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

Abstract

The principal goal of this paper would be to explain extreme behavioral habits that the writers have seen in dealing with Latina adolescents who will be suicidal and their moms and dads in the framework of dialectical behavior therapy (DBT). These extreme habits, called dialectical corollaries, provide to supplement the adolescent/family dialectical dilemmas described by Rathus and Miller (2002) as an element of 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” plus they are described in-depth. We also identify particular therapy goals for every corollary and discuss therapeutic practices aimed at attaining a synthesis involving the polarities that characterize each corollary. Finally, we recommend clinical techniques to make use of whenever therapists reach a therapeutic impasse with the parent-adolescent dyad (in other words., dialectical problems).

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 year and 14% had involved with one or more committing committing suicide attempt (Centers for infection Control and Prevention). These SA prices had been more than those for African-American (8.8%) and Caucasian-American adolescent females (7.9%). The majority of patients are Latina adolescents at Montefiore Medical Center’s Adolescent Depression and Suicide Program in the Bronx, NY. Our group carried out studies with Latina adolescents, moms and dads, and dealing with clinicians because of the aim of enhancing our therapy protocol with this high-risk team (Germán, González, & Rivera-Morales, 2013; Germán, Haaz, Haliczer, Bauman, & Miller, 2013).

A promising treatment plan for Latina adolescents who will be suicidal is dialectical behavior therapy (DBT), an evidence-based therapy initially developed for adults with borderline character disorder (BPD) who had been chronically suicidal (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991; Linehan et al., 2006; Van den Bosch & Verheul, 2007; Verheul et al., 2003) hookupdate.net/bhm-dating/. Dialectical behavior treatment 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 folks who practice suicidal and nonsuicidal self-injurious behaviors (NSSI) with an analysis of BPD usually turn to extreme behavioral habits, that are known in DBT as dialectical dilemmas. Whenever these habits occur, the shifts that are individual polarized behavioral extremes in order to regulate his / her psychological state. Nevertheless, these patterns are inadequate and sometimes function to over or under control the individual’s feelings and habits, and are also therefore considered as “dialectical problems.” correctly, Linehan (1993) developed therapy goals to locate a synthesis between your behavioral that is extreme by decreasing these maladaptive habits ( ag e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive actions (e.g., active problem solving, efficiently requesting assistance, and self-validation). See Linehan (1993) for a complete writeup on the DBT dialectical dilemmas that is original.

In using the services of adolescents that have numerous issues and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral habits that had been transactional in nature and took place amongst the adolescent and their or her environment. They identified three dialectical problems specific to using adolescents and their moms and dads (in other words., exorbitant leniency versus authoritarian control, normalizing pathological actions versus pathologizing normative behavior, and fostering dependence versus forcing autonomy). These dialectical issues were useful to conceptualize adolescents’ and their moms and dads’ problematic behavioral habits and to further formulate appropriate therapy objectives.

Centered on our research findings and medical observations of Latina adolescents and families, the existing writers expand upon the adolescent that is existing issues 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 give you extra interpretations for the adolescent dilemmas to foster a much better knowledge of the extreme behavioral habits that may manifest in Latino families and better inform our therapy goals and methods.

Quick Summary Of Adolescent Dialectical Problems 1

Extortionate Leniency versus Authoritarian Control

Parents 2 often waver between two extremes in this problem. Excessive leniency refers to moms and dads being extremely permissive by simply making too little behavioral needs on their teenagers. Authoritarian control refers towards the opposite—parents being too punitive. A good example of extortionate leniency occurs when moms and dads usually do not enforce effects because of their child 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, overwhelmed or guilty while they genuinely believe 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 appropriate effects continues, the adolescent’s emotional and behavioral sequelae often intensify (e.g., she now cuts college more often, is a deep a deep failing each of her senior school classes, and it is violating curfew).