Hope Box / Reasons for Living
A worksheet for building a personal hope box, physical or digital, of reminders of reasons for living, sources of comfort, and evidence of past survival, to be used when suicidal thoughts or hopelessness narrow the view.
About this resource
Hopelessness, the belief that things will not improve, is one of the strongest predictors of suicidal behaviour, stronger in many studies than depression severity itself. When hopelessness rises, attention narrows and memories of good times, connection and competence become hard to access. A hope box counters this by making those memories physical. It is a container, or a folder on a phone, filled with items the person has chosen in a calmer state: photographs, letters, small objects, song lists, reminders of things they want to do, and records of times they got through something hard.
The idea has roots in cognitive therapy for suicide prevention as described by Wenzel, Brown and Beck, where a hope kit is used to store evidence of reasons for living and to counter the memory bias that accompanies hopelessness. It also draws on Linehan's reasons for living work and the observation that people who can generate more reasons for living are at lower risk. Building the box is itself therapeutic: the search for items is an act of engaging with life, and the conversation about each item deepens the therapeutic relationship and the risk formulation.
This worksheet guides the person through identifying what will go in the box, why each item matters, and when and how the box will be used. It complements a safety plan and a crisis coping card rather than replacing either. The professional version adds a session guide for introducing the hope box without it feeling trite, suggestions for clients who say they have no reasons, guidance on digital versions, and notes for adolescents and families.
How to use it
- Introduce the hope box after a safety plan is in place, when the person is not in acute crisis but hopelessness or suicidal thinking are part of the picture. Explain the memory-narrowing idea so the box has a rationale.
- Work through the worksheet in session. For each category, ask for specifics and for the story behind each item. Record the story; the item alone may not carry its meaning in a crisis.
- Ask the client to assemble the box between sessions. A shoebox, a tin, a small bag, or a phone album all work. Some clients bring it to the next session; some prefer to describe it.
- For clients who struggle to generate items, start with the smallest things: a pet, a taste, a song, a place. Past survival is often the most powerful category; ask about the hardest time they have already got through.
- Add the hope box to the safety plan as a step under things the person can do on their own. Agree where it will be kept.
- Revisit the box periodically and add to it. It should grow as therapy progresses.
References
- Wenzel, A., Brown, G. K., & Beck, A. T. (2009). Cognitive Therapy for Suicidal Patients: Scientific and Clinical Applications. American Psychological Association.
- Linehan, M. M., Goodstein, J. L., Nielsen, S. L., & Chiles, J. A. (1983). Reasons for staying alive when you are thinking of killing yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51(2), 276-286.
- Beck, A. T., Steer, R. A., Kovacs, M., & Garrison, B. (1985). Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry, 142(5), 559-563.
- Bush, N. E., Dobscha, S. K., Crumpton, R., Denneson, L. M., Hoffman, J. E., Crain, A., Cromer, R., & Kinn, J. T. (2015). A Virtual Hope Box smartphone app as an accessory to therapy: Proof-of-concept in a clinical sample of veterans. Suicide and Life-Threatening Behavior, 45(1), 1-9.
