A model for treating difficult adolescents and their families is presented. Part 1 offers six basic assumptions about the causes of severe behavioral problems and presents the treatment model with guidelines necessary to address each of these six causes. Case examples highlight and clarify major points within each of the 15 procedural steps of the model. Part 2 presents five key principles within the model that are essential for change: (1) setting clear rules and consequences; (2) troubleshooting; (3) changing the timing and process of confrontations; (4) neutralizing the adolescent's "five aces" (running away, truancy/poor school performance, suicidal threats or behaviors, threats or acts of violence, and disrespect); (5) restoring nurturance and tenderness. The counselor is provided with practical instruction to engage an uncooperative adolescent, empower parents to change parent-adolescent communication, stop the adolescent's most severe behavioral problems, and restore nurturance and tenderness between parent and teenager. Part 3 outlines specific strategies addressing special treatment issues: working with outside systems (peers, school, etc.); single-parent families; divorce and stepfamily problems; and drug and alcohol use. Part 4 presents the research and describes how process-outcome research was used to refine key theoretical concepts within this model. (EMK)