Young people under 18 years of age are responsible for a significant proportion of officially recorded sexual offences worldwide, including in Australia. In this article we examine the wider problem of youth sexual violence and abuse, and propose solutions for the Australian context. We describe an ecological, field-based clinical forensic practice model developed in Queensland, and show how engagement with youth sexual offenders within their natural social ecologies has led to the discovery of specific endemic problems that would normally remain hidden or beyond the reach of conventional clinical services. Drawing on public health and crime prevention concepts and methods, we present a comprehensive framework for organising prevention strategies and describe how this framework has guided our approach to developing place-based prevention strategies at two sites. We conclude by outlining the changes we see as necessary for forensic psychology practitioners to engage in a wider crime prevention agenda.