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A follow‐up study of 141 young people in 48 children's homes examined changes in their moods, relationships with their family and adjustment. The average scores of the group on these variables changed little between first interview and follow‐up 6–9 months later. However, some individuals improved and others deteriorated. Improvements in family relationships were more likely in homes where the head of home could describe strategies for fostering family ties. Improvements in adjustment were also more likely in homes where the head of home could articulate ways of enabling change in key areas of the residents' lives. Residents who spoke of attempts to bully them were more distressed at the time of the first interview and less adjusted at follow‐up. The study underlines the damaging effects of bullying and the key role of the head of home.

Background: Deinstitutionalisation has stressed where care is no longer taking place. Home treatment in rehabilitation reflects the steady increase in emphasis on support and treatment for individuals with long-term disorders where it matters for them - in their own homes. Materials and Discussion: Whether dealing with individuals discharged after long periods in hospital or with the increasing number who have experienced repeated short-term admissions, most modern day rehabilitation takes place in the patients' homes and neighbourhoods. We are increasingly convinced that this decentralisa tion is a positive strength, not a problem. Its advantages include improving social inclusion and the ability to conduct more accurate, personalised assessments of disabilities and strengths. Skills training is more focused and we discuss the components of home treatment and assertive community treatment as they are relevant to rehabilitation. This involves both medication and practical help, broker age and involvement with the voluntary sector. Conclusions: Rehabilitation remains, at its core, a set of relationships between whole individuals (not just skills and needs). A home-based approach is proposed as the norm, not the exception. It is based on a rounded understanding of the patient as a unique person and emphasises the importance of a strong working alliance.

It is the present trend in dealing with youthful offenders that diversion techniques be utilized whenever possible. Staff and administration of existing treatment centres are to be commended for their efforts to reduce the number of youths placed in those institutions for treatment. However, there remains continual pressure from various areas to view these institutions as a desirable placement for any youth having behaviour problems in the community. Every effort should be made to view placement at these institutions as a last, and in most cases, an undesirable alternative treatment. It has been noted by various persons that while institutionalized, a youth learns "new and better techniques for committing additional delinquent acts upon his release (Wittey and Lawrence, 1973 p. 15)." Further rationale for discouraging placement in these institutions have been noted by others in stating that youths are labelled delinquent by being placed in such institutions and that once a youth acquires such a label, there is no effective way to remove it (e.g. Faust, 1973 and Elssuer, 1969).

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