Therapy with adolescents challenges even the most skilled clinicians. Teenagers are difficult to engage in treatment, and the systems in which they are involved (schools, juvenile justice) frequently do not understand or support therapy's goals. Adolescents with behavior and drug problems live in families characterized by emotional estrangement or turmoil, sometimes both. Adolescents showing problems are involved with peer systems that are difficult for therapists to understand because of their secretive nature. Parents of these adolescents have generally not found previous attempts at seeking help useful or effective. In the face of these formidable challenges, therapists work in settings in which they must carry large caseloads, too often with inadequate This article is based on a paper by the author delivered at a symposium titled "Engaging Family Members in Drug Abuse Treatment" (E. Rahdert, Chair) at the 1994 American Psychological Association Annual Meeting in Los Angeles.