Abstract
The primary aim of this paper is to describe the central dialectical dilemmas the authors have observed in treating suicidal adolescents and their families using Dialectical Behavior Therapy (DBT). These dilemmas supplement those described by Linehan in standard DBT with adults. The adolescent/family dialectical dilemmas are excessive leniency vs. authoritarian control, normalizing pathological behaviors vs. pathologizing normative behaviors, and forcing autonomy vs. fostering dependence. We also discuss the corresponding treatment targets we have identified; these are aimed at achieving a synthesis between the polarities inherent in each dialectical dilemma.
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