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The ideals of a capitalist “neoliberal” society are surreptitiously inscribed in the modes of functioning of teams, services, healthcare institutions and social work, and in associations. These challenge the values on which their practices are based. Much clinical research developed over the years is being undermined by the “de-institutionalization” of care and social work in which the market logic and economic and managerial discourse are becoming the dominant factors. Some are even pressuring for procedures to be applied to treatment practices. By making a distinction between “instituting values” and the different “systems of organization,” our conception of institutional analysis is perhaps even more relevant in the face of this absence of organizational and institutional representation. The same is true of our analysis of the evolution of the professional identities internalized by individuals and of the institutional agenda and the founding values of the organization. This paper presents an analysis that was conducted over four years in a psychiatric center with eight units. It is possible to respond to the initial demand for an “analysis of practice” once the internal functioning and conflicts between units have been dealt with, once the therapeutic focuses of each unit have been defined, and once a global project for the entire center has been established.