This paper describes an approach to working with ego-impaired children and adolescents. The structure and process of psychotherapy groups within a residential program are discussed. We describe how insight-oriented groups act as a collective superego, thereby encouraging maturation. Functions of the group relating to socialization, milieu issues, peer issues, family relationships, personal issues, selfesteem, empowerment, and special issues are discussed. The focus of the discussion is on the structure and process of the groups. Brief clinical vignettes are utilized to illustrate components of the approach.This paper describes an approach to working with children and adolescents who have impaired ego functioning. We have found that daily participation in group psychotherapy is the cornerstone of a residential treatment program. One way a program can work toward helping such ego-impaired children is by utilizing groups as a collective superego, which in turn facilitates ego development within these youths. This paper describes how an eclectic approach to treating children and adolescents in groups fosters ego development. The focus of this discussion will be on how the structure and process of the group facilitates the client's progress.Our approach helps clients address a variety of issues in the group session, such as transference, socialization into and out of the home, milieu issues, peer issues, family relations, personal issues, self-esteem, empowerment, and special issues. While, for purposes of presentation, these topics are discussed separately, we do not assume them to be mutually exclusive. In fact, within a single group session, different clients can be working on a variety of issues. We offer several brief clinical vignettes to illustrate the issues discussed. We describe the more structured uses of the group first and conclude with a discussion of less structured group tasks. A unique aspect of this approach is that this program treats children and adolescents with ego impairment in the same group sessions. Our approach derives from the ideas developed in both the child and adolescent group psychotherapy literature as well as from our experience.