somewhat different problems of young adult persons with severe psychiatric disability, many of whom have spent only brief episodes in mental hospitals. Such individuals demonstrate severe handicaps in social adaptation and often resist engagement in professional services; moreover, their deficits, while less extensive than those of the older institutionalized patient, are marked by instability, intercurrent crises, and sensitivity to stress. Thus, even though CMHC personnel seemed to be intrigued by primary intervention for the not yet ill, and enamored of intensive verbal therapy for the not yet chronic, some of the innovations of the CMHC initiative became very much a part of the psychiatric rehabilitation field. Psychosocial Rehabilitation Centers. The realization that severely and chronically mentally ill persons would rarely experience a full return of psychosocial functioning in the community led to a movement emphasizing accommodation to the needs of these persons in sustaining some semblance of normalization. With mental health professionals' neglect of the chronic mentally ill, nonprofessionals and patients themselves initiated psychosocial selfhelp clubs located in cities where the mentally ill congregated in large numbers. The early clubs, such as Fountain House and Horizon House, were founded by groups of expatients for the purpose of mutual aid and support. These early social clubs gave birth to comprehensive, multiservice psychosocial rehabilitation centers such as Thresholds in Chicago; the Social Rehabilitation Center in Fairfax, Virginia; Center Club in Boston; Fellowship House in Miami; Hill House in Cleveland; and Portals House in Los Angeles. The psychosocial centers assist patients to deal with their "real life" problems by providing opportunities for acceptable role performance and successful mutually interdependent relationships with others, by buffering stressors, and by making available a range of housing and employment options. From the very beginning, these centers have emphasized (1) strategies to help people cope with the environment rather than succumb to it, (2) health induction rather than symptom reduction, and (3) belief in the potential productivity of the most severely psychiatrically disabled client (Beard, Propst, and Malamud 1982). Psychosocial centers have not valued the development of therapeutic insight (Dincin 1981). Their orientation has been on reality factors rather than intrapsychic factors, and on improving the person's ability to do something in a specific environment, even in the presence of residual disability (Grob 1983). Psychosocial centers have played a significant role in the development of the psychiatric rehabilitation field. Their influence in the foreseeable future should be even greater since Fountain House has been conducting a training program to assist CMHCs and other types of mental health settings to establish rehabilitation services based on the psychosocial center model. In a 5-year period, individuals from agencies located in 38 states, the District of Columbia, Sweden, and Canada have been trained. During that time the number of rehabilitation programs has increased from 18 to 148. As the number of psychosocial rehabilitation centers continues to grow, this serves to ensure the presence of settings in which future research can be conducted and new rehabilitation techniques tested. Skills Training. The most recent development in shaping psychiatric rehabilitation has been the introduction of skills training methods derived from social learning principles, human resource development training, and vocational rehabilitation. Effective coping with life stressors requires skills to promote problem solving, engage others in successful affiliative and instrumental relationships, mobilize supportive networks, and engage in work. Rehabilitation techniques that use active-directive learning principles—behavioral practice and role playing, social and tangible reinforcement, shaping, coaching, and prompting, and generalization activities—strengthen an individual's problem-solving capacities and confer protection against exacerbations of psychiatric symptoms (Cohen, Ridley, and Cohen 1983; Wallace and Liberman 1985).