This is the third volume in the Success Series on important topical areas working with challenging young people. The focus here is on individuals who engage in self-harm, either suicidal acts or non-suicidal self-injury. Self-harm can have several different intentions. Because of this it is very difficult and complex and requires helpers to enter the world of the young person to fully comprehend the motivations involved. Due to the way these young people think and act, they can be very problematic to understand and therefore to communicate with and to help. This topic is difficult to talk about or even to think about, but we must face self-harm directly if we are to rescue children who are caught in habitual patterns of self-injury. The place we must begin this journey is to understand that experiences in early childhood years often produce the problem of self abuse and self-harm, and these individuals deserve our support and compassion to change this negative pattern. However, understanding is only the beginning. How and when to intervene can make all the difference, perhaps even between life and death.