Therapists must assess patients' situations realistically, looking out for constructive possibilities that may give them cause for hope. Encouragement is valid only if therapists are genuinely aware of and can face the patients' dire situations. Advice should be realistic and if possible specific and flexible. For example, disturbed patients who function poorly may be great strains on their environment. Yet efforts by wellmeaning persons to lessen the pressure on them may result in their never being able to adjust to ordinary life. The therapeutic task is to stand by and help patients to cope with the situation, or allow them a short period of rest, and then try to guide and pressure them back into their normal situation; otherwise, the temporary emergency may lead to permanent inadequacy. Inadequacy at work and in ordinary life characterize these disturbed offenders. Helping them gain a slightly higher vocational, educational, and social level is a high priority for building self-esteem. Personal relations of these offenders are also often poorly developed. They may have a consistent history of lost battles and a justified fear of future failure. They are paralyzed by their fear of failing again, drifting into inertia and indolence and making only inept efforts at assertion. Therapists must try to break the vicious circle between low self-esteem, poor performance, and failure. They must be able to gauge patients' performances and enable them to get along with people in an acceptable manner, pushing only as much as they can tolerate. Four case studies are included.