This paper proposes that clinical practice based on psychiatric diagnoses and categories of harmful behavior may be inadequate at best and harmful at worst. An alternative model of functional family formulations is proposed based on exposure to danger, developmental processes around danger, information processing regarding danger, and strategies for coping with danger. These are encompassed by the dynamic-maturational model of attachment and adaptation (DMM). DMM theory is outlined, then four types of harmful behavior that have resisted treatment are described, each with a case and treatment outcomes: physical abuse, disruptive child behavior, psychosis, and autism. We conclude by describing how these four cases address both children’s and parents’ need for safety and developmental progress in representing and responding to threats, and also professionals’ need for a treatment-relevant nosology of human suffering.

中文翻译：

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作为心理治疗指南的家庭功能配方

本文提出，基于精神病学诊断和有害行为类别的临床实践可能充其量是不充分的，最坏的情况是有害的。基于暴露于危险、围绕危险的发展过程、关于危险的信息处理以及应对危险的策略，提出了功能性家庭公式的替代模型。这些都包含在依恋和适应的动态成熟模型 (DMM) 中。概述了 DMM 理论，然后描述了四种拒绝治疗的有害行为，每种都有一个案例和治疗结果：身体虐待、破坏性儿童行为、精神病和自闭症。我们最后描述了这四个案例如何解决儿童和父母在代表和应对威胁方面对安全和发展进步的需求，