The overall goal of the MS is to teach the resident a sense of responsibility for his own behavior and its consequences. The three programs are designed to provide increased levels of freedom contingent on the resident's display of self-management in five developmental areas. The initial program for all new residents is a highly structured, contingency-management point economy, which provides a maximum amount of instruction and feedback, naturally available reinforcers in the home environment, and a realistic opportunity to succeed. As the resident develops the necessary behavior repertoire and assumes an attitude of responsibility, the structured elements of the programs are reduced and replaced by a more natural set of feedback conditions. The MS design is such that failure at one program level can be remedied by returning the resident briefly to the preceding more structured program. Ideally, a resident can progress through the MS in 6 months; however, this would require an unusual degree of integrity. The expected length of time is projected to be 6-12 months. When a resident progresses through the third program and shows success for 1 month, plans are made for discharge on a trial visit. After discharge at the end of the trial visit, contact is made twice a week by telephone, with home visits made every 2 weeks for 2 months.