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author image by sofia | 0 Comments | 15 de marzo de 2021

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


The main purpose of this paper would be to explain extreme behavioral habits that the writers have seen in dealing with Latina adolescents that are suicidal and their moms and dads inside the framework of dialectical behavior therapy (DBT). These patterns that are extreme called dialectical corollaries, provide 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 brand new school” and “overprotecting” versus “underprotecting” plus they are described in-depth. We also identify particular therapy objectives for every single corollary and discuss techniques that are therapeutic at attaining a synthesis involving the polarities that characterize each corollary. Finally, we recommend medical techniques to make use of whenever practitioners reach a healing impasse with the parent-adolescent dyad (for example., dialectical problems).


Last year, the Youth Behavior Risk Surveillance System unearthed that 21% of Latina adolescent females seriously considered a committing suicide effort (SA) in the past year and 14% had involved in a minumum of one committing committing suicide attempt (Centers for infection Control and Prevention). These SA prices were greater 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 with all the goal of increasing our therapy protocol because of this high-risk team (Germán, González, & Rivera-Morales, 2013; Germán, Haaz, Haliczer, Bauman, & Miller, 2013).

A treatment that is promising Latina adolescents who will be 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 ended up being adapted to be used with teens by Rathus and Miller (2002). Studies comparing DBT to treatment-as-usual conditions demonstrate promising leads to reducing deliberate behavior that is self-harm 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 habits, that are referred to in DBT as dialectical dilemmas. When these habits happen, the specific changes between polarized behavioral extremes in an attempt to manage their psychological state. Nonetheless, these habits are inadequate and sometimes function to over or under manage the individual’s emotions and habits, and therefore are therefore considered as “dialectical failures.” Correctly, Linehan (1993) developed therapy objectives discover a synthesis involving the extreme behavioral styles by decreasing these maladaptive habits ( ag e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive actions (e.g., active problem solving, effortlessly requesting assistance, and self-validation). See Linehan (1993) for a complete report about the original DBT dialectical dilemmas.

In using the services of adolescents who possess numerous dilemmas and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral habits that had been transactional in the wild and happened between your adolescent along with his or her environment. They identified three dialectical problems specific to using the services of 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 are beneficial to conceptualize adolescents’ and their moms and dads’ problematic behavioral habits and also to further formulate appropriate therapy targets.

Centered on 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 frequently seen in Latino families. We first review the existing adolescent/family dialectical dilemmas, then talk about the dialectical corollaries. Our objectives are to give extra interpretations for the adolescent dilemmas to foster a far better knowledge of the extreme behavioral habits that can manifest in Latino families and better inform our therapy targets and methods.

Quick Overview Of Adolescent Dialectical Issues 1

Extortionate Leniency versus Authoritarian Control

Parents 2 frequently waver between two extremes in this problem. Excessive leniency refers to moms and dads being extremely permissive by simply making too little behavioral demands on their teens. Authoritarian control refers to your opposite—parents being too punitive. A typical example of exorbitant leniency is whenever moms and dads usually do not enforce effects with their child skipping classes simply because they genuinely believe that she may take part in self-harm behaviors if she gets an effect. Therefore, moms and dads can be left feeling resentful, powerless, unclear or guilty while they believe that their parenting behavior is not in line making use of their personal values. In this instance, after a while 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 with greater regularity, is a deep a deep failing most of her senior high school classes, and it is violating curfew).

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