Emergency Kit (Crisis Intervention at Home)

An emergency kit is a prepared collection of contacts, strategies, and agreements for the moment when a child or adolescent experiences an acute emotional crisis. This refers to extreme situations such as self-harm, suicidal thoughts, or a severe escalation in which no one can think clearly anymore.

The core of the idea: Decisions are made in advance, during a calm period. When the crisis hits, no one has to wonder who to call or what will help. Everything is right at hand.

The term comes from Dialectical Behavior Therapy (DBT), where adolescents pack a small box with items that help them cope with stress. For families at home, this usually takes the form of a combination of an actual box and a written emergency plan, which might be posted on the refrigerator door or saved on a cell phone, for example.

Crises rarely come out of nowhere. There are usually early warning signs that can be identified. A step-by-step plan assesses the child’s state and outlines specific steps for each stage. Many families use a tension scale from 0 to 10 for this purpose.

• Yellow (mild stress): The child becomes restless, withdraws, and reacts irritably. At this stage, your own coping skills and a calm offer of closeness can help.
• Orange (high stress): The pressure increases noticeably; the first signs of self-harm or severe despair appear. This is when more intensive support strategies and the agreed-upon points of contact come into play.
• Red (acute danger): Specific suicidal thoughts with a plan, self-harm that has already begun and poses a risk of injury, or a complete loss of control. At this point, professional help is essential; if in doubt, call emergency services.

It’s best to work with your child to write down which signs they exhibit and which level they correspond to. A family crisis plan like this only works if everyone involved is familiar with it.

The content can be organized into four sections:

• Contacts: a list of names and numbers. People the child trusts, the treating doctor’s office or clinic, the on-call medical service, crisis hotlines, and emergency numbers. The exact numbers are listed below.
• Skills and Calming Strategies: specific actions that have a noticeable effect and reduce tension.
• Agreements: what the child can do on their own, when they should reach out, and what you as parents will handle.
• Reminders: Photos, a letter to themselves, reasons to keep going, a favorite song.

For many children, a physical box with tangible items works better than just a piece of paper. It’s important that the child help design the box themselves. What helps one child may not work for yours.

Skills are brief, physical actions that provide a strong stimulus and thus interrupt internal tension. They temporarily help overcome the urge to self-harm. Several categories have proven effective in clinical practice:

• Cold stimuli: a cold pack on the back of the neck, a cold shower, an ice cube in the hand.
• Strong sensory stimuli: biting into a chili pepper or lemon, smelling ammonia or rubbing alcohol, squeezing a spiky ball.
• Movement: climbing stairs, doing push-ups, listening to loud music and dancing.
• Redirecting thoughts: counting backward in threes, naming all the blue objects in the room.

Within the family, calming down together is also important. Your calm voice and your own composure rub off on the child. This principle is called co-regulation and is especially important when the child is not yet able to regulate their emotions on their own.

Two agreements form the basis of the plan. The first is a simple signal the child uses to let others know that they’re not safe at the moment—a word, an emoji, or a color. That way, they don’t have to find the right words in a crisis.

The second concerns dangerous objects. Experts recommend restricting access to medications, razor blades, knives, and other potential hazards during an acute phase. This means locking away pills and removing sharp objects from the room. This measure may sound harsh, but it saves lives because many crises come in waves and subside again within minutes.

Address both of these issues openly. A child who realizes that you take their distress seriously and remain calm is more likely to open up than if they expect punishment or panic.

In the event of an acute life-threatening situation—such as after a suicide attempt or a serious injury—call 112 without hesitation. The emergency dispatch center will send help and can arrange for admission to a child and adolescent psychiatric facility.

If the situation is serious but not immediately life-threatening, you can reach the on-call medical service 24 hours a day at 116 117. For conversations at night or on weekends, there are free, anonymous numbers:

• TelefonSeelsorge: 0800 111 0 111 or 0800 111 0 222, also via 116 123. Day and night, free of charge.
• Nummer gegen Kummer, Children’s and Youth Helpline: 116 111, Monday through Saturday from 2:00 p.m. to 8:00 p.m. For your child to call directly.
• Nummer gegen Kummer, Parent Helpline: 0800 111 0 550, Mondays, Wednesdays, and Fridays from 9 a.m. to 5 p.m., Tuesdays and Thursdays from 9 a.m. to 7 p.m.

The article “Crisis Hotline: Where Do I Call and When?” explains in detail which number is appropriate for which situation.

An emergency kit helps get you through acute moments but is no substitute for treatment. Only a child and adolescent psychiatrist (KJP) or a medical or psychotherapeutic specialist can determine whether an underlying condition is causing the crisis and what kind of therapy will help. Rückenwind Eltern provides coaching and support along this journey but does not make diagnoses.