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Contemporary child and adolescent psychoanalytic technique has evolved and changed a great deal in the last thirty years. This paper will describe the analysis of an adolescent girl from early in the author's career to demonstrate the ways in which technique has changed. The clinical material presented highlights six areas in which contemporary child and adolescent analysts practice and/or understand material and the clinical process differently than they did thirty years ago: (1) the contemporary perspective on mutative action, (2) the contemporary emphasis on mental organization, (3) the developmental lag in integrating the structural model, (4) the child analyst's multiple functions, (5) the child analyst's use of countertransference, and (6) the child analyst's work with parents. The author discusses how he would work differently with the patient now using his contemporary perspective. But he also wonders what might have been lost by not working in a more traditional manner, in particular the opportunity to analyze the patient's hypersensitivity to feeling hurt and mistreated so directly in the transference.