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We start from the genealogical work of Michel Foucault and the clinical-institutional thinking of François Tosquelles and Jean Oury to develop the close relationship between clinical practice and the way health services are managed. This idea implies that, in order to change clinical practices, it is essential to change work appropriation practices. The way of appropriating work in institutional psychotherapy calls into question the processes of normation and normalization described by Michel Foucault, especially by rethinking hierarchical and partitioning structures such as professional “status.” Our aim is to reflect on the link between clinical practice and the institution. We postulate that it is only through this way of thinking about the institution that institutional psychotherapy can lead to a clinic of singularity. The institution, on behalf of the clinic, is turned toward the emergence of singularization processes which unfold via the idea of a transferential constellation, via co-management of the “therapeutic club” by users and professionals, and via the permanent attempt at an institutional analysis.