It's a reality tv show where he confronts people about issues they aren't ready to confront. He's surprisingly effective at it, though I wouldn't like sensitive people to go on the show. He's a one man intervention, it's always going to be hard to hear but for those who hear it, it can be a bridge to getting their life in order.
They try and set up therapy for people after the show but I doubt it's much good. It's a big picture view of psychology, when it needs to be on a more personal level. He is very quick on his feet and able to meet people effectively. He may be a bit of a douchebag but he's got skills.
I don't see the problem with Lindsay Lohan's mum. She clearly needs to be told to wake up from her stupor. Why you'd pay more respect to Howard Stern's opinion is beyond me.