A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents.

Abstract

As so-called third wave therapies, Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT), alongside with Mode Deactivation Therapy (MDT), are derivatives of Cognitive Behavioral Therapy (CBT). (Classical behavioral therapies are referred to as the first wave, and classical cognitive therapies as the second wave.) Currently these three types of therapy have been showing an increased amount of success with adolescent youth who have been suffering from disorders such as Conduct Disorder, post-traumatic stress symptomology, and other mood disorders (Apsche, DiMeo, & Kohlenberg, 2012; Apsche, Bass, & Backlund, 2012; Powers, Vording, & Emmelkamp, 2009). Dialectical Behavior Therapy DBT was developed in 1993 by Prof. Marsha Linehan, who wanted to adapt CBT when she recognized the shortcomings of the approach with her borderline personality disordered patients (Bayles, Blossom, & Apsche, 2014). The main objective was to accommodate those specific characteristics such as extreme emotional reactivity and high sensitivity to vulnerabilities like perceived rejection. DBT uses a variation of CBT that teaches the patient specific skills they will need to cope with stress, and to help in regulating their emotions (Apsche, 2010). Since then, it has been shown to be useful for treating a wide variety of presenting issues, including suicidal behaviors, substance abuse, eating disorders, and depression (Murphy & Siv, 2012; Dimeff & Koerner, 2007). The main goal of DBT is to teach the individual the skills that they will need to cope with stress (Apsche & DiMeo, 2012). This gives them tools that they will need to change their current negative coping mechanisms into positive ones that will help them to regulate their emotions and improve relationships with others around them (Apsche, 2010). It will then teach the individual the skills that are needed to cope in a positive manner to stress, regulate their emotions, and to help them improve relationships with other such as for adolescents their parents and other family members. There are four key components that make DBT successful; (a) cognitive behavioral theoretical framework, (b) validation, (c) dialectics, and (d) radical acceptance (Bayles, Blossom, & Apsche, 2014). DBT uses dialectics which applies the concept that everything is made up of opposites and the change that happens is when one opposing force is stronger than the other. This has three basic assumptions, first being; all things are interconnected. Second, change is constant and inevitable. Third, the opposites can be integrated to form a closer approximation (Apsche, 2010; Murphy & Siv; 2012, Apsche, DiMeo, & Kohlenberg, 2012). Today DBT is mainly used with individuals who present strong urges to harm themselves and or who have self-destructive behavior (Apsche, DiMeo, & Kohlenberg, 2012). This is one reason why this has been successful in adolescents, particularly young males. DBT also encourages acceptance and change. The acceptance is unconditional and change is brought about through the direct change of thoughts in a positive manner (Apsche, DiMeo, & Kohlenberg, 2012). DBT has been shown to improve behavior in three strong areas that disordered adolescents typically need help in improving: (a) lack of the needed behavioral coping skills, (b) accepting reality as it is, and (c) maintaining strong commitment to change (Arch, Eifert, Davies, Vilardaga, Rose, & Craske, 2012). DBT gives skills that are needed to become productive members of the outside community in which the individuals live in and helps them to gain a positive perspective on value and acceptance of their personal struggles, and enhances them for positive change (Apsche, Siv, & Matteson, 2005). A downfall to applying CBT elements in the DBT methodology is that since its nature is to constantly challenge the emotions of the individuals it is making it hard for them to accept their beliefs as real and reasonable. …