Spouse-assistants of patients undergoing maintenance home hemodialysis have been noted to suffer a variety of psychological problems if either the assistant or the patient is given sole responsibility for the conduct of home treatment. The current report is based on a prospective study of patients and spouses in the Iowa City Veterans Administration Hospital Home Hemodialysis Program, in which both partners are thoroughly trained in dialysis techniques (and the patient is expected to assume responsibility for his or her own home care). Data are presented from follow-up interviews with 32 patients and 29 spouses who had been in home treatment for a minimum of 6 months after the completion of home training. The data suggest that depression, anxiety, and marital problems are encountered less frequently in this group of spouse-assistants than in those described in earlier reports from programs with different training philosophies.