Germán Miguelina, Smith Heather L, Rivera-Morales Camila, González Garnetta, Haliczer Lauren A, Haaz Chloe, Miller Alec L
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
Am J Psychother. 2015;69(2):179-97. doi: 10.1176/appi.psychotherapy.2015.69.2.179.
The primary aim of this paper is to describe extreme behavioral patterns that the authors have observed in treating Latina adolescents who are suicidal and their parents within the framework of dialectical behavior therapy (DBT). These extreme patterns, called dialectical corollaries, serve to supplement the adolescent/family dialectical dilemmas described by Rathus and Miller (2002) as part of dialectical behavior therapy for suicidal adolescents with borderline personality features. The dialectical corollaries proposed are "old school versus new school" and "overprotecting" versus "underprotecting," and they are described in-depth. We also identify specific treatment targets for each corollary and discuss therapeutic techniques aimed at achieving a synthesis between the polarities that characterize each corollary. Lastly, we suggest clinical strategies to use when therapists reach a therapeutic impasse with the parent-adolescent dyad (i.e., dialectical failures).
本文的主要目的是描述作者在辩证行为疗法(DBT)框架内治疗有自杀倾向的拉丁裔青少年及其父母时所观察到的极端行为模式。这些极端模式被称为辩证推论,用于补充拉瑟斯和米勒(2002年)所描述的青少年/家庭辩证困境,这是针对具有边缘性人格特征的自杀青少年的辩证行为疗法的一部分。所提出的辩证推论是“老派与新派”以及“过度保护”与“保护不足”,并对其进行了深入描述。我们还确定了每个推论的具体治疗目标,并讨论了旨在实现每个推论所特有的两极之间综合的治疗技术。最后,我们提出了治疗师在与亲子二元组陷入治疗僵局(即辩证失败)时可采用的临床策略。