After having defined and located milieutherapy, four main modalities of goalsetting in institutions are described: psychotherapeutic, (re-)validating, training and nursing. Each of these modalities has its own consequences as far as concerns attitude, building and psychical setting, furniture and decorating, and organizational structure. These are elaborated, as hare the fitting role and task of the psychiatrist, who is as well a coordinator as one of the coordinated. The demands which the psychiatrist has to meet, concerning personality features and training are discussed, as well as the question whether it always has to be the psychiatrist who should be in the coordinating position in the team. Finally, after a recapitulation of the requirements for a good milieutherapeutic setting, a review follows of the forgeries that are produced so frequently in this area.