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The author focuses on ambulatory, individual, psychodynamically oriented psychotherapy with adolescents and discusses the major developmental issues of early (12 to 15 years), middle (15 to 18), and late (18 to 21) adolescence, correlating these with some expectable modifications in therapeutic technique. Early adolescence, a time of great and embarrassing drive pressures, of nascent autonomy, of concrete thinking and action-oriented behavior, is a particularly difficult period in which to attempt psychotherapy. Esman recommends, if possible, a same-sex therapist who is willing to be verbally active without playing "pal," who can remain somewhat flexible about scheduling, and who will listen patiently to much "superficial" chatter about concerns of daily life. Objectives should usually be limited and therapy relatively brief. Mid-adolescents are usually emotionally and cognitively readier to converse in therapy. The therapist must be more "active" than in work with adults. She or he must be willing to set firm limits to destructive behavior if necessary and to express opinions at times as the patient struggles with moral issues. The author warns that countertransference (overidentification with either the adolescent or the parents) is particularly strong in work with these patients, and constant self-scrutiny is advised. Late adolescents behave much like older adults in therapy except that they may be less able to complete transference explorations. Therapy may need to be confined to "pieces" of analytic work.