TREATING THE TOUGH ADOLESCENT
A Family-Based, Step-by-Step Guide
Part I. A Family-Based Model for Tough
Adolescents
Chapter 1. Introduction
Why a Family-Based Model?
Who Are Our Tough Adolescents?
Basic Principles of Treatment
Plan of the Book
Chapter 2. Point of Entry: Why Difficult Teenagers Have Problems
An Incongruous Hierarchy
Misuse of Outside Forces
The Protective Function of Behavior Problems
The Pleasure Principle
Thinking Two Steps Ahead
Button-Pushing Skills
Chapter 3. A Model for Change
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
Step 6:
Step 7:
Step 8:
Step 9:
Step 10:
Step 11:
Step 12:
Step 13:
Step 14:
Step 15:
Engagement
Defining and Redefining Problems
Parental Empowerment
Setting Clear Rules and Consequences
Troubleshooting
Changing the Timing and Process of Confrontations
The Adolescent’s Bid to Reclaim Authority
Neutralizing the Adolescent’s “Five Aces”
Working with Outsiders
Improvement in the Adolescent’s Functioning
Restoring Nurturance and Tenderness
Surfacing of Other Family Issues
Predicting Relapse
Maintenance of Change or Relapse
Follow-up
Part II. Specific Principles and Guidelines
Chapter 4. Setting Clear Rules and Consequences:
The Basic Work of Therapy
Stumbling Blocks for Parents
Strategies for Constructing Effective Rules and
Consequences
Troubleshooting
Summary
Chapter 5. Changing the Timing and Process of Confrontations
Strategy 1: Finding and Neutralizing Buttons
Strategy 2: Uncovering Exceptions and Possibilities for Future
Change
Strategy 3: Showing Parents How to Respond Nonreactively
and Calmly
Summary
Chapter 6. Neutralizing the Adolescent’s “Five Aces”
Ace 1:
Ace 2:
Ace 3:
Ace 4:
Ace 5:
Summary
Running Away
Truancy and Poor School Performance
Suicidal Threats or Behaviors
Threats or Acts of Violence
Disrespect
Chapter 7. Restoring Nurturance and Tenderness
Where to Begin
Strategies to Restore Nurturance and Tenderness
Initiating Soothing Sequences of Communication
Pulling It All Together: Implementing the Seven Nurturing
Strategies
Summary
Part III. Special Treatment Issues and
Circumstances
Chapter 8. Working with Outsiders
Knowing the Territory
Strategies for Working Effectively with Outside Systems
Summary
Chapter 9. Single-Parent Families:
Sharing Parental Responsibility
Strategy 1: Working Both Sides of the Fence
Strategy 2: Joint Determinations of Rules and Consequences
Strategy 3: Employing the Assistance of Other Children
Strategy 4: Community Family Counseling
Summary
Chapter 10. Divorce and Stepfamily Problems
The Exceptionally Difficult Divorce: Strategies for Conducting a
Controlled Encounter
Stepfamily Issues: Strategies for Addressing Unrealistic
Expectations
Summary
Chapter 11. Alcohol and Drug Use;
“I Don’t Have a Problem”
Strategy 1: Determining the Extent of the Adolescent’s
Substance Use
Strategy 2: Mobilizing Multiple Systems
Strategy 3: Implementing Severe Consequences for Drug or
Alcohol Use
Strategy 4: Addressing Other Family and Environmental Issues
Summary
Part IV. Research Findings and Future
Implications
Chapter 12. Process-Outcome Research and the Family-Based Model:
Refining and Operationalizing Key Theoretical Concepts
Current Challenges and Controversies in Mental Health Care
Research
Goals and Objectives of My Project
Development of the 15-Step Model: A Task Analysis Approach
Beyond the 21st Century: Conclusions and Future Implications
References
Index