Thanks James,

I have to make a CPD presentation and felt this may be an interesting topic particularly in relation to working with children in residential care. I wasn't too sure about the possibility of using CBT for personality disorder strategies with such a population.

I am guessing the point of any intervention in the child/adolescent population is to interrupt the development of schemas that are negative and dysfunctional before they become standard methods of interacting with the world. My only question is to know when these schemas are pervasive and persistent.

The aim of working with the family is key to treatment but it is difficult if the family system is a maintaining factor. What recommendations would you suggest for a passive-aggressive approach to change in an adolescent?