The author, a therapist, relates the 2 year process of psychotherapy with Heather, a 19 year old Down's syndrome girl. Psychotherapy was seen as the least restrictive alternative because it recognized that the girl, in addition to some concerns related to her handicap, was upset by her own inner emotional pressures and entitled to a neurotic depressive disturbance as a conflicted adolescent; and because the recommendation of insight psychotherapy was a normative alternative for an adolescent with neurotic conflicts and the capacities and motivation to work on them. The girl's record and test findings are reviewed, as are initial and subsequent meetings with her parents. It is explained that as Heather's relationship with her boyfriend Wayne (also retarded) developed, he also was included in the therapy sessions. Heather's progress is traced through living in her own apartment and her marriage to Wayne. Poems written by Heather are offered throughout the report. (SW)