Decisions regarding the development of innovative inpatient programs a
re difficult ones. Program developers and administrators are well-advi
sed to consider a variety of issues including clinical indications, tr
eatment efficacy, service delivery, staff training, allocation of staf
f resources, and quality assurance research. Cognitive therapy with in
patients represents an exciting clinical opportunity. Accordingly, thi
s article discusses clinical and administrative concerns that program
developers interested in cognitive therapy in an inpatient setting sho
uld consider. The paper presents a brief review of the literature on c
ognitive therapy with inpatients and proffers clinical examples from t
he experiences of the Mesa Vista Hospital Cognitive Therapy Program; A
dministrative issues are also similarly discussed on the basis of both
the extant literature and clinical experience.