Dialectical Behavior Therapy for Suicidal Latina Adolescents: Supplemental Dialectical Corollaries and Treatment Targets

Abstract

The main goal of this paper would be to describe extreme behavioral habits that the authors have actually seen in dealing with Latina adolescents that are suicidal and their moms and dads inside the framework of dialectical behavior therapy (DBT). These extreme habits, called dialectical corollaries, serve to supplement the adolescent/family dialectical dilemmas described by Rathus and Miller (2002) included in dialectical behavior therapy for suicidal adolescents with borderline personality features. The dialectical corollaries proposed are “old college versus brand new school” and “overprotecting” versus “underprotecting” and they’re described in-depth. We also identify specific therapy objectives for every corollary and discuss techniques that are therapeutic at attaining a synthesis amongst the polarities that characterize each corollary. Finally, we recommend clinical techniques to utilize whenever practitioners reach a healing impasse with the parent-adolescent dyad (in other words., dialectical failures).

Introduction

Last year, the Youth Behavior Risk Surveillance System discovered that 21% of Latina adolescent females seriously considered a committing suicide effort (SA) in the past 12 months and 14% had involved in one or more committing committing suicide attempt (Centers for infection Control and Prevention). These SA prices were more than those for African-American (8.8%) and Caucasian-American adolescent females (7.9%). At Montefiore healthcare Center’s Adolescent anxiety and Suicide Program within the Bronx, NY, nearly all patients are Latina adolescents. Our group carried out studies with Latina adolescents, moms and dads, and treating clinicians utilizing the objective of enhancing our treatment protocol because of this group that is high-riskGermán, González, & Rivera-Morales, 2013; Germán, Haaz, Haliczer, Bauman, & Miller, 2013).

A promising treatment plan for Latina adolescents who’re suicidal is dialectical behavior treatment (DBT), an evidence-based therapy initially developed for adults with borderline character disorder (BPD) have been chronically suicidal (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991; Linehan et al., 2006; Van den Bosch & Verheul, 2007; Verheul et al., 2003). Dialectical behavior treatment had been adjusted for usage with teenagers by Rathus and Miller (2002). Studies comparing DBT to treatment-as-usual conditions show promising leads to reducing deliberate self-harm behavior, psychiatric hospitalizations, suicidal ideation, despair, hopelessness, and borderline personality disorder symptomatology (Mehlum et al., 2014; Rathus & Miller, 2002).

Marsha Linehan (1993) proposed that people who participate in suicidal and nonsuicidal self-injurious behaviors (NSSI) with an analysis of BPD usually turn to extreme behavioral patterns, which are described in DBT as dialectical dilemmas. Whenever these habits happen, the shifts that are individual polarized behavioral extremes in an attempt to control his / her psychological state. Nonetheless, these habits are inadequate and frequently function to over or under control the individual’s feelings and habits, as they are hence considered as “dialectical problems.” Consequently, Linehan (1993) developed therapy objectives to locate a synthesis involving the behavioral that is extreme by decreasing these maladaptive habits ( e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive habits (e.g., active problem solving, efficiently requesting assistance, and self-validation). See Linehan (1993) for a complete writeup on the original DBT dialectical dilemmas.

In working together with adolescents who possess numerous issues and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral patterns that had been transactional in the wild and occurred between your adolescent and their or her environment. They identified three dialectical problems specific to dealing with adolescents and their moms and dads (in other terms., extortionate leniency versus authoritarian control, normalizing pathological actions versus pathologizing normative behavior, and fostering dependence versus forcing autonomy). These dialectical issues were beneficial to conceptualize adolescents’ and their moms and dads’ problematic behavioral habits and also to further formulate appropriate therapy objectives.

According to our research findings and medical findings of Latina adolescents and families, the present writers increase upon the current adolescent dialectical problems by proposing supplemental dialectical corollaries usually noticed in Latino families. We first review the existing adolescent/family dialectical dilemmas, then talk about the dialectical corollaries. Our Mocospace tips objectives are to give extra interpretations for the adolescent dilemmas to foster a significantly better knowledge of the extreme behavioral habits that will manifest in Latino families and better inform our therapy targets and methods.

Quick Report On Adolescent Dialectical Problems 1

Exorbitant Leniency versus Authoritarian Control

Moms and dads 2 frequently waver between two extremes in this issue. Excessive leniency refers to moms and dads being overly permissive by simply making too little demands that are behavioral their teenagers. Authoritarian control refers towards the opposite—parents being too punitive. A good example of extortionate leniency is whenever moms and dads try not to enforce effects with their child skipping classes that she may engage in self-harm behaviors if she receives a consequence because they believe. Consequently, moms and dads might be left feeling resentful, powerless, puzzled or guilty while they genuinely believe that their parenting behavior is not in line due to their values that are personal. In this instance, over the years while the parents’ not enough enforcing consequences that are appropriate, the adolescent’s emotional and behavioral sequelae often intensify (e.g., she now cuts college more often, is a deep failing every one of her highschool classes, and it is violating curfew).

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