When the physically handicapped patient continuously fails to achieve his goal, a growing state of stress and disorganization reflected in ineffective and inappropriate behavior results. Therapeutic conditions favorably influence behavior by affecting the immediate goals to which the patient attends so that they are more attainable and linked to the desired goal. Under such conditions the performance of an effective action (i.e., one that achieves its goal) reduces stress and restores the organization necessary for appropriate behavior and constructive learning. Thus the nature of the therapeutic conditions may determine the current balance between appropriate and inappropriate behavior and enable constructive learning to take place in the presence of severe stress.Abstract Teaser