25. Can unmanageable adolescents be changed for the better?

By Tom O'Connell

Defiant young people can pose "an enormous problem to society," says clinical psychologist Neil Bernstein, Ph.D., author of "Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders."

Bernstein, who consults on difficult adolescent behavior with schools, clinics, and psychiatric facilities, reports, "In the absence of effective intervention, their conflicts are likely to escalate, thus paving the way for a lifelong pattern of antisocial behavior."

Common symptoms exhibited by these teens were listed by this highly regarded expert during his workshop at Albert Einstein College of Medicine's Cape Cod Institute:

•     Aggressive behavior.

•     Lying.

•     Stealing.

•     Chronic violations of rules.

•     Substance abuse. 

A key line he used was: "Unfortunately, these youngsters neither feel that they want or need help." This poses a challenge to anyone who has to deal with them. And some of the tips Bernstein gave to therapists may be helpful for anyone who tries to relate to difficult teens, especially in group settings.

Here's what he called "The Major Thinking Errors: Illustrations and Challenges."

MINIMIZING: "It's no big deal."
Example: "He wasn't hurt that badly when we beat him up. Somebody had to
                   teach him a lesson."
Challenge:1) "The fact is that he was hurt and it was unnecessary."
                         (Confronting)
              2) "So you did it because everyone else did. Don't you have a mind
                         of your own?" (Reversing)

SELF-CENTERED: "I'm entitled, just because...."
Example: "I took the kid's bike because I wanted it."
Challenge: 1) "You think it's cool to steal, but it's really dumb." (Re-labeling)
               2) "I'll bet that kid was really upset. He probably can't afford to
                          replace the bike." (Confronting)

ASSUMING THE WORST: Attributing hostile motives to the actions of others.
Example: "He was going to jump me anyway; so I hit him first."
Challenge: 1)"How could you be so sure he would jump you?" (Checking it out)
                    2) "You reacted without even thinking first." (Confronting)

BLAMING OTHERS: Placing responsibility outside oneself. ("It's someone
                                      else's fault that I did it.")
Example: "I wouldn't have stolen the beer if the man who works at the Seven   | 
                  Eleven didn't go to the bathroom."
Challenge: 1) "You mean that it's his fault that you stole the beer." (Reversal)
                    2) "You chose to steal the beer. The fact is that shoplifting is a
                           crime.  (Confronting.)

It is not easy to reason with unmanageable adolescents, but Bernstein has learned a variety of ways to reach them. And in his 20 years of concentrating on such work he reflects that the most helpful technique of all for the kids is "being able to share problems and get help from others." And that's why group therapy works so well.

However, handling troubled young people is very sensitive work. Bernstein says, "Seventy percent of the families of these kids are from broken homes." And often a parent's drinking has caused serious problems, and needs to be dealt with. "The therapist has to encourage self-disclosure, deal with anger, and reduce impulsivity."

When kids in a group are disruptive and make wisecracks, Bernstein says they are trying to get attention and win the respect of their peers. "Roll with their resistance instead of trying to control them or fighting them."

When two or three in a group are disruptive, he suggests, "Distract them instead of chastise them. Blow the whistle, turn off the lights, run to the window, hold a sign behind the head of the offender!" If the whole group is disruptive, he advises, "Set a limit and enforce the limit. For example, stop the group and postpone until another day."

When working with teens, he suggests, "Get them all involved." They can be given assignments and play roles such as "policeman," "facilitator," etc. If someone won't participate and is tuning out, he recommends, "Talk about the kid. Say, 'I wonder what's going on with him!' And let his peers discuss the situation and figure out ways to get the one that's tuning out involved."

A key piece of advice is, "Focus on the group process, not the individual. Get them to run their own group. There's power in a cohesive group." When structuring a teen group, Bernstein says, "Forty five to sixty minutes is ideal, not ninety minutes!"

There's no quick fix for troubled teens, but if this subject interests you, you may benefit from Neil Bernstein's recent book, "Treating the Unmanageable Adolescent."

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