This study evaluated the Say It Straight™ (SIS) Training Program for its ability to improve straightforward communication, increase self-esteem, increase an individual's overall perception of group and family belonging or cohesiveness within a residential treatment setting and decrease an individual's perceived level of anomie. Effectiveness of SIS training was evaluated with paired sample t-tests (2-tailed) on six objective questionnaires given before and after training. Participation in the study was voluntary. Of the 39 patients in residence, 26 participated in SIS training, (23 attended over 80% of the sessions and 3 attended over 50%). Three were excluded from the study due to developmental or dementia-related diagnoses, 3 chose not to participate, 5 were discharged routinely prior to completion and were not post-tested; and 2 were discharged against medical advice during the training. It is interesting to notice that on the average there are about 5 discharges against medical advice per month at the facility, but during the five weeks of SIS there were only 2. Self-reports of empowering behaviors, quality of family and group life and self-esteem showed highly significant increases following SIS. Self-reports of disempowering behaviors (placating, passive-aggressive, blaming, irrelevant, intellectualizing) showed highly significant decreases following SIS and anomie showed …