The nature of a 'therapeutic climate' which was and is used in psychiatrie hospitals depended specifically on the model used. Since the time of Pinel, this climate functioned mainly on a medical basis. After a few experiments in the 19th century, H. Simon, the great reformer of this therapeutic climate formed, in the 20th century, the 'orthagogic model'. The psychiatrie hospital will benefit by developing to an orthagogic-medical setting, with smalle flexible living communities for the 'psycho-socially handicapped', for whom sheltered living is necessary. The reform should be based on three levels: architectural, organic and therapeutic. On this last level, a reform in a socio-therapeutic direction is necessary. The theory and experiences from the orthopedagogy can be of use here.