This study examines how treatment staff at Swedish SiS youth homes experience and manages the balance between institutional control and youths’ selfdetermination. Using Goffman’s concept of total institutions and Foucault’s ideas on surveillance and normalization, the study investigates how staff navigate conflict-laden situations in daily practice. Data were collected through seven semi-structured interviews and analyzed thematically. Results show that control and self-determination coexist in complex, situational practice. Three main themes emerged: (1) relationships and trust, emphasizing the importance of professional yet supportive interactions; (2) balancing control and autonomy, illustrating strategies like providing limited choices within fixed routines; and (3) surveillance, normalization, and boundary-setting, highlighting how institutional structures shape behavior. The study contributes to knowledge on institutional care by showing how staff negotiate tensions between security, care, and autonomy, and how relationships function as both a resource and a potential source of conflict. The findings have practical implications for staff training, institutional policies, and the development of practices that promote youth empowerment within structured care settings.