Marco Schneider, Arianna Modena, Francesca Zuccalà, Alessia Galimberti

ABSTRACT

This paper proposes a theoretical/clinical reflection on the concept of resistance toward therapy by adolescent subjects.

The possibility that a patient, especially an adolescent, will manifest resistance behaviors in therapy can sometimes be quite high. This depends on several factors: both the quality of psychic suffering presented by the patient and cultural dimensions typical of our Western society, including high levels of narcissism, a specific focus on the dimensions of individual freedom and self-determination, and a widespread reluctance to trust and rely on the other.

When the patient is an adolescent, this likelihood of manifesting resistance is increased because of the very characteristics of the adolescent phase, which physiologically poses a number of problems with respect to interpersonal relationships and the possibility of trusting the other. 

Resistance toward psychological treatment is a phenomenon that has a long tradition of study, even as far back as Freud’s classic psychoanalytic conceptualization (Freud, 1900/2010, choice transl.it.). The father of psychoanalysis dealt extensively with resistance, connoting it as a phenomenon that hinders change and protects the subject from contact with painful psychic contents. 

This article aims to integrate the classical view of resistance with contributions from later authors, including Kernberg (1975, 1984), Gabbard (2015), Safran and Muran (2000), and the systemic-relational view, with the goal of highlighting how the evolution of the conceptualization of resistance in therapy has allowed for a shift in focus from the idea of an intrapsychic defensive mechanism to that of a complex relational modality rich in communicative meanings on multiple fronts. 

A reading of resistance toward therapy that draws on the systemic-relational tradition is proposed here, understanding this behavior as a significant indicator of the subject’s positioning toward both the therapeutic context and his or her context of belonging, informative in this sense of the functioning of the patient’s family system. The distinction between the two main types of resistance (“in” and “to” care), an integral part of “Resistance Theory” (Schneider, 2021b, 2025), is presented in this paper by highlighting its specific communication aspects and goals toward the subject’s family system.

KEY WORDS: adolescence, resistance in therapy, psychotherapy, oppositionality, family system, relational theory, systemic psychology.

INTRODUCTION 

As is well known, adolescence represents a fundamental and delicate phase of human development, during which the transition from childhood to adulthood takes place. In this time frame, which most recent conceptualizations date from ages 11-12 to 18-20, the individual experiences significant transformations at the biological, psychological, cognitive and social levels that progressively contribute to the formation and definition of a stable and mature identity. Unlike childhood, the adolescent experiences a developmental phase characterized by instability, ambivalence, a search for meaning, and increasing personal freedom, movement and self-determination.

During this phase, the body, which is constantly changing, is particularly affected by the influence of the hormonal system, which initiates sexual maturation; in parallel, complex cognitive processes such as abstract thinking and introspection are activated, leading the subject to question himself, the world and his own future. Relationships with peers assume a central role, while family ties are redefined in light of the growing need for autonomy (Schneider, 2021a). In this scenario, it is common to observe in adolescents an internal tension between growth drives and the need for protection, between the desire for emancipation and the fear of loss. This tension can also express itself through dysfunctional, oppositional or withdrawal behaviors which, if placed within a clinical context, can also take the form of resistance toward psychological treatment.

It turns out to be crucial to distinguish between the adolescent’s “normal” (because physiological) resistance behaviors from problematic oppositional behaviors, the latter understood by systemic psychology as the signal and at the same time the result of dysfunctional family dynamics at multiple levels, on which it is necessary to intervene appropriately. 

It may happen that adolescents in therapy experience some fears that reduce trust in the psychologist, such as the fear that he may appropriate their innermost thoughts. Other teens may show a pronounced need for independence and autonomy that may push them on the one hand to want to preserve their “privacy” as much as possible and on the other hand to want to solve their problems independently, even when they may not have adequate tools. In this sense, therefore, some adolescents may be uncooperative with respect to therapy in a way that we might call “physiological,” that is, related to dimensions pertaining to typical aspects of adolescence, without necessarily entering the realm of pathology of the therapeutic bond. 

In therapy, on the other hand, the clinician may register the presence of resistance behaviors that turn out to be strongly connected to specific dysfunctional family dynamics, which find sustenance precisely in the adolescents’ resistance behaviors: in these cases, adolescents may manifest oppositional and noncooperative attitudes that not only transcend the normal physiological boundaries of resistance, but also turn out to be fundamental to the psychological functioning of their family.  

For example, an adolescent  may show resistance in order to “protect” specific relational arrangements, or conversely “activate” subjects outside the family in order to change a relational situation experienced as intolerable. 

We will see shortly how the evolution of the concept of resistance, in the light of the systemic perspective, has made it possible to recognize an important communicative, strategic and relational component in this behavior, a component that certainly reveals aspects of the patient’s internal functioning but also much about his positioning in the family and the family dynamics themselves. 

As emphasized in the opening, this paper aims to expound the theory of resistance by distinguishing between two basic forms of it: that “in” care and that “to” care (Schneider & Bertolazzi, 2021; Schneider, 2025), interpreting resistance as a meaning-bearing relational dynamic capable of guiding both clinical understanding and intervention in therapeutic contexts with adolescents.

THE CONCEPT OF RESISTANCE: EVOLUTION AND PERSPECTIVES

The concept of resistance has historically constituted one of the foundational cores of psychotherapeutic theory and practice for many orientations, including psychodynamic therapy, since the earliest Freudian elaborations. 

Without any claim to exhaustiveness but as a general reference, it is recalled here that in classical psychoanalytic theory Freud introduces the concept of resistance by understanding it as an unconscious mechanism that prevents access to removed mental contents, particularly painful or conflicting desires, impulses and memories. For example, in “The Interpretation of Dreams” (Freud, 1900/2010, choice transl.it.), Freud describes one of the possible forms of resistance in the fact that the subject’s mind activates a “censorship” that deforms unconscious contents, thus hindering, for defensive purposes, the emergence into consciousness of previously repressed psychic material. Later, in “Remembering, Repeating and Reprocessing” (Freud, 1914/2006, choice transl.it.) the father of psychoanalysis deepens the theme of resistance by observing how it emerges in the analytic relationship mainly through the repetition of internal conflicts, which prevent the patient from processing and remembering traumatic events.

Throughout the twentieth century, the concept of resistance was reworked and expanded, again within the psychodynamic approach, by several authors. In particular, Kernberg (1975, 1984), working with patients with personality disorder, emphasized the centrality of resistance as a defense aimed at protecting the fragile structure of the self in patients with borderline and narcissistic functioning. According to the author, resistance is not only a defense against psychic pain, but also an expression of the way in which the patient maintains an internal coherence, opposing change. 

Within the contemporary psychodynamic perspective, Gabbard (2015) describes resistance in psychotherapy as the patient’s tendency to resist change during treatment, manifesting an implicit desire to maintain the status quo. This phenomenon often emerges as an obstacle to the therapeutic process, as the patient may avoid changing established patterns while still participating in the therapeutic process. Resistance, then, along the lines of this author, can be seen as a defense that protects the patient from the pain associated with profound changes.

If, as we have seen very briefly, classical conceptualizations of a psychodynamic matrix have basically understood resistance toward treatment as an hindering factor that prevents for various reasons from achieving a valid change in the patient through the therapeutic pathway, scientific thinking on resistance has evolved along other lines as well.

In this sense, the dynamics present in the therapeutic system composed of psychologist and patient have been considered. As an example, Safran and Muran (2000) highlight the interpersonal nature of resistance, which manifests itself in the relationship between therapist and patient as a form of negotiation and struggle for control of the therapeutic process. These authors emphasize the importance of the tool of metacommunication as an aid to deal with ruptures in the therapeutic alliance also given by resistance and to strengthen the therapeutic relationship. In this framework, resistance becomes a valuable relational marker that invites the therapist to reflect on his or her own positioning, countertransferential responses, and the quality of the therapeutic encounter.

This shift makes it possible to consider resistance in therapy no longer only as a rejection of treatment or as avoidance due to intrapsychic dynamics, but as a relational phenomenon related, for example, to difficulties in giving trust, in emotional exposure, in tolerating dependence on the other, or in undertaking a process of change, especially if perceived as threatening. So, resistance becomes a specific element to be observed and treated within the therapeutic path. 

Subsequently and thanks to the contribution of systemic-relational psychology, the focus has been on relational and “triadic” aspects of resistance. From this perspective at the basis of resistant behavior may be motivations related to family relationships: the patient may fear, for example, that by “changing” he may lose some “advantages” guaranteed by his symptomatology or, more generally, he may want to preserve already existing relational balances that would instead be challenged if he were to “change.” 

Systemic psychology has specifically placed a great deal of attention on the relational and triadic analysis of resistance phenomena, evaluating such behaviors primarily in light of the subject’s relationships with his or her context of origin and belonging. 

As a result of this open-ended look at relational and systemic dimensions, the concept of resistance to treatment has gained increasing importance and an increasingly central role in the process of understanding the patient and his or her family. 

RESISTANCE “IN” TREATMENT AND “TO” TREATMENT

The “Theory of Resistance” (TR) was developed by one of us following a significant experience in a context in which it is very common for patients to show resistance: the judicial context and in particular that of juvenile criminal justice. 

Several colleagues participated in the development of the theory in various capacities and over time: in addition to the coauthors of this work, Arianna Modena and Francesca Zuccalà, Alice Annibale, Dara Bertolazzi, Arianna Rossi and Elisa Scaramella.

The next few lines reconstruct the most significant steps in the elaboration of the “Theory of Resistance.”

A first publication on the topic is from 2018: an article published in the journal “Family Therapy” entitled “When the Risk is Prison. Psychotherapy with young offenders” (DOI: 10.3280/TF2018-118001), by M. Schneider. The paper focuses on adolescents between the ages of 14 and 18 years reported to the Italian judicial authority for the commission of one or more crimes, who manifest oppositional behavior and poor cooperation with psychosocial workers and the justice system. The article highlights how, in this area, traditional methodologies focused on preliminarily seeking to activate the young person’s intrinsic motivation in order to achieve a “spontaneous” therapeutic alliance are insufficient, so much so that intervention approaches need to be rethought. The article’s proposal concerns the need not to counter the young person’s resistance to the psychological path with the goal of a “transformation” of his or her personality, but rather to recognize it as a fundamental clinical construct and as a possible relational resource. In particular, it is observed that often in the criminal context, adolescents’ adherence to the therapeutic path does not stem from a genuine desire for change or “repentance” for what they have committed, but rather from an instrumental motivation aimed primarily at avoiding harsher criminal sanctions. In this dynamic, the therapist assumes the role of the young person’s “tactical ally,” helping him or her transform these initially opportunistic goals into more coherent and adaptive behaviors, progressively accompanying him or her in a process of identity reworking. The therapist is placed, in the proposal of this article, in a strategic position within the justice system, serving as a “bridge” between the youth and the criminal justice authority. His role goes beyond simply fulfilling an institutional mandate: in fact, he is configured as a facilitator who promotes subjective responsibility, understood as the young person’s ability to attribute meaning, intentionality and direction to his own actions, including illegal ones. 

Later, in a 2020 paper published in N° 1 of the journal “Quaderni SIRTS” (Scientific Journal of the Italian Society for Systemic Research and Therapy; www.sirts.org/quaderni ) entitled “Adolescent offenders. Possible strategies for therapeutic intervention in juvenile criminal justice with uncooperative youth,” (DOI: 10.48299/QS1-2020-001-001), by M. Schneider, a strategic approach to working with these youths is proposed that is based on a review of Gaetano De Leo’s concept of the “educational-reparative contract” and focuses on four key aspects: dual commissioning (youth and Judicial Authority), the positioning of the therapist as a “bridge” between the youth and the judge, specific management of confidentiality that sees active communication by the therapist with other stakeholders, and finally the therapeutic use of the youth’s instrumentality. This work reinforces the idea of making the therapist a resource for the young person, especially if resistant, who can use therapy to achieve his or her goals in the criminal justice process while fostering the development of responsibility and recognition of authority. 

In 2021 in an article titled “The treatment-resistant patient as a resource for family change” (DOI: 10.48299/QS3-2022-003-013) published in  N° 3 of “Quaderni SIRTS,” by M. Schneider and D. Bertolazzi, began to formalize the “Theory of Resistance” by applying it to adult patients as well and proposing a more articulated theoretical framework, which sees its center in the idea of considering such behavior not as an obstacle to be eliminated in order to then “actually” work with the patient, but as a resource for both individual and family change. Resistance is conceptualized here as the expression (albeit counter-intuitive) of a strong bond of the patient with his or her family system, even to the point of being configured as a sign of deep “loyalty” to the family having the purpose of maintaining the equilibrium, albeit dysfunctional, family, or in other cases as a “sacrifice” of the patient made in order to initiate a process of family change. Through a systemic-relational reading in this paper, the most common reactions of family members to their loved one’s resistance behaviors, the most common forms of requesting therapy for a resistant and uncooperative family member, and the implicit expectations of family members are indicated. Some strategic directions for turning this resistance into an effective therapeutic tool are also outlined. The proposal is to consider the patient’s resistance as a “political” act aimed, on the one hand, at preventing deep-seated family problems from disrupting a fragile family balance if brought to the surface, and, on the other hand, at asserting through a “strong” gesture such as resistance an individuality of one’s own with respect to a relational context steeped in dysfunctional power-related dynamics (thus proposing a general change in the family): the resistant patient is understood as one who sacrifices his or her own life in an attempt to activate actors outside the family in order to bring about “necessarily and without possibility of procrastination” changes in the family, in relational dynamics and placements. 

In a subsequent 2022 text titled “Sexuality, Risk Seeking and Extreme Behaviors in Adolescence” (Schneider Edizioni, Milan), by M. Schneider, the presence of a significant correlation between “externalizing” behaviors in adolescents and resistance attitudes is reported. In particular, it is indicated that young people who exhibit such externalizing behaviors also frequently tend to manifest resistance behaviors, expressing it through oppositionality, non-cooperation both with parents and other adult figures of reference (such as teachers or sports coaches), inappropriate sexual and risk-seeking behaviors. These behaviors are read communicatively as a way to “activate” the adult world with respect to a different presence with adolescents. 

In 2024, a new article is published in No. 5 of the N° 5 of the “Quaderni SIRTS”, entitled “A systemic proposal for understanding extreme externalizing behaviors of today’s adolescents,” (DOI: 10.48299/QS5-2024-003-030), by Schneider M, A. Hannibal, A. Rossi, E. Scaramella, in which they point out that many of the resistance behaviors of Western adolescents and the “extreme” behaviors exhibited by them are in close connection with the modern change in educational models (from a “normative” model, based on clear rules and consistency, to an “affective” one, based on emotional understanding and acceptance), but also with a number of macro-social factors that have played a decisive role in the last four decades: globalization, economic and health crises, large-scale migration flows, the emergence of the Internet and social media just to name a few, all of which have created strong uncertainties in families with respect to the best educational and relational methods to have with their children. Added to this is how Western society proposes a “performative” model that emphasizes personal success, competition and effectiveness. These changes and conditions have generated a crisis of reference for young people, who find themselves navigating a world without defined boundaries and, at the same time, experience constant pressure to achieve high goals. The extreme behaviors of adolescents are in this work linked to low levels of self-esteem, to an ideal self-image fueled by external expectations that emphasize performance. Failure or frustration thus becomes intolerable and triggers extreme emotional reactions, including stubborn forms of resistance.

In a 2025 article published in the “Quaderni SIRTS” (N° Special Issue “SIRTS in Mexico”) entitled “‘Externalizing’ Adolescents Who Do Not Accept Therapy” (DOI: 10.48299/QSS1-2025-003-041), by M. Schneider, “Resistance Theory” is first explicitly discussed. In this work, two distinct forms of resistance are explicitly identified: the first, called “resistance in care,” is characterized by the subject’s formal acceptance of a psychological or generally helping (educational, social, etc.) pathway accompanied, however, by a lack of cooperation from the patient/user. The second, called “resistance to treatment,” on the other hand, implies a clear refusal to be taken in charge and to undertake any kind of psychological or more generally helping path.

Entering now more into the technical aspect related to the “Resistance Theory,” we see how the one “in” care is the most studied in the literature and is normally interpreted as a homeostatic phenomenon at the individual level: the patient resists change in order to preserve the status quo and resist insights or personal transformations, as pointed out for example by Gabbard (2015). Resistance Theory, presented here, proposes an expansion of the said perspective by including a relational dimension as well. In particular, the subject may, while following a path, reject change not for purely individual purposes but to protect existing balances and dynamics with significant figures, thus safeguarding specific relational interests. TR thus also defines this type of resistance as “homeostatic” behavior, but the focus is related more to relational dimensions. The goal remains to “not change things,” but the meaning is relational, in that the act of “resisting” is done to “protect” and keep certain relationships unchanged, e.g., alliances, but also in a negative sense conflicts. 

Two clinical vignettes may be helpful in better understanding this type of resistance.

Federico asks his parents to start therapy for “anxiety.” During the sessions, he often does not speak, shares little, says he feels sick but cannot explain why, and cooperates little, does not perform the tasks assigned to him. When the therapist asks him what the therapy is for, he cannot answer. He insists on continuing, but the therapist is exhausted and develops a negative countertransference. The family is uncooperative, fearing that therapy may reveal sensitive issues (particularly related to court cases in the adolescent’s mother’s family of origin).

Anna is a diligent and precise student. She says she is angry with her classmates because they exclude her. However, she has built a “wall” with her parents but does not explain why. She has asked for therapy herself but does not clarify the reasons. She often forgets appointments and does not notify. She claims she wants to continue, even though the sessions seem “empty” and still to her. The parents are confused and do nothing but talk about the girl and her behaviors. This unites them greatly. 

Resistance “to” treatment, on the other hand, is a less studied behavior despite its clinical relevance. This probably stems from the fact that clinicians less frequently come into contact with these patients, except in certain contexts, such as the court setting, which, however, only marginally sets therapeutic transformative goals. Resistance “to” treatment is manifested by a clear and almost total refusal to initiate a course of treatment, despite the fact that relevant symptomatology is often active. The symptoms associated with this type of resistance are often more severe than resistance “in” treatment, and the impact on the social and family context of the resistant individual is more intense. This greater impact on the patient’s relational context is an important element to consider when trying to understand the reasons why a subject so strenuously resists offers of help: as proposed by “Resistance Theory,” this impact generates significant activation of the environment (family, school, institutions, etc.). Resistance “to” treatment, combined with the patient’s often evident symptomatology and the impact of it on the subject’s system of belonging, is in fact posed as an “activating others” behavior in that it is often the people close to the resistant subject who are the ones who are activated to change things, requesting specialized interventions or, in some cases, involving the Judicial Authority.

These considerations make it possible to formulate two important reflections according to TR: the first is that resistance “in” care is an active and paradoxical behavior that avoids change through the adoption of a behavior of apparent willingness to change. Resistance “in care” in fact sees the subject adhere, at least formally, to a pathway and this induces him but especially others around him to “block” any other form of activation, even in the absence of concrete “results,” with a view to waiting for the pathway to produce its effects of change. This type of resistance in fact produces a situation in which the patient first but also the therapist and all those around the patient are “stationary” and therefore do not consider options other than therapy since in any case the patient, even if he does not change, is “following a path.” 

The second consideration, on the other hand, concerns resistance “to” treatment, which is understood as a more direct and clear behavior that tends in its pragmatic effects to result in an activation of subjects close to the patient. The patient in fact, although symptomatic, does not intend in this type of resistance to adhere to any project of help and change, and this triggers in the subjects close to him a series of reactions, so to speak, “obligatory.” Often, in fact, the patient’s symptomatology is so evident and at times disturbing that it dictates, in light of the patient’s refusal to therapy, that nonetheless “something must be done,” thus producing a third party activation with respect to the patient. The fact that the patient through his refusal does not intend to remedy a situation that often has major effects on third persons as well is a condition that is often intolerable for those close to him, normally putting family members in a position that imposes the imperative need to “do something.” This leads in many cases, and certainly much more frequently than with resistance “in” care, to the initiation of a process of activation of family members, which is in various circumstances more likely to transform the patient’s own relational context, a transformation made possible precisely because of the patient’s rejection of care.  

In a systemic perspective, the patient resistant “to” care (and in particular the adolescent) can be regarded as an agent of change in that, while formally opposing change, he or she lays the groundwork for that process of change to take place, mostly by family members and often also within a short time frame (given the urgency dictated by some of the adolescent’s behaviors).

In addition to the pragmatic effects of the two types of resistance and their implicit goals, TR is also concerned with trying to define some of the underlying motivations for resistance, dividing them into individual and family. 

With regard to the individual level, resistance (both “to” treatment and “in” treatment) may be acted upon by the subject when he or she has a perception of the futility of the proposed intervention or experiences a failure to recognize his or her individual needs by the practitioners and the psychologist. Resistance toward therapy may also take on an instrumental function, aimed at maintaining secondary advantages over the family unit or social context. 

On the family level, on the other hand (i.e., with respect to the behavior of family members), resistance behavior may be fueled by fears regarding the consequences for other family members of the adolescent’s possible participation in treatment. For example, in the case of child protective services, the fear concerns younger children: there is a fear that the adolescent may reveal dynamics or information that may harm other family members. In other cases, there is a fear that the adolescent’s change in therapy may disrupt fragile family balances, such as a conflicting couple relationship but rendered silent by the adolescent’s symptomatology. The driving force for resistance, however, may also be at the family level the desire to keep important family secrets hidden or be fueled by feelings of anger and resentment toward services and practitioners, perhaps because of the family’s previous negative experiences with services or the treatment system as a whole. 

CONCLUSIONS

The concept of resistance, historically rooted in the psychoanalytic tradition, has gradually transformed into a complex and multidimensional category capable of integrating intrapsychic, relational and systemic aspects. In adolescence, this concept assumes particular relevance because it allows for the interpretation of oppositional or dysfunctional behaviors not as mere obstacles to treatment, but as significant expressions of the subject’s relational world and its most meaningful alliances.

Through the distinction between physiological and pathological resistance and between resistance “in” treatment and “to” treatment, proposed by the “Theory of Resistance,” it is possible to articulate a complex reading of the ways in which adolescents relate to therapy and helping contexts, capturing not only their fears, defenses and ambivalences but also, and above all, the implicit signals and goals of this behavior. 

“Resistance Theory” is proposed as a way of reading patient and family members’ resistance behaviors toward therapy that can integrate the different reflections produced by the psychodynamic perspective with the systemic view, inviting us to consider resistance as an active behavior that “speaks” to many subjects at once and for that reason results in a clinical resource to be welcomed, understood and utilized.

In the systemic-relational perspective, resistance cannot in fact be configured as simple individual behavior, but should be read in a “circular” way as an outcome and at the same time an active producer of complex family, school and/or institutional dynamics. 

On a therapeutic level, recognizing the correct type of resistance manifested by the patient and understanding the meanings, both individual and family-related, represents a privileged pathway to gaining deeper knowledge of a given patient and their family, as well as to strengthening the therapeutic alliance.

Bibliography

Freud, S. (1900/2010). L’interpretazione dei sogni [The interpretation of dreams] (trad. it.). Torino: Einaudi.

Freud, S. (1914/2006). Ricordare, ripetere e rielaborare [Remembering, repeating and working-through] (trad. it.). Torino: Einaudi.

Gabbard, G. O. (2015). Psychodynamic psychiatry in clinical practice (5th ed.). Washington, DC: American Psychiatric Publishing.

Kernberg, O. F. (1975). Borderline conditions and pathological narcissism. New York, NY: Jason Aronson.

Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press.

Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York, NY: Guilford Press.

Schneider, M. (2020). Adolescenti autori di reato. Strategie possibili di intervento terapeutico nel penale minorile con giovani non collaboranti [Adolescent offenders. Possible strategies for therapeutic intervention in juvenile criminal justice with uncooperative youth]. Quaderni SIRTS, 1, 4–15. Retrieved from http://www.sirts.org/images/quaderni/finiti/quaderni_n1-2020.pdf

Schneider, M., & Bertolazzi, D. (2021). Il paziente resistente alla cura come risorsa per il cambiamento familiare [The treatment-resistant patient as a resource for family change]. Quaderni SIRTS, 3, 39–47. Retrieved from https://www.sirts.org/images/documenti-generali/quaderni/numeri-pubblicati/quaderni_numero_3_definitivo.pdf

Schneider, M. (2021). I tanti misteri dell’adolescenza. Accompagnare i propri figli tra paure, scoperte e bisogno di affermazione personale [The many mysteries of adolescence. Accompanying one’s children amid fears, discoveries, and the need for personal affirmation] (2nd rev. & expanded ed.). Milano: Schneider Edizioni.

Schneider, M. (2022). Sessualità, ricerca del rischio e comportamenti estremi in adolescenza [Sexuality, risk-seeking and extreme behaviour in adolescence]. Milano: Schneider Edizioni.

Schneider, M. (2025). Adolescenti “esternalizzanti” che non accettano la terapia [‘Externalizing’ adolescents who do not accept therapy]. Quaderni SIRTS, Special Issue “SIRTS in Messico”, 21–34. Retrieved from https://www.sirts.org/images/documenti-generali/quaderni/numeri-pubblicati/Quaderno_speciale_messico.pdf

Translation by Arianna Modena, Francesca Zuccalà and Alessia Gallimberti

Freud, S. (1914/2006). Ricordare, ripetere e rielaborare (trad. it.).

Autors

 1 Marco Schneider, Clinical Psychologist and Systemic-Relational Psychotherapist, lives and works privately in Italy. He is the Director of the Master’s program in “Clinical Systemic Adolescence” for the Italian training organization “Spazio Iris” (www.spazioiris.it ), for which he is also a lecturer in the Master’s program of Higher Education in Psychology “Pathological Addictions.” He is an expert on troubled families and adolescence. In his career, he has worked among others at the juvenile prison “C. Beccaria” in Milan (Italy), at “S.O.S. Telefono Azzurro” (Emergency Help Line for Childhood and Adolescence), at several Public Services for young offenders, for families in difficulty in collaboration with the Juvenile Court, for Hospital Child Neuropsychiatry. Since 2019, he has been Editor-in-Chief of the journal “Quaderni SIRTS,” a journal of the Italian Society for Systemic Research and Therapy, founded in 1985 by Boscolo and Cecchin. He is on the Board of the Italian Society for Research in Systemic Therapy (www.sirts.org), is a member of the European Society of Family Therapy (EFTA – CIM) and the Italian Society of Psychology and Relational Psychotherapy (SIPPR). He regularly lectures in Italy and abroad, participating as a speaker at international congresses. He is the author of several scientific articles on problematic adolescence and three volumes on adolescence.

He is involved in family psychological treatment of difficult youth and therapy with resistant and uncooperative patients.

2 Arianna Modena, graduate in Psychological Science and Techniques, with experience in supporting minors in fragile situations, gained through work in the educational field, with schools, children’s services and associations. She has taken part in rehabilitation activities in hospital settings.

3 Francesca Zuccalà, holds a degree in Psychological Sciences and Techniques and student in Clinical and Health Psychology: person, family and community relations.

In her work, she has gained experience in the field of disability, particularly in educational and relational work with people with Down syndrome. She currently collaborates with the Italian Multiple Sclerosis Association-Provincial Section of Milan.

4 Alessia Galimberti, holds a degree in Psychological Sciences and Techniques, with experience in child protection contexts, in the psycho-social-educational field, and in working with families in difficulty. She is currently engaged in ADM activities in the Milan area. She also had the opportunity to further her studies at the Université Paris Nanterre, completing her Master’s research thesis in the field of developmental psychology and child protection.