WISe crisis planning helps families prepare for behavioral health crises before they happen. Every family enrolled in Wraparound with Intensive Services (WISe) receives a crisis plan outlining warning signs, helpful strategies, and available support. When a young person experiences self-harm or suicidal ideation, a separate safety plan may also be developed to address those specific concerns.
A behavioral health crisis rarely arrives at a convenient time.
It may happen late at night, during a school day, after an argument, or when everyone in the family is already tired and overwhelmed. In those moments, it can be difficult to remember phone numbers, explain what usually helps, or decide who should be contacted first.
That is one reason crisis planning is an important part of Wraparound with Intensive Services, commonly called WISe.
Washington’s Health Care Authority describes WISe as an intensive, team-based behavioral health service that includes 24/7 crisis support from people who are familiar with the family’s situation.[1] Every family enrolled in WISe receives a crisis plan developed with the young person and family. When a young person experiences self-harm or suicidal ideation, the team also develops a separate safety plan as needed.
A crisis plan cannot prevent every hard day. But preparing important information, supports, and strategies ahead of time can give families and their WISe team a clearer starting point when things become difficult.
What Is a WISe Crisis Plan? How Is It Different From a Safety Plan?
Washington’s WISe manual uses the combined term “Crisis/Safety Plan/Support Plan” for a family-friendly planning document, generally one to two pages, developed with the youth and family.[2] For clarity, this article distinguishes between the two purposes: every WISe family receives a crisis plan, while a separate safety plan is created as needed when self-harm or suicidal ideation requires specific steps to protect the young person.
The crisis plan’s purpose is practical: identify potential behavioral health crises and help everyone involved know how to respond. A safety plan, when needed, focuses specifically on reducing risk and maintaining safety when self-harm or suicidal thoughts are present.
The plan is meant to include information such as 24/7 response options, formal and natural supports, back-up care, what tends to lead to a crisis, strategies that have worked before, and the young person’s and family’s strengths.[2]
This is different from trying to predict exactly what will happen.
Instead, the family and team are preparing for situations that are reasonably possible based on what they already know about the young person.
Start by Defining What a Crisis Means for Your Family
Not every family experiences a behavioral health crisis in the same way.
Washington’s WISe Crisis and Safety Plan form specifically asks for the youth and family’s definition of a crisis.[3]
That matters because a crisis is not simply a clinical term on a form.
For one young person, a crisis may involve leaving home unexpectedly. For another, it may involve escalating aggression, threats of self-harm, severe emotional dysregulation, or becoming unable to participate safely in everyday routines.
Families can begin by asking:
What does a hard day look like before it becomes a crisis?
What tells us that things are moving beyond what we can manage with our usual strategies?
Being specific can help the team build a plan that reflects the young person rather than relying on a generic response.
Identify Warning Signs Before the Situation Escalates
A crisis may feel sudden, but families often recognize patterns once they have time to think about previous experiences. WISe crisis planning helps families identify these early warning signs so they can respond before a situation escalates.
The Washington WISe planning form asks families and teams to identify warning signs and triggers across home, school, and community settings.[3]
You might think about changes such as:
- Becoming unusually quiet or withdrawing from others
- Escalating arguments or irritability
- Difficulty sleeping
- Refusing school or other normal activities
- Pacing, yelling, or becoming increasingly restless
- Talking about feeling hopeless or unsafe
- Leaving a supervised area
- Changes in behavior that your family recognizes as an early sign of distress
The warning signs that matter most are the ones that are meaningful for your child.
The goal is not to create a long list of every behavior that could possibly occur. It is to identify the signs that tell your family and team, “We may need to respond differently now.”
Think About Triggers and Anticipated Stressors
The state WISe form also asks teams to consider anticipated crises and potential events that could lead to one, including situations at home, school, and in the community.[3]
Some stressors can be anticipated.
A change in school placement, conflict with a peer, a family transition, a difficult anniversary, a court date, a change in visitation, or another major disruption may increase stress for a young person.
Knowing that a stressful event is coming does not mean a crisis will happen.
It does mean the team can talk ahead of time about additional support, schedule changes, coping strategies, or people who may need to be available.
Preparation can be especially useful when a family already knows that certain situations have been difficult in the past.
Write Down What Actually Helps
When a young person is escalating, well-intended adults may try many things at once.
Sometimes that makes the situation harder.
A useful crisis plan identifies strategies that have worked before. Washington’s WISe manual specifically includes successful past strategies as information that should be part of the plan.[2]
Think beyond formal treatment techniques.
What helps your child feel safer or regain control?
It might be:
- Having fewer people talking at once
- Moving to a quieter space
- Calling a trusted family member
- Taking a walk with a safe adult
- Using music, movement, sensory tools, or another familiar coping strategy
- Having clear choices instead of open-ended questions
- Giving the young person appropriate time and space
- Connecting with a WISe team member who already knows the family
Also consider what tends not to help.
If repeated questioning, raised voices, physical proximity, or too many adults entering the situation typically increases distress, that is useful information for the team to know.
A strong plan is not only about what professionals can do. It captures what the family has already learned about the young person.
Know Who You Can Call
An important part of WISe crisis planning is identifying who families can turn to for support before a crisis occurs. Knowing who to contact ahead of time can help families respond more confidently during difficult situations.
WISe is designed to include both formal supports and natural supports. Washington HCA describes natural supports as trusted people such as family, friends, and community members, while professional team members may include therapists, school staff, and others involved in the young person’s care.[1]
Your crisis plan can clarify who should be contacted, under what circumstances, and who may be available as a back-up.
That may include members of the WISe team as well as trusted people in the young person’s life.
Washington requires WISe providers to have 24/7 crisis services available to WISe participants from people who are familiar with the youth’s safety plan, preferably members of the WISe team.[4]
Families should know how to access that support before they need it. Ask your WISe team which number to call after hours and what to expect when you call.
Keep Important Information Easy to Find
During a crisis, families should not have to search through emails or paperwork for basic information.
The Washington WISe Crisis and Safety Plan form includes medical information such as diagnoses, medications, allergies, primary care information, and psychiatric provider information.[3]
Depending on your child’s situation, it may be helpful to keep an updated copy of the plan somewhere accessible.
Make sure the information your team needs is current, especially after medication changes, provider changes, or other significant updates.
Families can also ask who should have a copy of the plan and how updates will be shared with relevant team members.
Plan for Home, School, and the Community
WISe crisis planning considers how a young person’s needs may differ across home, school, and community settings. Preparing for these different environments helps families and their support teams respond more effectively when challenges arise.
The state crisis-planning form asks teams to think about warning signs, triggers, and anticipated crises across settings such as home, school, and the community.[3]
That can help families move beyond a plan that only works in the living room.
If a crisis begins at school, who should the school contact?
If your child becomes overwhelmed in the community, what helps?
If a trusted caregiver is unavailable, who is the back-up?
These are useful questions to work through with the Child and Family Team.
The answers may change over time, which is why the plan should be treated as a working document rather than something completed once and forgotten.
Make Sure Your Child’s Strengths Are in the Plan
Crisis planning can easily become focused on risk.
But WISe intentionally includes strengths.
The state WISe manual says the planning document should include strengths alongside triggers, supports, and strategies.[2]
That might include your child’s ability to ask for a particular person, willingness to use a coping skill when prompted, connection with a sibling, sense of humor, interest in music or sports, relationship with a teacher, or ability to recognize when they need space.
Strengths are not included to minimize the seriousness of a crisis.
They help the team remember what can be built on when the young person is struggling.
Talk About When the Plan Is Not Enough
A crisis plan should also make it clear when additional help is needed.
Washington HCA provides 24-hour crisis resources statewide. For a suicide or behavioral health crisis, people can call or text 988. HCA advises calling 911 for a life-threatening emergency.[5]
Families enrolled in WISe should also follow the crisis instructions provided by their WISe team.
Talk about these thresholds before a hard day.
Ask the team what situations should prompt a call to WISe crisis support, when other crisis resources may be appropriate, and what the family should do if there is an immediate safety emergency.
Having that conversation in advance can reduce uncertainty when quick decisions are needed.
Review the Plan After Things Change
WISe crisis planning is an ongoing process that should reflect the young person’s current needs. As circumstances change, families and their WISe teams should revisit the crisis plan to ensure it remains useful and relevant.
If a strategy stops working, update it.
If a new school staff member becomes an important support, add that information.
If medication changes, contact information changes, or the family learns something new after a difficult event, bring it back to the team.
A hard day can reveal useful information.
What helped the situation settle? What made it worse? Who was available? Was there confusion about whom to call? Did the plan match what the family actually needed?
Those observations can help the Child and Family Team make the plan more useful for the future.
Prepare Before You Need the Plan
Families do not need to wait for a crisis to start thinking through these questions.
Before the next difficult day, consider whether you can answer:
- What does a crisis look like for my child?
- What are the early warning signs?
- What situations commonly increase stress?
- What helps my child regulate or feel safer?
- What tends to make escalation worse?
- Who are our natural and professional supports?
- Who can provide back-up care or support?
- How do we reach our WISe crisis support after hours?
- Where is our current WISe crisis plan, and do we also need a separate safety plan for self-harm or suicidal ideation?
- When should we use additional emergency or crisis resources?
You do not have to create those answers alone.
Crisis planning in WISe is meant to be collaborative. The youth, family, and team build the plan together using what they know about the young person’s needs, strengths, supports, and previous experiences.
Terapia Three Rivers provides WISe and other behavioral health services for children, youth, and families in Washington.
If your child is receiving WISe, talk with your Three Rivers Therapy team about reviewing your crisis plan before the next hard day. If self-harm or suicidal ideation is a concern, ask whether a separate safety plan is needed. Make sure you know who to contact, what strategies are included, and how your family’s plan should be used when additional support is needed.
Fuentes
- Washington State Health Care Authority. Wraparound with Intensive Services (WISe).
- Washington State Health Care Authority. WISe Service Delivery, Policy, Procedure, and Resource Manual. Updated April 2025.
- Washington State Health Care Authority. WISe Crisis and Safety Plan Form (82-0447).
- Washington State Health Care Authority. Behavioral Rehabilitation Services and WISe: Providing Services Concurrently.
- Washington State Health Care Authority. Mental Health Crisis Lines.
