This case study presents a problematic patient who has been resident in a special hospital for mentally handicapped people for years due to a gross sexual fantasy disorder, continuous self-injurious behaviour and an array of disordered conducts which resulted in negative nursing reports. The introduction of Rogers' model, with its abstract finer conceptualizations produced an alternative framework by which to assess the patient. This holistic interactive model generated a paradigmatic shift in the nursing perceptions, at a conceptual level, which was manifested in their reporting behaviours. The results appeared to indicate a sudden and dramatic change in the patient's behaviour. However, alternative interpretations proved the more convincing on closer analysis. The use of Rogers' framework proved difficult in its practical application due to its underpinning requirements for role adoption and negotiation, both being problematic in a secure environment.