The cognitive, physical, personality, sexual, and moral developmental tasks of childhood and adolescence are monumental at best. Youth need support, guidance, encouragement, and safety in order to make a successful transition to maturity. Without safety, consistency, fulfillment of dependency needs, and attainment of love and a sense of belonging, they will struggle to develop a positive sense of identity, attachment, and ego strength. Child abuse greatly hinders the developmental process, and chronic child abuse causes serious concerns for adolescents. Adolescents who have received appropriate care throughout their childhoods, only to face abuse that emerges during adolescence, also suffer; however, the fact that sufficient attention has been given to critical developmental tasks gives adolescents without previous abuse a more optimistic prognosis, particularly if the crisis brought on by familial adolescent abuse can be successfully resolved within the family system. Children who have been abused all their lives have not had similar opportunities to achieve physical, emotional, personality, or cognitive development. Chronic abuse may have left them debilitated or impaired. As adolescents they will have numerous issues to resolve: developmental delays; impaired identities; feelings of insecurity; inability to trust; internalized or externalized anger; and varying degrees of impairment in their abilities to form positive attachments, friendships, or rewarding intimate relationships. At the same time, many of the qualities that clinicians describe as difficult -- resistance, opposition, manipulation, anger, negative attention-seeking -- may be these juveniles' way to assert boundaries, get their needs met, and exert control in ways denied to them previously. Clinicians must constantly address their countertransference responses to avoid engaging with adolescents in interactional modes reminiscent of their dysfunctional parents. Clinicians must also monitor adolescents' transferential responses and behaviors designed to elicit negative, hostile, or sexualized responses. Case histories are included to illustrate the concepts discussed.