Billy was taken into Local Authority care when he was 10 years old, due to his mother's inability to care for him. While in care he was sexually abused by a male worker and suffered bullying at the hands of other children. His behavior subsequently deteriorated, and he became difficult to manage. He frequently tried to run away from the home and was prone to intense aggressive outbursts. During these outbursts he would damage property and, occasionally, also be violent towards other children and staff alike. At this time, he also started to self-harm, by cutting his forearms and torso and punching and head-butting walls. At age 12, he made a suicide attempt by trying to hang himself from the light fitting in his room. He was consistently truanting from school and eventually left care with no formal qualifications. He was then homeless for a time and supported himself by working as a rent boy and selling drugs. He was also a heavy user of alcohol, heroin and crack cocaine. While in the community, he had never managed to hold down regular employment and had several intense but short-lived relationships with women. These relationships were volatile and characterized by frequent