Though August Aichhorn, in name, remains a significant figure in the history of psychoanalysis, his ideas have been all but abandoned in the modern clinical conception of the treatment of children and adolescents who act out. The current treatment of children and adolescents, so disturbed that their behavior demands treatment outside of their home environment, is currently rudderless and highly dependent on broad societal counter-transferential reactions to disturbed youth. We argue that not only does Aichhorn hold a distinguished position in the history of the treatment of youngsters, but that his ideas about the meaning of severely disruptive behavior as well as the techniques which align with those theories remain relevant and, if utilized, would improve the treatment of severely disturbed youth.