“…A high turnover of patients is also a feature, and indeed necessary, to maintain their function. The main issues related to the risk of self-harm in a PICU are as follows (after Pereira & Lipsedge (2001) show persistent challenging behaviour may find that, over time, their ability to maintain a therapeutic relationship is impaired. This may lead to distancing or avoidance of the patient, a form of negative countertransference (Watts & Morgan, 1994).…”