No-Harm Contracts: A Review of What We Know


Address correspondence to Lisa McConnell Lewis, Indiana University School of Social Work, 410 Van Avenue, Shelbyville, Indiana 46176; E-mail:


Few events in the practice of a mental health clinician can be as devastating as the suicide of a client. Although suicide is a rare occurrence, clinicians face assessment of clients' risk for harming themselves on a regular basis. One well-accepted and widely practiced intervention for suicidal ideation is the use of no-harm contracts (NHC), although opinions about NHCs range from enthusiasm to apathy. The existing research does not support the use of such contracts as a method for preventing suicide, nor for protecting clinicians from malpractice litigation in the event of a client suicide.