The population of children discussed in the monograph are those whose behavioral disturbances, caused by abuse, are so severe that, without improvement, they would probably be permanently isolated from society. The pragmatic and personal obstacles that block adult understanding of these children's emotional pain are examined. Treatment facilities for these children must provide means of controlling staff and patient frustration, must retain their focus on the children's needs, and must look for the unique experiences that shape each child's behavior. The monograph explores the forces that shaped the children's lives before entering treatment including deprivation, separation and loss of caring figures, depression, reality distortion and denial disorganization, physical attack, sexual activity, and destructive or sadistic feelings. The final section of the monograph discusses the treatment program which seeks to change the child's understanding of past experiences and provides a sense of security as a context for the future. Issues that appear in the early phase of treatment, complications and difficulties in treatment, reactions of staff and therapists, and methods for achieving therapy goals are explored. Chapter references.