Self-referral is one pathway an offender may choose to treatment by a forensic psychotherapist. Some offenders will voluntarily seek treatment because of the conflict between an urge to commit criminal acts and the desire to have a life free of such urges and their consequences. Many patients, however, are unable or unwilling to seek help on their own. An offender's initial contact with the criminal justice system is through the police. Under the Police and Criminal Evidence Act of 1984, the police have a responsibility to recognize mental illness and have an "appropriate adult" present during interviews with anyone whom they believe to be mentally ill. The alleged offender must also be given access to a solicitor, who may be experienced enough to recommend psychiatric assessment. Other points of possible referral to a forensic psychotherapist are at the initial court appearance, remand into custody, the trial, the disposition, and while serving a sentence. Forensic psychiatric health services may be rendered in special hospitals, medium-secure units, and locked wards and intensive care units. At maximum and medium levels of security, and often on intensive care units, patients are managed by a ward multidisciplinary team with special forensic expertise. The practice of forensic psychotherapy in each of these settings and through multidisciplinary teams is discussed in this paper.