Two Alliances in the Treatment of Adolescents: Toward a Working Alliance with Parents and a Therapeutic Alliance with the Adolescent*

“Why do grownups want to talk to adolescents when they only get angry?”

I have been persuaded in my time by the rationale of each approach of psychotherapy. In the course of my training and other early experiences I have worked in a number of settings with differing theoretical orientations and ground rules. I have treated all the members of families, both individually and as family groups, and I have “split” cases with other psychiatrists. I have also treated children and adolescents in clinics in which parents were seen by social workers and in which the index patient and his therapist were shielded from any and all contact with the parents. Nevertheless, it is possible to recover from training. This is a report of an approach and some underlying principles in the management of adolescent patients and their families.

Although I have been associated with adolescent clinics, this report is based on private practice with adolescents with the usual concomitant features of high intelligence, affluence, middle to upper social class ambiance, one or two (or more) vocationally accomplished parents, some prior orientation to psychoanalytic