The paper suggests that severely disturbed adolescents need the benefits of psychoanalysis if they are to overcome their self-destructive, unconscious defensive attitudes. However, the normal psychological drives of adolescence run counter to analytic intervention. Additionally, the psychic experiences of childhood and babyhood trauma are renewed in adolescence like the rumblings of a dormant volcano, which makes resistance to insight still more desperate. However, it is possible to devise a residential treatment experience that is similar in quality and effect to that of a full psycho-analysis. The paper considers three of the most important ingredients of this — the Culture, the Residents and the Leadership.