A comprehensive literature review of Mode Deactivation Therapy.

Abstract

Abstract In this article literature published on Mode Deactivation Therapy (MDT) was reviewed in depth. Several studies were identified that used a common outcome measure of reduction of physical and sexual aggression, other risk related behaviors. Comparisons of MDT and, other standardized approaches typically used in treating aggression in juveniles, were made. The studies involved individual clients and small groups using MDT and comparative methodology. The studies involved varying periods in treatment settings and longitudinal follow ups. The results document a greater degree of treatment success for MDT as compared with a standard Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) or Social Skills Training (SST). These comparisons were made in varying combinations, with observances made with similar subjects or subject groups. The degree of change associated with MDT was highly discernable in the studies, and will be reviewed and evaluated in meta-analysis study in the near future. MDT was developed for an specific age group, (141/2-18) with specific disorders. It has been demonstrated as an effective methodology as an Evidenced Based Psychotherapy. Implications for further outcome and process studies in cognitive therapy are discussed. Keywords: Mode Deactivation Therapy (MDT), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), adolescents, Social Skills Training (SST). Introduction In the process of analysis of MDT, this methodology has been compared to the alternative methodologies and strategies of standard CBT, DBT and SST. This review examined literature delineating the effectiveness of MDT in treating adolescent clients with reactive emotional dysregulation, who presented with behaviors involving parasuicidal acts, sexual offenses other aggression. Case studies involved clients with complicated histories of sexual, physical, or emotional abuse, as well as neglect, and multi-axial diagnoses. Data indicates that MDT is effective in reducing the rate of physical and sexual aggression across treatment. MDT is an evidenced based treatment developed to treat adolescents with problems relating to conduct, personality and aggression. It is an empirically based therapy, rooted in CBT, DBT, (Linehan, 1993), and Functional Analytic Psychotherapy (FAP), ([Kohlenberg & Tsai, 1993] Apsche & Ward 2003). Elements from Functional Analytic Behavioral Therapy MDT also incorporates principles from Functional Analytic Behavioral Therapy (Kohlenberg and Tsai, 1993). First, MDT aligns with FAB in affirming that perceptions of reality and unconscious motivations evolve from past contingencies of reinforcement, such as families of origin. Second, MDT uses an assessment and Case Conceptualization method that combines elements from Beck's (1996) case conceptualization and the Factor Analytic Behavior Therapy model of Nezu, Nezu, Friedman and Haynes (1998). The assessment and case conceptualization procedure concentrates on core beliefs, fears and avoidance behaviors that are reflective of the Post-Traumatic Stress Disorder and developing personality disorders, (Apsche & Ward Bailey, 2003, 2004b, 2004c). Unique Qualities of MDT One crucial difference between Mode Deactivation Therapy and Cognitive Behavioral Therapy is that the core beliefs (or schemas) of the individual are not seen and challenged as dysfunctional because this action necessarily invalidates the person's life experience. Instead, in MDT, core beliefs are consistently validated as legitimate creations from the person's life experience (no matter how irrational and even if they have little more than a tiny grain of truth), which are then balanced through the collaborative therapeutic process to deactivate the maladaptive mode responses. Another difference between MDT and CBT is that MDT uses the balance the belief technique to remediate the youth's emotional dysreguation. …