THE PATUXENT INSTITUTION DEALS WITH CONVICTED DANGEROUS FELONS WHO ARE REMANDED TO THE INSTITUTION ON AN INDETERMINATE CIVIL SENTENCE, WITH APPROPRIATE LEGAL SAFEGUARDS. FROM HIS EXTENSIVE EXPERIENCE AT PATUXENT, THE AUTHOR FOCUSES ON THE COURSE OF GROUP THERAPY WITH AN ALLEGEDLY INTRACTIBLE, NONMOTIVATED, SOCIOPATHIC OFFENDERS' GROUP CONFINED UNDER THE SPECIAL CONDITIONS IMPOSED BY THE INSTITUTION. OPEN-ENDED, RANDOMLY SELECTED GROUPS OF PATIENTS ARE FORMED; 10 PATIENTS ARE CONSIDERED THE OPTIMAL NUMBER (ALTHOUGH THE GROUP WILL REDUCE IN NUMBER BY ATTRITION), WHILE A GROUP BELOW 5 MEMBERS CEASES TO FUNCTION AS A GROUP, TAKING ON THE CHARACTERISTICS OF INDIVIDUAL THERAPY IN A GROUP SETTING. THE AUTHOR HAS FOUND THE SOLE CONTRAINDICATION TO BE HAVING A SINGLE SEX OFFENDER IN A GROUP COMPOSED OF NON-SEX OFFENDERS, AS THE LONE SEX OFFENDER IS TOO INADEQUATE AND IMMATURE TO PERMIT EXPLORATION OF HIS UNDERLYING PROBLEMS BY OTHERS. THE INITIAL GROUP MEETING IS ONE AT WHICH LIMITS, RULES, AND REGULATIONS ARE SET; EXPLANATIONS FOR EACH RULE ARE GIVEN. DIFFICULTIES FOR THE THERAPIST IN THE INITIAL PHASE INCLUDE AVOIDING HOSTILE RESPONSES TO THE PATIENTS' REACTIONS, RESISTING CONFRONTATIONS AND INTERPRETATIONS, AND TAKING CARE NOT TO FRIGHTEN THE PATIENT OR ACT IN AN INSENSITIVE MANNER. THE SECOND PHASE OF THE PROCESS BEGINS WHEN GROUP MEMBERS START TO CHALLENGE OR SUPPORT EACH OTHER AND BRING UP LIFE EXPERIENCES IN THERAPY. AT THIS POINT, THE THERAPIST URGES THE PATIENTS TO CONCENTRATE ON THE FEELINGS THEY ARE EXPERIENCING 'HERE AND NOW.' IN THE THIRD PHASE, THE PATIENT MOVES FROM A 'PLATEAU,' WHICH HE HAS ATTAINED BECAUSE OF THE MINIMAL INSIGHTS GAINED IN THE SECOND PHASE THAT LEAD HIM TO FEEL CURED, TO TRUE INSIGHTS WHICH ARE REGARDED AS MAJOR BREAKTHROUGHS. AN ATMOSPHERE OF COHESIVENESS WITHIN THE GROUP DEVELOPS, AND THE GROUP AND THERAPIST ARE PERCEIVED AS WORKING TOWARD A COMMON GOAL. THE THERAPIST MUST NOT ALLOW HIMSELF TO BE CARRIED AWAY BY THIS WELCOME TRUST AND DEPENDENCY WHICH HAVE REPLACED THE PATIENTS' INITIAL HOSTILITY AND AGGRESSION. THE FINAL STAGE IN GROUP PSYCHOTHERAPY OCCURS WHEN THE PATIENT RECOGNIZES HIS IDENTIFICATION WITH THE THERAPIST; SUPPORT FROM PEERS AND THE THERAPIST IS ACCEPTED, BUT IS NOT VITAL FOR HIS FUNCTION. THIS PHASE IS COMPLETED WHEN THE PATIENT IS CONDITIONALLY RELEASED BY THE PATUXENT INSTITUTION BOARD OF REVIEW; CONDITIONAL RELEASE IS ALSO INDETERMINATE, AND TREATMENT FOR THE PATIENT CONTINUES IN THE OUTPATIENT CLINIC. THE AUTHOR CAUTIONS THAT THERAPY FOR THE OFFENDER DOES NOT FOLLOW A LINEAR PROGRESSION TOWARD EMOTIONAL STABILITY; THERAPY IS COMPOSED OF FALSE STARTS, PLATEAUS, AND STEPS BACKWARD, AND THE MOVEMENT TOWARD PERCEIVING THE SELF AND THE ENVIRONMENT IN A LESS CONFUSED MANNER IS A GRADUAL ONE. FUTURE DIRECTION FOR THE TREATMENT OF THE DANGEROUS OFFENDER IS SEEN AS THAT OF A UNIFIED WHOLE; REINTEGRATION OF THE OFFENDER INTO THE COMMUNITY RATHER THAN ISOLATION WILL BE THE GOAL OF SMALLER REHABILITATION-ORIENTED INSTITUTIONS. (DAS)