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

Abstract

The main purpose of this paper would be to explain extreme behavioral habits that the writers have seen in dealing with Latina adolescents who’re suicidal and their moms and dads in the framework of dialectical behavior therapy (DBT). These patterns that are extreme 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 certain therapy objectives for every corollary and discuss therapeutic practices aimed at achieving a synthesis involving the polarities that characterize each corollary. Finally, we recommend medical methods to make use of whenever practitioners reach a healing impasse with the parent-adolescent dyad (for example., dialectical failures).

Introduction

Last year, the Youth Behavior Risk Surveillance System discovered that 21% of Latina adolescent females seriously considered a committing committing committing suicide effort (SA) in the past year and 14% had engaged in a minumum of one committing committing suicide effort (Centers for infection Control and Prevention). These SA prices had been higher than those for African-American (8.8%) and Caucasian-American adolescent females (7.9%). At Montefiore health Center’s Adolescent Depression and Suicide Program into the Bronx, NY, nearly all clients are Latina adolescents. Our group carried out studies with Latina adolescents, moms and dads, and dealing with clinicians utilizing the objective of increasing bbd83df999c313dd341a34b62cd15a7f - Dialectical Behavior Therapy for Suicidal Latina Adolescents: Supplemental Dialectical Corollaries and Treatment Targets our therapy protocol with 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) who 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 therapy had been adjusted to be used with teenagers by Rathus and Miller (2002). Studies comparing DBT to treatment-as-usual conditions have indicated 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 take part in suicidal and nonsuicidal self-injurious behaviors (NSSI) with an analysis of BPD usually turn to extreme behavioral habits, that are described in DBT as dialectical dilemmas. Whenever these habits happen, the shifts that are individual polarized behavioral extremes in order to manage his / her emotional state. Nevertheless, these patterns are inadequate and frequently function to over or under control the individual’s feelings and habits, and generally are therefore considered as “dialectical failures.” Correctly, Linehan (1993) developed therapy goals to locate a synthesis between your behavioral that is extreme by decreasing these maladaptive habits ( e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive actions (e.g., active problem solving, effectively seeking assistance, and self-validation). See Linehan (1993) for the full post on the original DBT dialectical dilemmas.

In working together with adolescents who possess numerous dilemmas and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral patterns that had been transactional in nature and happened amongst the adolescent and their or her environment. They identified three dialectical issues specific to dealing with adolescents and their moms and dads (for example., exorbitant leniency versus authoritarian control, normalizing pathological actions versus pathologizing normative behavior, and fostering dependence versus forcing autonomy). These dialectical issues have now been useful to conceptualize adolescents’ and their moms and dads’ problematic behavioral habits and also to further formulate treatment that is appropriate.

Centered on our research findings and medical observations of Latina adolescents and families, the present authors increase upon the current adolescent dialectical problems by proposing supplemental dialectical corollaries usually noticed in Latino families. We first review the adolescent/family that is existing dilemmas, then talk about the dialectical corollaries. Our objectives are to deliver extra interpretations for the adolescent dilemmas to foster a much better comprehension of the extreme behavioral habits that can manifest in Latino families and better inform our therapy goals and strategies.

Quick Writeup On Adolescent Dialectical Problems 1

Exorbitant Leniency versus Authoritarian Control

Moms and dads 2 often waver between two extremes in this problem. Excessive leniency refers to moms and dads being extremely permissive by simply making not enough behavioral needs on their teenagers. Authoritarian control refers towards the opposite—parents being too punitive. A typical example of extortionate leniency is when moms and dads try not to enforce effects with their daughter skipping classes that she may engage in self-harm behaviors if she receives a consequence because they believe. Consequently, moms and dads can be left feeling resentful, powerless, disoriented or guilty because they think that their parenting behavior is not in line using their individual values. In this instance, after a while and also 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 each of her senior high school classes, and is violating curfew).



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