Thrive Beyond Trauma Counseling
37923 W 12 Mile Rd, Suite C · Farmington Hills, MI 48331
Phone: 248.392.3733 · Call, Text & WhatsApp: 248.378.4133 · Fax: 1-888-313-4538
Interactive Safety Contract
Fillable on this device · autosaves as you go
Safety Contract
For the person in recovery for sexual addiction (SA) — couple work and disclosure context
This contract is a shared commitment to safety during SA recovery and disclosure work. It is a clinical tool — it does not replace emergency care. Recovery, and especially the disclosure arc, surfaces intense material — shame, urges to act out, urges to use, urges to run, urges to disappear. The purpose of this document is to name those risks honestly and to lay out what you will do before you act on any of them.
This is a clinical tool. It does not replace emergency care. If you are in immediate danger of harming yourself, your partner, or anyone else, call 911 or call or text 988.
Client Information
What I Am Naming
I acknowledge that in the course of my recovery and during disclosure work, I may experience one or more of the following. I am naming them here so they are not hidden or minimized:
| # | Risk I am naming |
|---|---|
| 1 | Suicidal thoughts, or urges to end my life |
| 2 | Urges to harm myself — self-injury, self-punishment, or other forms of destructive self-soothing |
| 3 | Urges to act out — to use pornography, masturbate compulsively, fantasize to dissociate, contact an affair partner, seek new acting-out, or use media for escape |
| 4 | Urges to use substances (alcohol, drugs, food, work, screens) to numb, escape, or anesthetize |
| 5 | Urges to run — to physically leave, disappear, stop communicating, or go off-grid |
| 6 | Shame collapse — being unable to function, hiding from my partner and my support system, isolating |
| 7 | Urges to harm my partner — verbally, emotionally, physically, or through property damage |
| 8 | Dissociation — feeling unreal, cut off from my body, or zoning out for long stretches |
My Commitments
In the container of this recovery work and my relationship with my partner, I commit to the following. I will initial each commitment to make each one intentional.
| # | Commitment | Initial |
|---|---|---|
| 1 | I will not attempt suicide. I will not harm myself in any form. | |
| 2 | I will not act out in any form without first reaching out to a support contact listed below. | |
| 3 | I will not conceal a slip, relapse, or acting-out urge from my partner beyond the disclosure window we agreed to in our weekly check-in contract. Concealment is a betrayal. Delay is a betrayal. | |
| 4 | I will not disappear. If I need space, I will name it: "I need space. I will be back at [time]." | |
| 5 | I will not use my partner as my primary emotional container during crisis. My partner is not my therapist, not my sponsor, and not responsible for holding my shame. I will contact my sponsor, my individual therapist, or my group first. | |
| 6 | If I am unable to keep this contract on any given day, I will call my therapist, my sponsor, 911, or 988 — in that order, escalating as the acuity demands — rather than act on the urge. |
My Support Contacts
My recovery is held by a team. I will list the people and resources I can turn to:
If I Cannot Reach My Supports
Emergency resources are always available, regardless of this contract.
- 911 — if I or anyone else is in immediate danger.
- 988 Suicide & Crisis Lifeline — call or text 988 (available 24/7).
- Crisis Text Line — text HOME to 741741.
- Emergency Room — nearest emergency room or urgent care.
Joint Commitment to My Partner
Signatures
A copy of this signed contract is kept by the client, by the therapist, and (with the client's consent) may be shared with the partner for mutual transparency.