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This book explores the story of a county that privatized mental health services by forming a nonprofit agency. The privatization created massive change, and at this agency the change created results that differed from the dire negative images found in the literature. One explanation for these positive outcome was the use of an organizational analogue of Psychiatric Rehabilitation, a practice developed by William Anthony, from Boston University's Center for Psychiatric Rehabilitation, to help people cope with change. At this nonprofit, the PR analogue was used to assess the agency's readiness to change, providing a useful framework for understanding what occurred during and after privatization. Managing is difficult in any environment but in one of shrinking funds, increased risks of litigation and increasing oversight, leaders can lose their vision and their way. If we choose to manage, we have a responsibility to assure that agencies have the resources needed to provide for those who are most at risk but who like every other member of society deserve a chance to lead productive and satisfying lives. Finding innovative ways through the turbulence of change will insure the continuance of nonprofits and assure that the vision of recovery remains foremost on the agenda of mental health agencies now and in the future.