Challenges associated with behavioral training approaches for individuals with mental retardation and mental illness in the community are reviewed in this article. Family and nonfamily facilitated training are considered. Professional practice issues are reviewed, and justification for multifactor behavioral assessment is offered. Future research directions are discussed.

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A state of crisis exists in the community-based system that serves individuals with a developmental disability and accompanying behavioral or psychiatric disorders (i.e. a "dual diagnosis"). Staff and parental competence, morale and quality of life issues for consumers who present with the most serious symptomatology are all variables that have contributed to the current state of affairs. The mechanism for paradigm change is one that relies on crisis and systemic pressure to confront and ultimately alter long standing scientific theories. The current essay examines the challenges to change and offers recommendations for better serving those individuals who present with the most daunting behavioral profiles in community residential environments.

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