In hospital, I had to keep contracting to be safe....
My T had me make a safety contract with her too about various self-destructive behaviors I might be tempted to engage in, to not do them, and to be honest with her if I did. Therapy wasn't contingent on that......but I suppose if I had kept on doing things, she would have found that therapy wasn't helping me and that it would be unethical to continue treating me if I showed no improvement......