An empirical “real world” comparison of two treatments with aggressive adolescent males.

Abstract

This research study compares the efficacy of Mode Deactivation Therapy (MDT), an advanced form of Cognitive Behavioral Therapy based on Beck's theory of modes, and standard Cognitive Behavioral Therapy (CBT) for adolescent males in residential treatment. The results showed MDT was superior to CBT in reducing both physical and sexual aggression and reductions of external and internal psychological distress as measured by the Devereux Scale of Mental Disorder (DSMD) and Child Behavioral Checklist (CBCL). Keywords: CBT, MDT, Conduct Disorder, Aggression. Introduction This study compares two effective treatments, Mode Deactivation Therapy (MDT) and Cognitive Behavioral Therapy (CBT) for adolescent males in residential treatment. CBT has had numerous publications regarding its efficacy with adolescents (Reinecke, Dattilio, Freeman, 1996, 2004). MDT has been demonstrated to be an evidenced based treatment for adolescents in numerous studies (Apsche, Ward 2004, Apsche Ward, Evile 2004; Apsche, Bass, Jennings, Murphy, Hunter and Siv, 2005, compared MDT to CBT and social skills training (SST) in reducing physical aggression and sexual aggression with adolescents. MDT is shown to be more effective than CBT or SST in reducing both physical and sexual aggression in these adolescents as measured by the Devereux Scale of Mental Disorder (DSMD) and Child Behavioral Checklist (CBCL). Both CBT and MDT have been demonstrated to be effective treatments with difficult adolescents in numerous studies. CBT has a plethora of literature published in recent articles and books on its efficacy with adolescents. Reinecke, Dattilio, Freeman, 2004, Friedberg, Maclure, 2002. CBT has been demonstrated to be effective in treating adolescent depression, Rehm and Sharp, 1996, adolescent anxiety disorders, Kendall, 2004 and personality disorders, Beck, Freeman, Davis and Associates, 2004, aggression, Lochman, Whidby, Fitzgerald, 2000, and anger, Nelson and Finch, 2000. MDT has had several recent articles that demonstrate it is an effective treatment with aggressive and abused or reactive adolescents (Apsche, Bass, Siv, 2005; Apsche, Ward Bailey 2004.MDT and CBT were compared together and with social skills training (Apsche, Bass, Jennings, Murphy, Siv and Hunter, 2005); Apsche, Bass, Siv, 2005). The results suggest that MDT was superior to CBT and SST in reducing both physical and sexual aggression in adolescents in a residential treatment center. The results of these studies suggest that MDT is effective in treating physical and sexual aggression in adolescent males. These results also suggest that MDT is more effective in treating these adolescents than standard CBT or SST. (Apsche et. al., 2005). METHOD Sample Characteristics A total of 40 male adolescents participated in the study. All subjects were referred to the same residential treatment facility for the treatment of physical aggression and/or sexual aggression. In this study, subjects were randomly assigned to one of the two treatment conditions at the time of admission based on available openings in the caseload of the participating clinicians. Both treatment conditions showed similarity in terms of the frequency of Axis I and Axis II diagnoses, age, and racial background. To ensure consistency in the delivery of the two respective treatments, therapists were specifically trained in one of the two treatment curriculums/methods. The average length of residential treatment across all conditions was around 11 months. Cognitive Behavioral Therapy (CBT) Participant: Nineteen male sexual offenders from a residential sex offender treatment program for adolescent males were assigned to the CBT condition. The group was comprised of 15 African Americans, 3 European Americans and 1 Hispanic American with ages between 11 and 18 years with an average age of 16.1. The principal Axis I diagnoses for this group included Conduct Disorder (15), Oppositional Defiant Disorder (4), and Post Traumatic Stress Disorder (9). …