Psychotherapeutic techniques with treatment-resistant adolescents

Psychotherapy with adolescents is difficult for at least two reasons: 1) adolescents frequently do not trust adults; and 2) adolescents are often poorly motivated for treatment. Consequently there may be significant problems eliciting the cooperation needed to implement successfully various psychotherapeutic treatment approaches with adolescents in general, and treatment-resistant adolescents in particular. This article presents several techniques designed to capture adolescents' attention, further the psychotherapeutic alliance, and facilitate cooperation. Techniques include: a) siding with the adolescent; b) teaching strategic skills; c) interpreting interpersonal relationship patterns; d) risks of honesty and deception; e) exploring moral dilemmas; f) wagering on cognitions and behaviors; and g) alternative communication strategies. It is recommended that psychotherapists consistently review the quality of their relationship with adolescent clients in order to facilitate successful implementation of psychotherapeutic interventions.