This review updates the previous literature on what we know about inmate needs and the programs designed to address those needs. A more neutral terminology than inmate "deficits" or "needs" is used by referring to the different domains as "skill sets." A skill implies mastery and competence rather than a personal liability. Although this orientation to inmate skills is somewhat symbolic, it emphasizes the interaction of training or teaching in conjunction with the individual's proficiency and achievement. This is a small step away from the medical model toward a paradigm that emphasizes the role of the offender in his or her own successful reentry. This review also discusses the medical/mental health needs of releasing inmates and the barriers that are encountered both within the criminal justice system, and the community, as well as the barriers to productive prison programming. The skill and medical/mental health needs of releasing offenders are viewed as complementary and overlapping issues that require integration. In the last section, we introduce a "self help" model that integrates concepts in both the medical and skill set literature. In this last section, we also recognize and discuss the limitations of the "what works" model that focuses on interventions that address primarily the propensity to commit crime. What is needed is a coherent theory that relates the skills/needs literature to other theories of crime that bring in social context, opportunity, and social embeddedness. Some of the life course literature in criminology is increasingly moving in that direction.