided that, when weighing the conflicting interests, the protected interest substantially outweighs the one impaired and the act is an appropriate means. Applied to professional confidentiality, this means: the disclosure of a secret can be justified in an individual case if that is the only way to protect a person’s life (Section 34 StGB; Section 203 StGB).

The requirements are deliberately narrow. Present describes a danger where harm is imminent or the danger can turn into harm at any moment – vague fears or general distress are not enough. Cannot be averted in any other way means that milder means, in particular seeking consent or help that the person agrees to, are not available or not sufficient. The weighing-up of interests requires that the protected interest – here life – substantially outweighs the impaired interest, that is, the interest in secrecy. And the disclosure must be an appropriate means – only as much is communicated as is necessary to avert the danger, and only to those who can actually help, such as the emergency medical service or medical staff.

Civil-law involuntary admission under Section 1831 BGB

Custodianship law regulates the conditions under which a legal custodian may arrange for the person under their care to be admitted involuntarily with deprivation of liberty. Under Section 1831(1) no. 1 BGB, such admission is permissible, among other things, for as long as it is necessary because, owing to a mental illness or a mental or psychological disability, there is a danger that the person under custodianship will kill themselves or inflict considerable damage to their health. The law thus ties involuntary admission to a danger to oneself that is caused by the illness or disability, and to necessity – it is permissible only for as long as it is actually needed.

Equally important is the procedural safeguard: under Section 1831(2) BGB, involuntary admission is permissible only with the approval of the custodianship court. Without prior approval it is permissible only if delay would involve danger; the approval must then be obtained without undue delay. The decision thus does not rest with a single person but is subject to judicial oversight. It should be emphasised that civil-law involuntary admission serves to protect the person under custodianship themselves: protecting third parties is not sufficient as a ground (AG Psychiatrie der AOLG, 2023). It also presupposes that legal custodianship (rechtliche Betreuung) exists with a corresponding area of responsibility.

Public-law involuntary admission under state law

Alongside custodianship law there is public-law involuntary admission. It is regulated in the states’ acts on mental illness (Psychisch-Kranken-Gesetze), acts on help for people with mental illness (Psychisch-Kranken-Hilfe-Gesetze) or acts on involuntary admission (Unterbringungsgesetze), and applies when, as a result of a mental disorder, there is a specific danger to oneself or to others. There is no uniform federal act for this; the states regulate procedure and enforcement differently (AG Psychiatrie der AOLG, 2023). Unlike civil-law involuntary admission, public-law involuntary admission does not presuppose legal custodianship, and it can also serve to protect other people. Two states serve as examples below – they are expressly not transferable to other states.

Example: North Rhine-Westphalia: Under Section 11 PsychKG NRW (the state mental health act of North Rhine-Westphalia), involuntary admission is permissible if, as a result of illness-related behaviour, there is a present, considerable danger to oneself or a considerable danger to significant legal interests of others that cannot be averted in any other way. Here too, then, we find the idea of immediacy and of being a last resort after milder means. For urgent cases, Section 14 PsychKG NRW provides that, where delay would be dangerous, the local regulatory authority (Ordnungsbehörde) can order immediate involuntary admission on the basis of a medical report; it must then apply without undue delay for a court decision (PsychKG NRW).

Example: Bavaria: The Bavarian Act on Help for People with Mental Illness (BayPsychKHG) expressly combines help and protection. Under Article 1 BayPsychKHG, the districts (Bezirke) set up and run crisis services consisting of control centres and mobile professionals; the control centres can be reached around the clock on a single, uniform telephone number. The requirements for involuntary admission are regulated in Article 5 BayPsychKHG, and immediate provisional admission in urgent cases is regulated in Articles 11 to 13 BayPsychKHG. Among the bodies responsible are, for example, the district administrative authority, the police and the facility itself (BayPsychKHG). The Bavarian example shows that state law does not only regulate compulsory measures but can also anchor low-threshold support that, in the best case, makes involuntary admission unnecessary.

Minors: a brief note on taking into care

For children and young people in acute crises, a further instrument applies. Under Section 42(1) sentence 1 SGB VIII, the youth welfare office (Jugendamt) is entitled and obliged to take a child or young person into care, among other situations when the child or young person themselves asks to be taken into care or when an urgent danger to their wellbeing requires it. For professionals outside the youth welfare office, this above all means: in the case of an acute danger to minors, the youth welfare office should be involved early, and young people can also turn to the youth welfare office themselves. The procedure and details of taking into care are covered in more depth in a separate course and are not part of this module.

PART 3 – Practice I: passing on information – a structured decision route

From gut feeling to a reasoned decision

In an acute crisis, the professional is under time pressure and emotional strain. It is precisely then that a clear mental sequence helps, preventing you from acting hastily or, out of uncertainty, not acting at all. The following decision route is a teaching aid derived from the structure of Section 203 StGB and Section 34 StGB. It replaces neither the organisation’s procedures nor consultation with the manager, but it makes visible which questions need to be clarified, and in what order.

The first step calls for as objective a description of the situation as possible. This is where the insights from the previous modules come in: how concrete are the suicidal thoughts that have been expressed? Are there preparations or a point in time? Are protective factors and supporting people reachable? The professional does not make a diagnosis; they describe what they perceive and what the person says. In the second step, consent is sought – not as a formality but as a genuine offer of relationship. Many people in crisis agree to help when they are taken seriously and can have a say in what that help looks like.

The third step underlines that professionals do not have to, and should not, decide alone. Consulting the manager or colleagues is not only sensible legally but also provides emotional relief and improves the quality of the decision. In an acute emergency this can happen in parallel, for example when a colleague informs the manager while the professional stays in contact with the person. Only in the fourth step does the question of disclosure without consent arise. Here the elements of Section 34 StGB are run through mentally. If there is an acute threat to life, the emergency medical service is to be called via the emergency number 112 (Land Niedersachsen, 2025). Finally, the fifth step links action with traceable documentation: what was perceived, which alternatives were tried, why and how was the decision made, who was informed?

Documentation as protection for everyone involved

Careful documentation in crisis intervention is not a bureaucratic add-on. It makes your own decision traceable, protects the professional if questions are asked later and ensures continuity of support when other colleagues take over. What should be recorded are the perceived indications of danger, with statements reproduced as literally as possible, the alternatives offered and the person’s response, the question of consent, consultations within the team, the weighing-up, and the type, extent and recipients of any disclosure. Evaluations should be recognisable as such and kept separate from observations. The exact form depends on the organisation’s requirements; the topic is covered in more depth in the last module of this course.

PART 4 – Practice II: involuntary admission – role, limits and cooperation

Two routes to involuntary admission compared

In practice it is helpful to keep the two forms of involuntary admission clearly apart. They differ in the trigger, the decision-making route and the bodies involved. The following overview summarises the differences; at state level, only the two examples of North Rhine-Westphalia and Bavaria are given.

What professionals do – and what they do not do

A common misunderstanding is that social workers can have someone ‘sectioned’. This is not the case. Social work professionals do not order involuntary admission and cannot consent to involuntary admission on someone’s behalf. The only exception is the situation in which a professional has themselves been appointed legal custodian for a person – in that case they act in that capacity and are bound by the approval of the custodianship court (Section 1831 BGB). In all other roles – in counselling, in hospital social services, in homelessness services or integration assistance – the task is to notice dangers, inform the responsible bodies, provide factual information to the extent necessary and accompany the person in a humane way.

This clarity of role is not a weakness but a strength. Precisely because social workers have no powers of compulsion, they can remain a trusted point of contact for the person – even when other bodies take compulsory measures. They can make sure that the person’s perspective is heard, that relatives are involved with the person’s agreement and that the return to everyday life is prepared after an involuntary admission. Where regional crisis services exist, such as the crisis services of the districts anchored in law in Bavaria (BayPsychKHG), it is worth knowing in advance when they can be reached and how they work, because mobile crisis support can in some situations help to avoid involuntary admission.

PART 5 – Critical perspective: areas of tension, limits and open questions

Self-determination and protection

The central area of tension in this module cannot be resolved, only shaped responsibly. On the one hand there is every person’s right to decide for themselves about their life and about the disclosure of personal information. On the other hand there is the protection of life in situations in which a mental crisis or illness can limit the capacity for free decision-making. The law responds by tying interventions to narrow requirements, to proportionality and to judicial oversight. That the federal government and the states regularly address the protection of people in the psychiatric support system before and during interferences with fundamental rights is shown by the report of the Psychiatry Working Group to the Conference of Health Ministers (AG Psychiatrie der AOLG, 2023). Involuntary admission is a considerable interference with liberty – and it must therefore always remain the last resort.

For social work, this results in a dual mandate: it should take dangers seriously and not remain inactive out of misplaced reticence, but at the same time prevent compulsion from being used where relationship, counselling, involvement of the person’s network or low-threshold crisis support would be enough. Human-rights-oriented practice means seeing the person, even in a crisis, as a bearer of rights and bringing their perspective into every step.

Uncertainty, overreaction and failure to act

In practice, two opposite kinds of error can be seen. Some professionals hesitate too long, out of concern about breaching confidentiality, even though there is an acute threat to life. Others, out of uncertainty or a wish to cover themselves, pass on information too quickly, for example to relatives, without there being consent or the requirements of Section 34 StGB being met. Both can harm people: hesitation, in the extreme case, their lives; hasty disclosure, their trust and their willingness to seek help in future. Justifying necessity is therefore neither a free pass nor a taboo, but an instrument for the justified exceptional case.

It helps to become aware of this tension in advance and to discuss it in the team. Those who use case discussions, become familiar with the organisation’s procedures and mentally rehearse typical situations act more confidently in an acute situation. Legal certainty in the sense of a guarantee does not exist in such situations; what does exist is the possibility of acting in a traceable, reasoned way and in line with professional standards.

Federal diversity and ongoing reforms

A further challenge lies in the federal structure. Because each state has its own act on help and involuntary admission in cases of mental illness, requirements, responsibilities and procedures differ (AG Psychiatrie der AOLG, 2023). The examples from North Rhine-Westphalia and Bavaria show typical structures but must not be transferred to other states. Anyone working in another state should become familiar with the act that applies there and with local procedures – ideally together with the manager and using the organisation’s documents.

The legal framework is also in motion. State laws are amended regularly, as the most recent amendments in North Rhine-Westphalia and Bavaria show. At federal level, new rules are being discussed, for example on compulsory medical measures; such drafts, however, become relevant only once they have been adopted and have entered into force. For professionals this means: knowledge of legal bases has a shelf life and should be refreshed at regular intervals – without every professional having to become a lawyer.

Consequences for practice

Several consequences can be drawn from the considerations in this module. At the level of the individual professional, the aim is to know the basics of confidentiality, consent and necessity and to be able to recall a clear mental sequence in a crisis. At the level of the team, it is about reliable agreements on who is informed and when, and about a culture in which uncertainty may be voiced openly. At the level of the organisation, finally, crisis protocols are needed that summarise legal questions, availability and documentation requirements in an understandable way, as well as the option of obtaining legal expertise in difficult cases. In this way the legal framework is experienced not as a threat but as a scaffold that supports professional action in a crisis.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

Some crises do not arise from a loss or a life transition but from a threat: a client mentions in passing that her partner strangled her yesterday. A client no longer dares to come to the organisation because a relative is waiting for him outside the door. A mother reports that she locks herself in the bathroom with the children at night. In situations like these, the first question is not how a person can regain their emotional balance but how they can get through the next hours and days safely. This module therefore combines two perspectives that belong together inseparably in practice: crisis intervention, as you have come to know it in the previous modules, and legal and institutional protection against violence – in particular under the Violence Protection Act (Gewaltschutzgesetz). It shows what social work professionals can do in situations of acute danger, what protective instruments exist, who sets them in motion – and where the limits of your own role lie.

PART 1 – Introduction: violence and acute threat as a trigger of crisis

When violence triggers the crisis

Violence in the close social environment is among the most distressing experiences people can have. It strikes those affected where they expect protection, retreat and trust: in their own home, in their partnership, in their family. For crisis intervention, this means a particular starting point. Sonneck and colleagues describe the psychosocial crisis, in essence, as a loss of emotional balance that a person experiences when confronted with events and life circumstances they cannot cope with at that moment (Sonneck et al., 2016). An act of violence is such an event in a particularly acute form: it is often sudden, it injures body and self-image at the same time, and it can be repeated at any time. Unlike with many other triggers of crisis, the danger is therefore often not over when the conversation begins.

For this reason, a crisis caused by violence cannot be worked on solely with the means of a supportive conversation. The basic principles known from Module 2 – relationship, focus on the current trigger, activating resources – remain valid but are supplemented by a priority question: is the person safe now, today and in the next few days? Only once this question has been dealt with is there room for relief, orientation and longer-term planning. The order is not a rigid scheme but a professional priority: safety first.

Definitions: domestic violence and acute danger

In this module, domestic violence is understood – as a working definition for teaching purposes – as violence exercised between people who are or were in a close social relationship, in particular in (former) partnerships, in the family or in a shared household. It includes physical, sexual and psychological violence, threats, control and stalking. The term does not describe a single offence but a pattern in which one person exercises power over another and restricts their self-determination. Domestic violence affects people of all genders, age groups and social situations; in counselling practice, however, professionals particularly often encounter women who experience violence by a (former) partner – a fact that dedicated support structures such as the nationwide ‘Violence against Women’ helpline respond to (Bundesamt für Familie und zivilgesellschaftliche Aufgaben [BAFzA; Federal Office for Family Affairs and Civil Society Functions], n.d.).

The Violence Protection Act does not build on the concept of domestic violence but on the infringement of certain legal interests: body, health, liberty and sexual self-determination. What is decisive is that one person has intentionally and unlawfully infringed these legal interests of another; in addition, the Act also covers threats and stalking (GewSchG). The Act thus protects not only partners but any injured or threatened person – including against siblings, adult children, housemates or strangers. This breadth matters in practice because it opens up protection even where those affected do not see themselves as ‘victims of domestic violence’.

An acute danger exists – again as a working term – when there are concrete indications that a person’s life, health or liberty are seriously threatened in the near future. This can be the imminent return to the home of a violent person, a death threat that has been made, a fresh injury or a violent person waiting outside the organisation. The evaluation of whether there is an acute danger is neither a diagnosis nor a calculated value but a professional judgement that professionals make, wherever possible, together in the team and in line with their organisation’s procedures.

Violence, crisis and suicidality

In practice, experiences of violence and suicidal crises are often intertwined. People who are humiliated, controlled and injured over a long period often experience powerlessness, shame and the feeling that there is no way out. This very narrowing is a core feature of the pre-suicidal syndrome, which Sonneck et al. (2016) present in the tradition of Ringel. In addition, those affected often feel isolated: the violent person has restricted contacts with friends or family, financial dependence makes it harder to move out, and children or pets tie people to the home. When someone in this situation ‘simply can’t go on’, they sometimes mean exhaustion, but sometimes also thoughts of their own death.

For professionals, this calls for a double awareness. On the one hand they clarify the danger that threatens from outside, and on the other the danger that can arise from within. The stance described in Module 4 applies here too: suicidal thoughts are raised calmly and directly, because according to the evidence, asking does not lead to a significant increase in suicidal thoughts, and an open conversation can bring relief. Conversely, it should also be borne in mind that the violence itself can be life-threatening – for example in attacks to the neck. Combining both perspectives without overwhelming the person concerned is the real professional skill in this field.

PART 2 – Legal fundamentals: protection under the Violence Protection Act

Basic idea: civil-law protection on application

The Act on Civil-Law Protection against Acts of Violence and Stalking, in short the Violence Protection Act, follows a clear basic idea: whoever uses violence should leave – not the person who has suffered violence. For this purpose the Act provides civil-law instruments that a court orders on the application of the injured person (GewSchG). Civil-law means: the primary aim is not to punish an offence – criminal proceedings are responsible for that – but to protect the person concerned in future. Both routes can exist side by side; a criminal complaint is not a precondition for an application under the Violence Protection Act, and conversely a court protection order does not replace criminal proceedings.

For social work, the principle that an application is required is central. It is not the professional, not the organisation and not the youth welfare office that makes the application, but the injured person themselves. Professionals can inform, encourage, help with organisation and refer people to specialist counselling or legal help. They do not, however, provide legal advice in individual cases and do not decide whether an application has prospects of success. This clarity of role protects both sides: the person concerned keeps the decision over their life, and the professional does not overstep the limits of their remit.

Protection orders under Section 1 GewSchG

The core of the Act is the court protection orders. If one person has intentionally and unlawfully infringed the body, health, liberty or sexual self-determination of another, the court, under Section 1(1) GewSchG, on the application of the injured person, takes the measures necessary to prevent further infringements. The Act gives examples of what can be ordered: a ban on entering the injured person’s home, on staying within a certain radius of the home, on visiting certain other places where the injured person regularly spends time, on contacting them – including by means of remote communication – or on bringing about a meeting with them. In practice, these are referred to in simplified terms as orders not to enter, approach or make contact.

Under Section 1(2) GewSchG, the same applies, among other cases, where one person threatens another with such an infringement or stalks them. Protection is therefore possible even before an injury has occurred. This point is important precisely for people who are being threatened, followed or flooded with messages: they do not have to wait until ‘something happens’. Which orders are necessary and appropriate in an individual case is for the court to decide. Breaches of a court protection order are punishable (GewSchG); in the event of a breach, the person affected by violence can also call the police.

Allocation of the home under Section 2 GewSchG

Section 2 GewSchG is particularly significant for people who live with the violent person. If the injured person has run a shared household with the perpetrator that was intended to be long-term, they can demand that the jointly used home be allocated to them for sole use. This makes the principle ‘whoever is violent must leave’ concrete: it is not the person concerned and, where applicable, their children who have to leave their home, but the person who used violence.

The allocation is not, however, permanent in every case. If the perpetrator holds rights in the home, alone or jointly with third parties – for example ownership – the allocation must be limited to a maximum of six months. Under narrow conditions, for example if the injured person has not been able to find suitable replacement housing on reasonable terms within this time, an extension of a maximum of six further months is possible. The exact categories of case follow from the text of the provision and depend on the legal relationships to the home; specialist or legal advice is indispensable here (GewSchG). For social work, the time limit means above all one thing: the allocation of the home buys time but often does not replace a long-term housing prospect. In parallel with the protection order, support with finding housing, securing a livelihood and organising everyday life is therefore often needed.

The 2026 reform: location monitoring, perpetrator programmes, maximum penalty

The Violence Protection Act was extended in 2026. With the Act on the Introduction of Electronic Location Monitoring and Perpetrator Work in the Violence Protection Act of 2 July 2026, promulgated in BGBl. 2026 I No. 198, the legislator set three focal points; the Bundestag had passed the Act on 8 May 2026 (GewSchG). First, family courts will in future be able to order electronic location monitoring of perpetrators – colloquially often called an ‘electronic ankle tag’. The aim is to monitor compliance with orders not to approach more effectively and to warn those affected earlier. Second, family courts can oblige perpetrators to take part in social training courses or in counselling on violence prevention. This brings the responsibility of the violent person more into focus. Third, the maximum penalty for breaches of protection orders under the Violence Protection Act is raised from two to three years’ imprisonment.

For practice, one detail is decisive: the new provisions enter into force in stages. Professionals should not assess in an individual case which parts apply from what date, but have this clarified by specialist counselling services or by a lawyer. Restraint is therefore called for towards those affected: it would be professionally wrong to hold out electronic monitoring as something that is certainly available. It is more helpful to say that the legislator has widened the options for protection and that a counselling service can clarify what comes into question in the specific case.

PART 3 – Practice I: safety first – acting in acute danger

Recognising acute danger and calling the emergency number

The first professional question in any crisis involving violence is: is there a danger to life or limb now? If a violent person threatens to force their way into the organisation, if a client reports on the phone that she is being attacked right now, or if someone is seriously injured, the emergency call takes priority over any conversation. In Germany, you can reach the police on 110 and the fire service and emergency medical service on 112; 112 is free of charge and can be reached across Europe. The number 116 117, by contrast, is the out-of-hours medical service and expressly not an emergency number (Land Niedersachsen, 2025). This distinction sounds trivial but, as experience shows, is not always at the front of people’s minds in stressful situations – it is worth reminding the team of it regularly and displaying it clearly.

Professionals may, and should, call the emergency number themselves in an acute danger. Calling the emergency number is not a decision against the person concerned but a decision for their life and health and for the safety of everyone present, including the professional. The police can take their own immediate measures under the respective state law; the requirements and duration of these are regulated differently in the states and are not the subject of this module. For social work, it is enough to know that immediate police measures and court protection orders are different routes that can complement one another.

The conversation: believing, relieving, not pushing

If there is no immediate danger, the actual crisis conversation begins. For people who experience violence, it is often a big step even to talk about it. Shame, fear of consequences, loyalty towards the partner or family and the worry of not being taken seriously make many of those affected stay silent for a long time. The most important message from the professional is therefore: I believe you, and you are not to blame for the violence. This stance rules out questions such as ‘Why didn’t you just leave?’ because – even when well meant – they shift responsibility onto the person concerned.

The crisis literature describes how people, immediately after a shattering event, often appear calm and inconspicuous on the outside while being in chaos inside; Cullberg (1978) describes this as the shock phase of the traumatic crisis. An act of violence reported in a matter-of-fact way or even with a smile is therefore not a sign that it was ‘not that bad’. In this phase, short, clear sentences, orientation and concrete offers help more than lengthy explanations. Information about protection options is best also handed over in writing – in a form that is safe for the person concerned, for example without a conspicuous letterhead or on a slip of paper that is easy to hide if the violent person checks bags or phones.

At the same time: the professional does not push. Many of those affected need several attempts before they separate or take legal steps, and some deliberately decide against it. Respecting this decision does not mean ignoring the danger. It means thinking together about what the person can do today for their safety – and keeping the door open for a later conversation.

Taking warning signs seriously – and keeping suicidality in mind

Certain indications are regarded in professional practice as particularly serious: attacks to the neck such as strangulation, threats to kill, the use or display of weapons, an increase in the frequency and severity of violence, and the period around a separation, when the violent person risks losing control. Such indications are not points on a scale and do not allow prediction. But they are a clear signal to discuss the safety question particularly carefully with the person concerned and in the team and to involve specialist services. Strangulation, for example, can be life-threatening even when there are hardly any visible outward marks; a medical check-up and documentation of the injuries is therefore advisable.

In parallel, professionals keep the danger from within in view. Statements such as ‘I can’t stand it any more’ or ‘It would be better if I weren’t here any more’ are picked up and followed by a direct question: ‘Do you sometimes think about taking your own life?’ As described in Module 5, a shared safety plan can come out of this. In cases of domestic violence, this often means taking both dangers into account in the same plan: who can be called when the fear of the partner becomes overwhelming, and who when your own dark thoughts get stronger?

PART 4 – Practice II: organising protection, using the network, keeping children in view

Informing about protection options – without legal advice

Social work professionals are often the first people those affected confide in – and they are rarely the right people to give binding answers to individual legal questions. Their task lies in between: they inform, in understandable language, that court protection orders and the option of allocating the home exist, that these are made on the application of the injured person and that specialist counselling services and legal representatives support the application and the proceedings (GewSchG). It helps to accompany the person with practical steps: gathering documents, making appointments, agreeing a safe means of communication, arranging childcare for the day of a court or counselling appointment.

A tried and tested aid is careful documentation of the incidents by the person concerned themselves – for example date, place, type of violence, witnesses, photos of injuries, medical findings or saved messages. Professionals can encourage this but must bear in mind that such records can become dangerous for the person concerned if the violent person finds them. Together you can think about where documents can be kept safely, for example with a trusted person.

The ‘Violence against Women’ helpline – also for professionals

A central nationwide service is the ‘Violence against Women’ helpline (Hilfetelefon “Gewalt gegen Frauen”) of the Federal Office for Family Affairs and Civil Society Functions. It can be reached on 116 016 around the clock, free of charge, confidentially and, on request, anonymously, advises in several languages and can bring in interpreters if needed; its legal basis is the Helpline Act (Hilfetelefongesetz) (BAFzA, n.d.). For social work it is particularly important that the service is aimed not only at affected women but also at their social circle and at professionals (BAFzA, n.d.). Anyone who is unsure how to evaluate a case or which regional support services exist can therefore call themselves – in anonymised form and without disclosing the client’s data.

The helpline replaces neither the emergency number nor longer-term support on the ground. But it can be a low-threshold bridge, especially for people who do not (yet) dare to go to a counselling service, who need help at unusual times or who do not speak German well. For men affected by violence and for people who do not identify as women, there are dedicated services in many regions; it is worth researching these in advance for your own catchment area and keeping them to hand in the organisation.

Children in the household: youth welfare office and taking into care

If children or young people live in the household, they are always affected by domestic violence too – even if they are not hit themselves. Witnessing violence between the people they depend on is a considerable burden and can endanger a child’s wellbeing. Professionals therefore keep the children’s situation in view and act in line with their organisation’s child protection procedures; in many cases the youth welfare office has to be involved. Supporting the parent affected by violence is often at the same time the most effective protection for the children.

Where an acute danger is concerned, one instrument deserves particular mention: under Section 42(1) SGB VIII, the youth welfare office is entitled and obliged to take a child or young person into care, among other situations when the child or young person themselves asks for this or when an urgent danger to their wellbeing requires it (Section 42 SGB VIII). The decision is made by the youth welfare office, not by a professional in another organisation. It is important for young people to know that they can also turn to the youth welfare office themselves. The procedure, time limits and legal protection in taking into care are covered in more depth in a separate course and are not the subject here.

Professional confidentiality and justifying necessity

What those affected confide about violence they have suffered is subject, for social workers and social education workers, to professional confidentiality protected by criminal law under Section 203 StGB. The consent of the person concerned is therefore always the first route when information is to be passed on to the police, doctors, the youth welfare office or relatives. In practice it is often possible to win this consent in the conversation – for example by the professional making transparent why they consider disclosure important, and by leaving the person as much control as possible over timing and content.

Only exceptionally can disclosure without consent be justified. Under Section 34 StGB, a person does not act unlawfully who, in the face of a present danger to life, limb, liberty or another legal interest that cannot be averted in any other way, commits an act in order to avert the danger from themselves or another, if, when weighing up the interests, the protected interest substantially outweighs the one impaired and the act is an appropriate means (Section 34 StGB). This provision is not a general permission to disclose as soon as violence is involved. It requires a concrete, present danger, a careful weighing-up in the individual case, the priority of milder means such as consent, consultation with the manager and team, and traceable documentation. How professional confidentiality and necessity interact in detail is covered in more depth in Module 6; in cases of doubt, legal advice is to be obtained through the organisation or provider (Träger).

PART 5 – Critical perspective: limits, areas of tension and consequences

The application principle between self-determination and being overwhelmed

The application principle of the Violence Protection Act respects the self-determination of those affected: nobody is drawn into court proceedings against their will. At the same time, it asks people in an acute crisis to do something that is particularly hard for them – to make decisions, gather documents, face a violent person in proceedings. Someone who, as Cullberg (1978) describes for the shock phase, feels inwardly paralysed may initially be overwhelmed by an application. Social work is therefore in an area of tension: it should respect the autonomy of those affected and at the same time prevent protection from failing on hurdles that are linked to the crisis itself. One answer is practical support that does not take decisions away but makes it easier to carry them out.

New instruments, open questions

The 2026 reform comes with clear aims: electronic location monitoring is meant to make orders not to approach more enforceable, mandatory perpetrator work is meant to address the cause of the violence, and the higher penalty range is meant to underline the binding nature of court orders (GewSchG). How these instruments will work in practice cannot yet be judged at the legal position of this module – not least because the entry into force is staged. Open questions concern, for example, how quickly monitoring can be set up, how those affected are warned of approaches, how many places are available in perpetrator work and how cooperation between courts, police, counselling services and perpetrator work organisations is organised. For professionals, this calls for an attitude of informed restraint: they know about the innovations but promise nothing that is not yet secured in the individual case.

Blind spots: who finds it hard to access protection

Protection from violence does not reach everyone equally. Anyone without a home of their own cannot benefit from the allocation of the home; anyone living in shared accommodation or a residential facility may meet the violent person in the corridor every day. People with disabilities, older people cared for by relatives, or people with an insecure residence status are often in particular dependencies that make it harder to disclose violence. Men who experience violence often stay silent out of shame, as Mr B.’s example shows, and find fewer specialised services. Language barriers are also a hurdle; multilingual services such as the helpline can build bridges here (BAFzA, n.d.) but do not replace counselling on the ground. Human-rights-oriented social work makes these gaps visible instead of attributing them to those affected as a personal failing.

Limits of your own role – consequences for practice

Social work professionals can achieve a lot in crises involving violence: they listen, believe, name the danger, open up routes and keep in contact. But they can neither issue protection orders nor order taking into care, nor guarantee a person’s safety. This can be a burden – especially when a client returns to the violent person after a conversation. Here it helps to define your own responsibility clearly: it lies in careful, caring and documented work in a team, not in the outcome, which other people and institutions help to decide. At the same time, it becomes clear how important robust structures in the organisation are: a crisis protocol, an up-to-date list of regional points of contact, clear agreements on emergency calls and the right to exclude people from the premises, reliable routes to managers and child protection specialists, and room for peer consultation after distressing situations. Those who know and use these structures act more calmly and more safely in an acute danger – for those affected and for themselves.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

When an acute crisis subsides, a feeling of relief often sets in: the client can be reached again, the young person is safe, the call on Friday evening has had a good outcome. It is precisely at this moment, however, that it is decided whether the support will have a lasting effect. This module is devoted to the often underestimated ‘second half’ of crisis intervention: aftercare and continuity, careful documentation, shared reflection in the team and the question of how professionals themselves stay healthy and able to work – even when a crisis has not ended well. In doing so it ties together the content of the previous modules and turns the focus to quality, responsibility and resilience.

PART 1 – Introduction: when the acute crisis is over

Crisis as a process – not as an event

Sonneck et al. (2016) describe the psychosocial crisis as a loss of emotional balance that a person experiences when confronted with events and life circumstances they cannot cope with at that moment. This definition contains a pointer that is central to aftercare: the overload exists ‘at that moment’. Crises are time-limited states whose course is open. That an acute peak has been overcome therefore does not yet mean that the person has regained their balance. Often the triggering circumstances – a separation, the loss of a home, a diagnosis – are still there, while the attention of those around them, and sometimes of the support system too, is already fading.

From this perspective, crisis intervention is not a one-off response but a process that merely enters a new phase once the situation has stabilised. In this phase, the aim is to bring the agreements made during the acute contact to life, to shape transitions into further support reliably and to record what has happened in a way that other professionals can pick up. At the same time, the focus turns to the helpers themselves. For professionals too can be temporarily thrown off balance by a distressing incident – for example after a conversation with a person in a suicidal crisis or after the news that a client has taken their own life. The definition by Sonneck et al. (2016) therefore applies not only to clients but can also help you understand your own reactions without interpreting them as personal failure.

Key terms in this module

In this course, aftercare means planned support after an acute crisis: agreed follow-up contacts, the review and adjustment of agreements, and referral on to support that goes beyond your own remit. Documentation means the prompt, written and traceable recording of the trigger, professional evaluation, agreements and decisions – including the question of what information was passed on to whom, and with whose consent. Peer consultation refers to structured consultation among professionals of equal standing without external facilitation, whereas case discussion usually takes place in your own team with a view to further case planning. Supervision is reflection on professional practice facilitated by an external, suitably qualified person. By postvention we mean all measures that support the bereaved, others affected and professionals after a suicide or suicide attempt. Self-care finally, covers conscious care for your own physical and mental health as a precondition for professional practice – a task that professionals do not carry alone but that also concerns teams and provider organisations (Träger).

PART 2 – Professional and legal fundamentals

Continuity and referral on as part of suicide prevention

The National Suicide Prevention Strategy of the Federal Ministry of Health (BMG) sees suicide prevention as a task that extends across several fields of action (Bundesministerium für Gesundheit [BMG; Federal Ministry of Health], 2024). Two of them are especially significant for aftercare: the field of action of psychosocial counselling and support expressly includes not only telephone and online counselling and crisis services but also referral on to further support services. The field of action of networking and coordination aims to ensure that the various bodies in the support system work not side by side but together (BMG, 2024). For social work, this means: the contribution of a counselling service, a social service or a residential group does not end when an acute situation has been defused but includes the question of how the person concerned will be reliably accompanied in the coming days and weeks.

Particular attention is due to transitions – for example discharge from a hospital, the end of a programme, a change of responsibility, holiday periods or the weekend. At such interfaces, support can drop away unnoticed because every body involved assumes that another is taking care of it. Aftercare therefore also means clarifying responsibilities explicitly: who contacts whom, and when? What happens if an agreed contact does not take place? And what information does the next service need so that the person does not have to tell their story all over again?

The safety plan as the common thread of aftercare

If a safety plan was developed during the acute contact, it forms an obvious bridge into aftercare. Stanley and Brown (2012) describe the safety plan as a written, prioritised list in six steps: personal warning signs, own coping strategies, people and social settings for distraction, people who can be asked for help, professional services and crisis services, and measures to make the environment safer. What matters is that the plan is created together and in the words of the person concerned and is expressly not a no-suicide contract (Stanley & Brown, 2012). It therefore does not require a promise but provides options for action.

From this character it follows that the plan is not a closed document. In follow-up contacts it is worth taking it up again together: which warning signs have appeared since? Which strategies helped, which did not? Were the named trusted people actually reachable? Have new contacts or points of contact emerged, for example after referral to a counselling service or to medical help? Aftercare thus turns the safety plan into a learning instrument that grows with the person – and shows the person that their experiences with the plan are taken seriously.

Professional confidentiality as the framework for all documentation

In social work, documentation and the disclosure of information operate within a clear framework of criminal law. Under Section 203(1) no. 6 of the German Criminal Code (StGB), state-approved social workers and social education workers commit an offence if they disclose without authorisation another person’s secret that was entrusted to them in that capacity or otherwise became known to them; the penalty is imprisonment of up to one year or a fine. Crisis conversations in particular contain especially sensitive content – suicidal thoughts, experiences of violence, family conflicts. Two things follow for documentation: first, careful consideration is needed of what actually has to be recorded for the professional work. Second, every disclosure must be noted together with its basis.

The first and primary route to disclosure is the consent of the person concerned, which ideally states specifically what information may go to whom. Only exceptionally can disclosure without consent be justified under Section 34 StGB – where there is a present danger to life or limb that cannot be averted in any other way, the protected interest substantially outweighs the one impaired when weighed up, and disclosure is an appropriate means. This weighing-up is always a decision in the individual case, made in line with the organisation’s procedures and, wherever possible, in consultation with the manager. Documentation makes it traceable afterwards: what danger was seen, which milder routes were tried, who was involved?

Postvention: the crisis of the bereaved

A suicide attempt or suicide among clients is a profound event for everyone involved. If the concept of crisis from Sonneck et al. (2016) is applied to this situation, it becomes clear that relatives, housemates, fellow clients and professionals themselves can enter a crisis: they are confronted with an event that they cannot cope with at that moment. Postvention therefore means applying the principles of crisis intervention to the bereaved. The BELLA mnemonic according to Sonneck et al. (2016) – build the relationship (Beziehung aufbauen), grasp the situation (Erfassen der Situation), relieve symptoms (Linderung von Symptomen), involve people (Leute einbeziehen), approach to problem-solving (Ansatz zur Problembewältigung) – offers a helpful structure here too, in aftercare: who is affected and how? Who needs to be approached now, who needs peace, who needs further help? Which people and services can be involved?

PART 3 – Practice I: shaping aftercare and documenting crises

Agreeing follow-up contacts that are binding

Aftercare begins as early as the end of the acute contact. A vague ‘Get in touch if anything happens’ leaves the initiative precisely to the person who, in a crisis, lacks strength and orientation. A concrete agreement is more helpful: when will the next contact take place, by what means – in person, by phone, by message – and who takes the initiative? An agreement on what happens if contact does not take place is just as important. Many organisations specify that the professional gets in touch actively and – where there is corresponding concern and in line with internal procedures – initiates further steps. Such agreements should be discussed transparently with the person so that they are experienced not as control but as an expression of reliability.

The following illustration summarises one possible course of aftercare. It is not a binding requirement but an orientation that has to be adapted to the field of work, the remit and the organisation’s procedures.

Referral on to further support

In a crisis, social work can relieve, provide structure and build networks, but it replaces neither medical nor psychotherapeutic treatment. Aftercare therefore includes the question of which support beyond your own remit makes sense: medical or psychiatric evaluation, psychotherapeutic services, specialist counselling services, regional crisis services, self-help groups or services for relatives. A mere list of addresses is often not enough in a crisis. An accompanied referral is more effective: calling together, making an appointment, accompanying the person to the first contact if they wish and – with consent – passing the most important information to the receiving service. In addition, low-threshold services can be included in the safety plan. The TelefonSeelsorge is free of charge, anonymous and available day and night on 0800 1110111, 0800 1110222 and 116 123 and also offers chat and email (TelefonSeelsorge Deutschland, n.d.). In an acute threat to life, the emergency number 112 is to be called (Land Niedersachsen, 2025).

What good crisis documentation does

In everyday work, documentation is often experienced as a tiresome duty. In crisis intervention, however, it fulfils several professional functions at once. It ensures continuity, because colleagues on late or weekend shifts and cover staff need to know what was agreed. It creates traceability, because decisions – for example about bringing in medical help or disclosing information – can be justified afterwards. It supports reflection, because writing things down creates a first distance from what was experienced. And it serves the protection of clients and professionals alike, because it makes careful practice visible.

The requirements of the respective provider organisation (Träger) determine the form and scope of crisis documentation. Regardless of form, some principles have proved their worth: write promptly, while the memory is fresh; separate observations from interpretations; record the person’s statements as literally as possible and mark them as quotations; do not formulate diagnoses but describe what was perceived; and minimise data, that is, record only what is actually needed for further work. The documentation itself is to be treated confidentially and stored so that only authorised persons have access.

PART 4 – Practice II: peer consultation, postvention and self-care

Reflection formats compared

Crisis intervention is teamwork. Distressing incidents should not be carried alone but reflected on together – not only for relief but also for quality assurance: what went well? Where were there uncertainties? What do we learn as a team for future situations? The National Suicide Prevention Strategy stresses that members of professions who come into contact with people in suicidal crises should be made even more aware of the issue and trained in dealing with people at risk (BMG, 2024). Reflection formats are an important place where such knowledge stays alive in everyday work. Three formats can be distinguished that complement one another:

Peer consultation typically follows a clear sequence: the presenting professional describes the situation, the group asks clarifying questions, the presenter formulates their key question, the advisers develop hypotheses and ideas for action while the presenter listens, and at the end the presenter gives feedback on what they take away. This structure prevents the consultation from sliding into blame or general complaints. For all formats: even in the team, only the information needed for professional reflection is discussed; cases are, where possible, presented in pseudonymised form. Whether and to what extent supervision is offered is regulated by the respective provider organisation; it is all the more important to raise the need for it actively after distressing incidents.

After a suicide attempt or suicide: accompanying the team, fellow clients and relatives

Postvention begins with information and orientation. After a suicide attempt or suicide, team members need reliable, factual information promptly to prevent rumours – without sharing more detail than is necessary for the work. Details of circumstances or means do not belong in team conversations with fellow clients. After that, the question is who is particularly affected: the professional who last had contact, the person who found the individual, housemates who were close to them. Following Sonneck et al. (2016), accompanying these people can be understood as crisis intervention – with an offer of relationship, grasping the individual strain, relief and involving further support. Sympathy towards relatives is important; what information may be passed on is to be clarified within the framework of professional confidentiality and in consultation with the manager.

Self-care: professional limits and relief

Working with people in crises is moving. That thoughts of a conversation linger in the evening is at first a sign of commitment and empathy, not of weakness. It becomes problematic when the strain continues: when sleep suffers, brooding does not stop, irritability or withdrawal increase or enjoyment of the work fades. Self-care therefore begins with attention to your own signals. Helpful are transition rituals between work and leisure – for example consciously closing the documentation, a short walk or a regular chat with a colleague before the end of the working day –, sufficient breaks, exercise, reliable private relationships and permission not to be reachable at all times.

Self-care also includes a realistic understanding of your own responsibility. Professionals act as part of a team and in line with their organisation’s procedures; they are neither solely responsible nor all-powerful. Those who know that decisions were coordinated, documented and shared by the team find it easier to let go after an incident. And anyone who notices that the strain extends beyond the professional sphere may – like anyone else – seek support for themselves.

The organisational level: a crisis protocol for the organisation

Whether aftercare, documentation and self-care succeed depends not only on individual professionals but crucially on the organisation. A crisis protocol for the organisation creates confidence in action, especially in situations where decisions have to be made under pressure. It can, for example, set out who is informed in a crisis, how the manager can be reached outside core hours, which regional points of contact and emergency numbers apply, how consent to disclosure is obtained and documented, how follow-up contacts and handovers are organised and what aftercare services staff receive after distressing events. Such a protocol does not replace professional evaluation in the individual case, but it brings relief, because not every professional has to think everything through anew in the acute situation. It should feed into the induction of new colleagues, be discussed together in the team and be updated regularly – for example after every major crisis, when it becomes clear what has worked and where there are gaps.

PART 5 – Critical perspective: limits, areas of tension and consequences

Documenting between covering yourself and the relationship

Documentation serves continuity and the protection of everyone involved – but it can also tip in a defensive direction. If writing is done mainly to cover oneself against possible reproaches, the danger grows that files become bloated, clients are described mainly as a risk and their resources drop out of view. At the same time, every additional piece of information is in tension with professional confidentiality under Section 203 StGB and with the requirement of data minimisation. Professionally good documentation is therefore not the most extensive but the kind that records the essentials clearly, respectfully and traceably. A helpful yardstick is the question of whether the person concerned could read the entry without feeling belittled.

Self-care is not a private matter

The term self-care carries a risk: it can suggest that professionals themselves are responsible for compensating for structural strain – staff shortages, high caseloads, missing cover arrangements – through private mindfulness. Individual strategies are important, but they do not replace good organisation. Time for debriefing, access to supervision, realistic responsibilities and a culture in which strain may be voiced are tasks for managers and the provider organisation (Träger). When professionals voice their needs, this is not a sign of unsuitability but part of professional responsibility.

Limits of responsibility and looking back

After a suicide or suicide attempt, teams almost inevitably ask whether it could have been prevented. This question is important because it can be learned from – but it is also dangerous because, in hindsight, connections seem clearer than they were in the situation at the time. Suicides cannot be predicted with certainty, and even careful crisis intervention cannot influence every course of events. A good debriefing therefore separates the question of possible improvements in the process from the question of personal blame. The aim is a learning team, not a search for one responsible individual.

Gaps in provision and open questions

Aftercare depends on a functioning support system, and this is developed very differently from region to region. The National Suicide Prevention Strategy recommends developing a concept for a central crisis service emergency number, available around the clock, with forwarding to the crisis services of the states (BMG, 2024) – no such nationwide number exists as yet. Professionals therefore need to know the services in their region and keep this knowledge up to date. In addition there are waiting times for further support, which have to bridge precisely the sensitive time after a crisis. For practice this means: aftercare should not depend on the availability of individual services but rest on several pillars – reliable follow-up contacts of your own, a jointly maintained safety plan, low-threshold points of contact and a team that supports one another. This course provides professional orientation knowledge for this; it replaces neither induction into the procedures of your own organisation nor does it establish any special authority to carry out crisis intervention.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.

All texts in this course were written independently. The sources cited are statutes and ordinances (official works under Section 5 of the German Copyright Act, UrhG), freely accessible publications by official bodies and specialist literature (within the right of quotation under Section 51 UrhG, without reproducing text). Citation style: APA 7 (German-language adaptation). All figures and tables: own illustration. Legal position: September 2026.

Legal sources

Achtes Buch Sozialgesetzbuch – Kinder- und Jugendhilfe – (SGB VIII) [Book VIII of the Social Code – Child and Youth Welfare] in the version published on 11 September 2012 (BGBl. I p. 2022), Section 42 Inobhutnahme von Kindern und Jugendlichen [taking children and young people into care], in the version currently in force. Available at https://www.gesetze-im-internet.de/sgb_8/__42.html

Bayerisches Psychisch-Kranken-Hilfe-Gesetz (BayPsychKHG) [Bavarian Act on Help for People with Mental Illness] of 24 July 2018 (GVBl. p. 583, BayRS 2128-2-A/G), Art. 1, 5 and 11–13, last amended by the Act of 26 March 2026 (GVBl. p. 75). Available at https://www.gesetze-bayern.de/Content/Document/BayPsychKHG

Bürgerliches Gesetzbuch (BGB) [German Civil Code] in the version published on 2 January 2002 (BGBl. I p. 42, corr. p. 2909; 2003 I p. 738), Section 1831 Freiheitsentziehende Unterbringung und freiheitsentziehende Maßnahmen [involuntary admission and measures involving deprivation of liberty], in the version in force since 1 January 2023. Available at https://www.gesetze-im-internet.de/bgb/__1831.html

Gesetz über Hilfen und Schutzmaßnahmen bei psychischen Krankheiten (PsychKG) [Act on Help and Protective Measures for Mental Illness] of the state of North Rhine-Westphalia of 17 December 1999, last amended by Art. 17 of the Act of 10 June 2025 (GV. NRW. p. 530), Sections 11 and 14, in the version in force from 1 July 2025. Available at https://recht.nrw.de/lrgv/gesetz/01072025-gesetz-ueber-hilfen-und-schutzmassnahmen-bei-psychischen-krankheiten-psychkg/

Gesetz zum zivilrechtlichen Schutz vor Gewalttaten und Nachstellungen (Gewaltschutzgesetz – GewSchG) [Act on Civil-Law Protection against Acts of Violence and Stalking (Violence Protection Act)] of 11 December 2001 (BGBl. I p. 3513), Sections 1, 2 and 4, amended by the Act on the Introduction of Electronic Location Monitoring and Perpetrator Work in the Violence Protection Act of 2 July 2026 (BGBl. 2026 I No. 198). Available at https://www.gesetze-im-internet.de/gewschg/BJNR351310001.html

Strafgesetzbuch (StGB) [German Criminal Code] in the version published on 13 November 1998 (BGBl. I p. 3322), Section 34 Rechtfertigender Notstand [justifying necessity], in the version currently in force. Available at https://www.gesetze-im-internet.de/stgb/__34.html

Strafgesetzbuch (StGB) [German Criminal Code] in the version published on 13 November 1998 (BGBl. I p. 3322), Section 203 Verletzung von Privatgeheimnissen [breach of private secrets], in the version currently in force. Available at https://www.gesetze-im-internet.de/stgb/__203.html

Literature and publications

Arbeitsgruppe Psychiatrie der Arbeitsgemeinschaft der Obersten Landesgesundheitsbehörden. (2023). Maßnahmen zum Schutz von Menschen im psychiatrischen Hilfesystem vor und bei Grundrechtseingriffen [Measures to protect people in the psychiatric support system before and during interferences with fundamental rights] [Report to the Conference of Health Ministers 2023]. https://www.gmkonline.de/documents/top-142-bericht-der-ag-psychiatrie.pdf

Bundesamt für Familie und zivilgesellschaftliche Aufgaben. (n.d.). Hilfetelefon „Gewalt gegen Frauen“ [‘Violence against Women’ helpline]. https://www.bafza.de/rat-und-hilfe/hilfetelefon-gewalt-gegen-frauen

Bundesministerium für Gesundheit. (2024). Nationale Suizidpräventionsstrategie [National Suicide Prevention Strategy]. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Praevention/abschlussbericht/240430_Nationale_Suizidpraeventionsstrategie.pdf

Bundesministerium für Gesundheit. (2026). Referentenentwurf: Entwurf eines Gesetzes zur Stärkung der nationalen Suizidprävention [Ministerial draft bill: Draft act to strengthen national suicide prevention] (draft as of 25 June 2026). https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/Gesetze_und_Verordnungen/GuV/S/Suizidpraeventionsgesetz_RefE_LP-21.pdf

Cullberg, J. (1978). Krisen und Krisentherapie. Psychiatrische Praxis, 5, 25–34.

Dazzi, T., Gribble, R., Wessely, S., & Fear, N. T. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44(16), 3361–3363. https://doi.org/10.1017/S0033291714001299

Land Niedersachsen. (2025). Die wichtigsten Notfallkontakte in Niedersachsen [The most important emergency contacts in Lower Saxony]. Portal Niedersachsen. https://www.niedersachsen.de/notfallmonitor/kontakte/die-wichtigsten-notfallkontakte-in-niedersachsen-236449.html

Sonneck, G., Kapusta, N., Tomandl, G., & Voracek, M. (Eds.). (2016). Krisenintervention und Suizidverhütung [Crisis intervention and suicide prevention] (3rd updated ed.). facultas.

Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256–264. https://doi.org/10.1016/j.cbpra.2011.01.001

Statistisches Bundesamt (Destatis). (2025). Zahl der Todesfälle aufgrund von Suizid 2024 leicht gestiegen [Number of deaths due to suicide rose slightly in 2024]. https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Todesursachen/suizid.html

TelefonSeelsorge Deutschland. (n.d.). TelefonSeelsorge – Sorgen kann man teilen [TelefonSeelsorge – worries can be shared]. https://www.telefonseelsorge.de/