Within the population of hospitalized adolescents there exists a group characterized by (1) frequent and gratifying recourse to disruptive acts: sexual promiscuity, property destruction, and abusive behaviors; and (2) the perception of significant adults as tormenting and persecutory. We call these patients

disruptive adolescents. Disruptive behaviors often elicit intense negative reaction from treatment personnel, cementing the patient's pre-existing view of the environment as persecutory and resulting in further disruptive acts. Therapeutic intervention must interrupt this cycle and help the patient gain control of the disruptive actions. Two cases are presented to detail a treatment intervention, integrating behavioral and psychodynamic approaches. Psychodynamic theory is employed to rationalize and systematize the available behavior modification techniques. Emphasis is placed upon the complementarity between the initial use of behavioral treatment strategies and the psychotherapy which follows.