Though only engaged in by a minority of sufferers, self-harm and violence can nevertheless occur within the context of a variety of mental illnesses, from personality disorder to affective disorders, to schizophrenia and other psychoses. Violence to the self (both with and without suicidal intent) and others are not uncommon occurrences on psychiatric wards. This paper explores the utilisation of a new mindfulness centred therapeutic protocol based on acceptance and commitment therapy for the management of self-harm and violence. The protocol was piloted on three patients with a history of high levels of violence to self or others on a psychiatric intensive care unit in London. An outline of acceptance and commitment therapy is provided, together with a detailed description of the protocol for the intervention itself, and some of the outcomes achieved. Recommendations for further adaptations, studies and clinical trials are considered.