Adolescents entering therapy present a variety of development-based problems to the therapist (Freud, 1958; Blos, 1962). These demand that adjustments be made to the standard techniques used in work with adults (Meeks and Bernet, 2001). Specific adolescent problems may compound the common difficulties inherent in psychotherapeutic work with adolescents. Experience suggests that the hostile adolescent, defined here as one in whom hostility has become a characteristic personality feature, may be one of the most challenging of troubled youths that we face in our clinical work. The preceding chapter explored the salient developmental and clinical aspects of hostility as they unfold and in their manifestations during adolescence. This chapter focuses specifically on the theoretical and technical aspects of psychotherapeutic work with such youths.