This chapter reviews the concerns of safety and risk management in the partial hospitalization program (PHP)/intensive outpatient program (IOP) and elaborates on ways of making the milieu safe. It explains how to gracefully play the game of having to make a protective services report and maintain relationships with the patients and/or their families. The chapter discusses suicidal and aggressive patients and analyzes safety issues pertaining to sex, trauma, religion, politics, and confidentiality. Challenges to safety in the PHP/IOP setting must be considered within the context of the clinician’s intense workpace and the multiple demands he/she faces. The aggressive patient may be verbally threatening or actually physically aggressive. The child and adolescent cohorts overall have a significant presence of aggressive patients. To foster peace of mind, a clinician experiencing angst over potential liability should consider purchasing a personal professional liability insurance policy as a supplement to whatever coverage the employer provides.