As Hildegard Peplau has established, the orientation phase of the nurse-client relationship represents the first stage of therapeutic work. The author studied the length of the orientation phase with clients with chronic mental illness. Findings suggested that the orientation phase was related to the number and length of hospitalizations, while demographic variables such as psychiatric diagnosis were unrelated to the length of the orientation phase. A return to the orientation phase can be triggered by a change of staff, even for brief periods, or internal factors within the client, such as worsening of paranoia or depression.