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Within the field of youth care and child protective services, professionals struggle with the number of youths who are being refused for treatment due to the risk of physical aggression. Their complex behaviour problems have often developed from unsafe or neglecting environments, child abuse, or other interpersonal trauma. Still, the fear of unsafety caused by their aggressive behaviour continually stands in the way of treatment of their externalizing symptoms. The current article addresses this paradox by emphasizing the importance of interpreting this behaviour in relation to the underlying causes, such as traumatic experiences and the development of Complex Posttraumatic Stress Disorder. Four elements are discussed in order to break this cycle of rejection and unsafety, namely: (1) co-regulation in the dyadic relationship (2) setting boundaries without rejecting the person, (3) trauma treatment, and (4) professionalisation of youth care professionals. [ABSTRACT FROM AUTHOR]