This paper explores the way psychodynamic factors can be used to extend and improve the quality of the assessment of adolescents at risk of self-harm. Conventional risk factors are clearly of value to identify those young people who require admission or other interventions. However, a consideration of the internal and external factors and their interaction, as manifest in the transference and in a consideration of the history and present circumstances, allows shape and depth to be added to the assessment. In this way an assessment can be a therapeutic intervention in its own right, and can play a part in reducing the risk. This approach is described and illustrated with clinical examples.