Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders

370 Pages·2000·14.6 MB·English

by  Neil I. Bernstein

Treating the
Unmanageable
Adolescent

TREATING THE
UNMANAGEABLE
ADOLESCENT
A Guide to
Oppositional Defiant
and Conduct Disorders
I. Pu.D.
NEIL BERNSTEIN,
A JASON ARONSON BOOK
ROWMAN & LITTLEFIELD PUBLISHERS, INC.
Lanham • Boulder • New York • Toronto • Oxford
A JASON ARONSON BOOK
ROWMAN & LITILEFIELD PUBLISHERS, INC.
Published in the United States of America
by Rowman & Littlefield Publishers, Inc.
A wholly owned subsidiary of The Rowman & Littlefield Publishing Group, Inc.
4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706
www .rowmanlittlefield.com
PO Box 317
Oxford
OX29RU, UK
Copyright© 1996 by Jason Aronson Inc.
First Rowman & Littlefield edition published in 2004
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of the publisher.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Bernstein, Neil I.
Treating the unmanageable adolescent : a guide to oppositional defiant and conduct
disorders I Neil I. Bernstein.
p. em.
Includes bibliographical references and index.
ISBN: 978-1-56821-630-0
1. Conduct disorders in adolescence-Treatment. 2. Oppositional defiant disorder in
adolescence-Treatment. I. Title.
RJ506.C65B47 1997
616.89'022--dc20 96-15620
Printed in the United States of America
8"'The paper used in this publication meets the minimum requirements of American
National Standard for Information Sciences-Permanence of Paper for Printed Library
Materials, ANSI/NISO Z39.48-l992.
To my mother, who gave me roots
and gave me wings.
To my children, Daniel and Julie,
who give me pride.

Contents
Acknowledgments ix
Introduction xi
1. Understanding the Disruptive Behavior Disorders 1
2. Laying the Groundwork for the
Therapeutic Alliance 31
3. Creating a Climate for Change:
Diffusing Resistance 53
4. A Model for Confrontation and Limit Setting 71
5. The Role of Therapist Self-Disclosure 91
6. The Road to Self-Control 109
7. Developing the Necessary Interpersonal Skills 133
8. Building Self-Esteem 155
9. Developing Empathy, Morality,
and Vulnerability 175
10. Guidelines for Managing Behavior Problems 197
viii
CONTENTS
11. Challenging Poor School Performance
and Other Failures to Thrive 215
12. Working with Families 237
13. Special Considerations for Group Treatment 273
14. Putting It All Together 297
15. Hard-Core Youth:
Learning from Treatment Failures 313
References 331
Index 345
Acknowledgments
Without question, the catalysts for this book were the
many adolescents and families who have shared their
ordeals with me over the years. As my professional
identity evolved, I was influenced by the ongoing feed
back from both patients and colleagues. Raising my own
children has convinced me that good parenting allows
for a large margin of error.
I am grateful to Darlene Atkins, Ph.D., for her
professional input and editorial assistance. Numerous
colleagues have shared their own experiences with me
and encouraged me to proceed when the task seemed
interminable. Finally, my mentor, E. James Lieberman,
M.D., deserves thanks for his influence early in my
career, helping me to express complex ideas simply and
put thought to paper.