We assessed effectiveness of four education programs in providing nursing assistants with ability to produce a therapeutic milieu supportive of intact residents' activities of daily living, positive self-esteem and mood: (1) a combination of Orem's Systems of Nursing Care and Skinner's Applied Behavioral Analysis, (2) Applied Behavioral Analysis, (3) Orem's Systems of Nursing Care, and (4) regular in-service education. We hypothesized that the combination program was most effective. Results revealed no significant difference among programs. Education alone is not sufficient. Administrative and supervisory involvement and support is crucial for nursing assistants' successful implementation of newly acquired knowledge and skills. (Contains 5 tables.)