Abstract. Since the years 1960, although not represented in support units per se, psychiatry and psychoanalysis have occupied a dominant position in French sanitary and medical-social institutions. In opposition, other disciplines have brought new support modality for autistic persons. Yet, the “everything is therapeutic” era never really existed. This was a fiction that was maintained by psychiatric and psychoanalytical point of view, that didn’t take into account other part of support such as simple childcare in asylum, or, on the other, schooling, or social and educative activity. “Supremacy” of psychiatry and psychoanalysis has declined, but it remains in the vocabulary of many support unit. For family there is a large confusion between “treatment”, “care”, “therapeutic”, “psychotherapy” and “institutional psychotherapy”. The later is not a single approach to analyse actions and interactions in the teams, and forge a constructive criticism which lead to innovation.