This article describes a secure residential treatment program for severely acting out adolescents. It identifies 29 adolescents out of 150 discharged from treatment over the past 4 years, on the basis of their multiply acting out pattern. The study found that these adolescents suffered far more parental separations in their first year of life than had other adolescents in the same program. Moreover, they had a zero rate of success after discharge from treatment, compared to a 60 percent successful rate for the treatment program as a whole. Prognosis for these youths is poor, and it is suggested that by early diagnosis, it may be possible to devise new and innovative treatment for this group. Thirty eight references are appended. (Author abstract modified)