Five New York City partial hospitalization programs serving chronic patients in acute phases of distress were examined. Patient and staff perceptions of their programs were compared and related to their evaluations of the programs. Although both patients and staff reported positive assessments of the help provided by the programs, they had different views regarding which elements or aspects of the programs were most helpful. Patients experienced a greater sense of being helped when the emotional climate of the program was highly evaluated, when the staff had been clear about the program goals and expectations, and when personal problems were not scrutinized. Staff felt that the most important program ingredients were the actual treatment elements dealing with personal and practical problems. The influence of the differing frames of reference of patients and staff are discussed regarding the orientation of community treatment programs for chronic psychiatric patients.