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

Neil I. Bernstein (Author)

Book Description

Publication Date: November 1, 2000

The problem of the out-of-control teenager demands immediate and effective attention from clinicians. As American town after town enacts curfew laws for minors and more and more teachers send youths for treatment, therapists are faced with an epidemic for which they often feel ill-prepared. In this book of nuts-and-bolts treatment approaches, mental health professionals are shown how to successfully help defiant and conduct-disordered young people who present with an array of symptoms including chronic truancy, drug abuse, dangerous sexual activity, and poor peer relationships.

Drawing on individual, cognitive-behavioral, group, and family approaches, the book emphasizes the process of diffusing the resistance to change and facilitating treatment compliance. The focus is on understanding as well as altering the rage, sense of entitlement, lack of self-control, and disregard for the rights of others. In particular, the book covers how to
* engage and motivate these youths
* teach patients anger management skills
* conduct group exercises and role play prosocial behavior
* work with empathy-induced guilt to promote change
* manage anticipated disruptions
* use therapist self-disclosure to enhance the therapeutic process
* foster resilience in the "at-risk" population.

To date, no single approach has consistently interrupted the pattern of escalating conflicts and the violations of social norms occurring in this difficult-to-treat population. Each of the prevailing schools of thought makes a contribution to the remediation process but falls short of integrating the diverse interventions available. By presenting a variety of interventions targeting the central deficiencies and systemic dysfunction in the lives of these youths, this book provides clinicians with what they need to make a difference in the lives of troubled young people and those around them.
A Jason Aronson Book

Editorial Reviews

Review

The book is solid throughout, including useful comments about the role of family and school in successful treatment, but the book really sings when it deals with the reality of the direct interaction with these youngsters in therapy, individual or group. The techniques offered for 'selling' therapy to the negative antisocial youngster alone are worth reading the book. It's a jewel written by someone who obviously has spent many hours nimbly sliding past the rage and distrust to touch the humanity at the core of all these young people. (John E. Meeks )

Warning: Start this book and you may be hooked! Neil Bernstein represents the best of the new mental health mentors, the outstanding player–coach. His long and varied experience with oppositional adolescents combined with an ability to integrate psychodynamic and behavioral theory gives us a model text. This wonderful handbook for mental health professionals is so clear and sensible that parents, teachers, judges, clergy, and policy makers will be able to find out for themselves what makes problem kids tick and what to do about it. (E. James Lieberman )

About the Author

Neil Bernstein, Ph.D., a clinical psychologist in private practice, has specialized in treating adolescents for the past twenty years. He has consulted to a number of schools, clinics, and psychiatric hospitals. Previously, he served as chief psychologist at a private psychiatric hospital, director of a behavior clinic at a large metropolitan children's center, and as a forensic consultant. Dr. Bernstein is a highly regarded expert on adolescent issues whose publications include Treatment of the Resistant Adolescent, Managing the Difficult Adolescent Patient, and Getting Adolescents on Track: The Crucial Ingredients.

Product Details

• Hardcover: 368 pages
• Publisher: Jason Aronson, Inc. (November 1, 2000)
• Language: English
• ISBN-10: 1568216300
• ISBN-13: 978-1568216300
• Product Dimensions: 8.3 x 5.8 x 1.1 inches
• Shipping Weight: 1.2 pounds (View shipping rates and policies)
• Average Customer Review: 3.2 out of 5 stars  See all reviews (4 customer reviews)
• Amazon Best Sellers Rank: #515,662 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

27 of 28 people found the following review helpful:

3.0 out of 5 stars an excellent guide to practical management, February 20, 1999

By A Customer

This review is from: Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders (Hardcover)

I was startled to read an earlier online review of this book becasue it was so much at varience with my own thoughts about Dr. Bersteins book. I am a psycholgist with a Ph.D. and 25 years experience working in clinical settings and I have never before encountered a book on conduct disorders that was so clearly the work of an experienced clinician and so deeply rooted in his experience. Bernstein's clinical examples could have come from my office or those of other psychologists I know and work with. His suggestions and illlustrations of his work with his patients was both reassuring and familiar as well as stimulating and provocative. If you chave to go out and work in the trenches with oppositional and conduct disordered, Dr. Bernstien's book is a very handy item to have along

22 of 23 people found the following review helpful:

4.0 out of 5 stars Angry, And Perhaps Rightly So, January 3, 2003

By 

Thomas J. Burns (Apopka, Florida USA) - See all my reviews
(VINE VOICE)    (REAL NAME)   

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This review is from: Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders (Hardcover)

Dr. Neil Bernstein's useful work on the counseling of oppositional teenagers is noteworthy in its humility, for a start. Clinical success, in the author's view, is established the old fashioned way: you have to work for it. In his introduction Bernstein confesses to a basic distrust of quick fixes for teenage problems, particularly those promulgated on the lecture/workshop circuit. He keeps a balanced head on the etiology of oppositional defiance, recognizing that disorders of mood, substance abuse, and dysfunctional families of origin, to name a few factors, must be given their day in court during the diagnostic phase of treatment. He is well read in adolescent development and recognizes that the teen years are inherently about distancing and defiance, in some way, shape, or form.

If one were to label the author's clinical approach, perhaps the Rogerian style comes closest to capturing this practitioner's persona. Without losing sight of the nuts and bolts, Bernstein seems to find his success in establishing empathy and trust with his young clients. The "opposition" of teenagers is directed against the systems that they perceive as having failed them: family, school, and the peer community. The defensive attitude of such youth is both a mask for their pain and insurance against further hurt. It is encouraging to see that a lengthy chapter has been devoted to family intervention [though some family specialists will inevitably argue that the family organism is the whole enchilada where childhood disorders are concerned.]

Bernstein's clinical examples-and they are numerous-appear to be drawn primarily from individual therapy sessions, i.e., without parents or others in the process. If this reflects the demographics of his paying clientele, then he must have a remarkable gift for developing engagement with his young clients, and he would apparently have enough leisure to plumb his clients' psyches at a pace that does not engender defensiveness. But aside from the wearisome issue of whether managed health care or the client's own limited resources put limitations on a style that calls for protracted contact and trust building, the one nagging question left hanging in this work is the role of the parents in the client's treatment. In Chapter 12 the author provides a substantive commentary on family therapy, noting among other things that parents frequently repeat the mistakes of their own mothers and fathers, implying that many oppositional clients have plenty at home to be oppositional about. Is such therapy without the parents the clinical equivalent of rowing with one oar? I would summarize Bernstein's position on parental participation in therapy as "optimal but not necessary." As a practitioner myself, unless I have compelling reasons to the contrary, I subscribe to the philosophy of the seasoned general who brought a long time rival into his inner circle on the grounds that "I'd rather have him inside my tent [urinating] out than outside my tent [urinating] in." Somewhat surprising to me is the desire of many of my ODD clients to have a parent in therapy with them, perhaps their way of telling me why they are so angry.

In the final analysis, this is a work from the traditional psychoanalytic school that extols the time proven methods of human respect and client interaction. It is an excellent didactic exposition, an opportunity for a practitioner to ask himself, "Do I sound like that?" There is an abundance of common sense and a minimum of psycho-jargon that makes this work accessible to teachers and many parents as well.

19 of 20 people found the following review helpful:

5.0 out of 5 stars Treating the Unmanageable Adolescent, December 8, 2000

By 

Susan H. Gordon, Ph.D. (Washington, D.C. United States) - See all my reviews

This review is from: Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders (Hardcover)

I've been working with difficult teenagers for over ten years and read this book hoping to gain new insights and skills into working with this population. By far, it is the best book I have ever read on this topic. It is explicit, practical, and offers numerous suggestions for addressing the multiple problems that this population faces. I have found it extremely useful in my practice because of the easily applicable techniques Dr. Bernstein presents, and his concrete suggestions about how to implement them. Dr. Bernstein shares many examples from his clinical practice which parents and clinicians alike should find helpful. Susan Gordon, Ph.D.