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 that are 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) 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 techniques that are therapeutic at attaining a synthesis involving the polarities that characterize each corollary. Lastly, we suggest medical techniques to make use of when practitioners reach an impasse that is therapeutic the parent-adolescent dyad (for example., dialectical problems).

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 12 months and 14% had involved in a minumum of one suicide effort (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%). At Montefiore health Center’s Adolescent Depression and Suicide Program within the Bronx, NY, nearly all clients are Latina adolescents. Our group carried out studies with Latina adolescents, moms and dads, and dealing with clinicians with all the aim 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) 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 treatment ended up being adapted 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 happen, the specific changes between polarized behavioral extremes in an attempt to manage their psychological state. Nevertheless, these habits are inadequate and sometimes function to over or under control the individual’s feelings and actions, and they are hence considered as “dialectical problems.” Appropriately, Linehan (1993) developed therapy objectives to get a synthesis amongst the behavioral that is extreme by decreasing these maladaptive habits ( ag e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive habits (e.g., active problem solving, effortlessly seeking assistance, and self-validation). See Linehan (1993) for the full overview of the original DBT dialectical dilemmas.

In working together with adolescents who possess multiple issues and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral habits that had been transactional in general and happened amongst the adolescent and their or her environment. They identified three dialectical problems specific to dealing with adolescents and their parents (in other terms., extortionate 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 existing writers increase upon the current adolescent dialectical issues by proposing supplemental dialectical corollaries usually noticed in Latino families. We first review the adolescent/family that is existing dilemmas, then discuss the dialectical corollaries. Our objectives are to give you additional interpretations associated with the adolescent dilemmas to foster a far 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 Issues 1

Extortionate Leniency versus Authoritarian Control

Moms and dads 2 frequently waver between two extremes in this problem. Excessive leniency refers to parents being extremely permissive by simply making too little demands that are behavioral their teenagers. Authoritarian control refers towards the opposite—parents being too punitive. A typical example of extortionate leniency is whenever moms and dads don’t enforce consequences 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 can be left feeling resentful, powerless, unclear or guilty because they think that their parenting behavior is not in line using their values that are personal. In this example, over the years 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 failing each of her twelfth grade classes, and it is violating curfew).

Comments are closed, but trackbacks and pingbacks are open.