Two cases are presented from a project to develop psychodynamicinterpersonal (PI) therapy (Hobson's ‘Conversational Model’) with long-term severe schizophrenia treated in a locked setting. We present two cases from a treatment development project including a description of the model and its use in this setting with some (anonymized) details of the therapy. The ward milieu can act as a container for disturbed dynamics during psychotherapy, but the lack of progress prior to the psychotherapy suggests that there is also the potential for the ward to reinforce or even replicate the disturbance in the patient's internal world. These complex interactions are considered in the light of the methodology for future studies.

Preliminary outcome data and a description of the positive changes observed are included, but with a note of caution about the difficulty of interpreting outcome findings from single case studies in a complex treatment setting.