[Psychiatric rehabilitation in a secure treatment setting]

Working with severely mentally ill persons within the locked environment of a secure residential treatment facility presents a provocative challenge in attempting to establish a rehabilitative program. The author describes the mission, goals and methods of one of Oregon's newly organized facilities for "hard to place" former state hospital patients. The value of teaching the residents self-control is emphasized. Clinical vignettes illustrate how the staff involve the residents in real-life tasks, apply natural consequences to problem behaviors, and make attempts at minimizing the potential sources of confrontation.