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

Abstract

The main goal of this paper is always 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) 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 objectives for every single corollary and discuss therapeutic techniques aimed at attaining a synthesis amongst the polarities that characterize each corollary. Finally, we recommend medical methods to utilize whenever practitioners reach a healing impasse with the parent-adolescent dyad (for example., dialectical problems).

Introduction

Last year, the Youth Behavior Risk Surveillance System unearthed that 21% of Latina adolescent females seriously considered a committing committing suicide effort (SA) in the past year and 14% had involved in a minumum of one committing suicide effort (Centers for infection Control and Prevention). These SA prices had been greater than those for African-American (8.8%) and Caucasian-American adolescent females (7.9%). At Montefiore healthcare Center’s Adolescent anxiety and Suicide Program when you look at the Bronx, NY, nearly all clients are Latina adolescents. Our group carried out studies with Latina adolescents, moms and dads, and dealing with clinicians because of the objective of improving our therapy protocol with this group that is high-riskGermán, González, & Rivera-Morales, 2013; Germán, Haaz, Haliczer, Bauman, & Miller, 2013).

A treatment that is promising Latina adolescents that are 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; https://worlddatingnetwork.com/ Van den Bosch & Verheul, 2007; Verheul et al., 2003). Dialectical behavior treatment ended up being adjusted for usage 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 participate in suicidal and nonsuicidal self-injurious behaviors (NSSI) with an analysis of BPD frequently turn to behavioral that is extreme, that are known in DBT as dialectical dilemmas. Whenever these habits happen, the specific changes between polarized behavioral extremes in an attempt to control his or her psychological state. Nevertheless, these patterns are inadequate and frequently function to over or under manage the individual’s feelings and actions, and generally are hence considered as “dialectical problems.” correctly, Linehan (1993) developed treatment goals to locate a synthesis amongst the extreme behavioral designs by decreasing these maladaptive habits ( ag e.g., active passivity, obvious competence, self-invalidation) and increasing adaptive actions (e.g., active problem solving, efficiently 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 numerous dilemmas and BPD features, Miller, Rathus, and Linehan (2007) described additional extreme behavioral habits that were transactional in nature and happened involving the adolescent and their or her environment. They identified three dialectical issues specific to working together with adolescents and their moms and dads (for example., 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 appropriate therapy objectives.

Considering our research findings and medical findings 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, and then talk about the dialectical corollaries. Our objectives are to present extra interpretations associated with the adolescent dilemmas to foster a much better comprehension of the extreme behavioral habits that will manifest in Latino families and better inform our therapy goals and methods.

Quick Breakdown Of Adolescent Dialectical Problems 1

Exorbitant Leniency versus Authoritarian Control

Moms and dads 2 usually 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 teens. Authoritarian control refers to your opposite—parents being too punitive. A typical example of extortionate leniency occurs when moms and dads try not to enforce effects with regards to their child skipping classes simply because they think that she may take part in self-harm behaviors if she gets an effect. Therefore, moms and dads could be left feeling resentful, powerless, unclear or guilty because they genuinely believe that their parenting behavior is not in line along with their individual values. In this example, over the years 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 a deep failing every one of her senior school classes, and it is violating curfew).