method of dealing with the impairments and disabilities of psychiatric patients; unfortunately, institutionalization also created its own set of secondary disabilities and handicaps. That society has not yet succeeded in compensating for the guest on 23 November 2021 VOL 12, NO. 4, 1986 549 impairments and disabilities of psychiatric patients is reflected in the extraordinarily high rates of unemployment and homelessness among this population (Anthony, Cohen, and Vitalo 1978; Farr and Koegel 1986). Psychiatric Rehabilitation The conceptual framework elucidated above, joined with the rehabilitation view of disability, provides a coherent set of strategies for rehabilitation interventions with the psychiatrically disabled. The clinical practice of psychiatric rehabilitation, just like its counterpart in physical rehabilitation, comprises two intervention strategies: (1) patient skill development and (2) environmental resource development. In developing these intervention techniques, psychiatric rehabilitation practice is guided by the basic philosophy of rehabilitation; that is, disabled persons need skills and environmental supports to fulfill the role demands of various living, learning, and working environments. The assumption of clinical rehabilitation is that if psychiatrically disabled persons' skills and/ or the supports in their immediate environment are augmented, they will be more able to perform those activities necessary to function in specific roles of their choice. In other words, interventions designed to lessen or compensate for the disability are assumed to lead to a decrease in the handicap. Interventions begin with a comprehensive medical-psychiatric diagnosis and a functional and resource assessment. This enables mental health and rehabilitation professionals to describe individuals by diagnostic disorder, level of behavioral functioning, and amount of environmental supports, key to identifying their impairments and disabilities. Identification of impairments and disabilities permits the mental health and rehabilitation practitioner to prioritize problems, formulate specific goals, and organize and implement treatment and rehabilitation plans. Medicalpsychiatric diagnosis and a functional and resource assessment are necessary to match patients to drug and psychosocial treatments and rehabilitation programs that will be effective (Taylor, Liberman, and Agras 1982). Furthermore, knowing the patient's diagnosis aids the clinician in providing the patient and family members with a reasonable prognosis and in determining the degree to which environmental support vs. remedial skills training can be provided to overcome handicaps. Reduction of Impairments. Rehabilitation interventions with psychiatric patients require reduction or elimination of the symptomatic and cognitive impairments that interfere with social and vocational performance. Interventions for reducing impairments are fortunately available from psychopharmacology. The past 20 years has seen major accomplishments in both treatment and prevention of morbidity from psychopathology through the use of antipsychotic, antidepressant, and anxiolytic drugs. Note that these psychotropic drugs are not panaceas. Even when taken regularly, they are frequently only able to reduce rather than abolish symptoms, and delay rather than prevent relapse. Psychotropic drugs are also associated with unpleasant side effects which at times can interfere with skills-training activities. However, they are usually helpful in reducing impairments to the point where psychosocial strategies can be used effectively to remediate disabilities and handicap. While a patient's symptoms and syndromal diagnosis clearly impair social and vocational performance, as is highlighted by the mixed symptomatic and functional criteria in DSM-11I, the remitting and exacerbating nature of most major mental disorders obscures the relationship between psychopathology at time A and behavioral functioning at time B. The changing character of the symptomatic impairments of psychiatric disorders with the passage of time accounts for the insubstantial correlations often found between