Social and conversational skills training has proven effective with chronic psychiatric populations. Little attention, however, has been directed towards examining the use of this training with individuals who have severe disabilities and have not been released from psychiatric institutions to the community. The present case study examined the utility of this training and constraints in attempting to conduct treatment with two groups of 4 and 3 female psychiatric inpatients who averaged 20 yr. of institutionalization. Significant improvement in orientation and attention, reduction in psychotic talk, and gains on three of five conversational skills were noted. Generalization gains were evident on two of the five specific skills. Observations of group process, examination of indicators of emotional impact, and suggestions for practice are discussed.