Summary of Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training with two year post treatment results.

Abstract

Abstract This study summarized two treatment research studies and included recidivism data for two years post discharge for group therapy. The study compared Mode deactivation Therapy (MDT), Cognitive Behavior Therapy (CBT), and Social Skills training (SST), results of the MDT series of studies and the two year post-study recidivism data. The data from the studies of Apsche and his colleagues (Apsche, Bass, Siv 2005; Apsche, Bass, Jennings, Murphy, Hunter, and Siv, 2005), were used to demonstrate the overall efficiency in treatment of MDT. The follow-up data suggests the MDT has positive generalization effects post-treatment. Keywords: Recidivism CBT, MDT, SST, Conduct Disorder, Aggression Introduction This research summarized the collected studies of outcome of Apsche and his colleagues. It includes recidivism data for two years since treatment was terminated and the adolescents were discharged. Recidivism data was collected by written surveys sent to parents, guardians and case worker's of the residents. Phone calls were initiated as reminders to case managers and their supervisors to assure confidence. The summary of the data suggests that in three groups of equal size in a total population of 60 male adolescents, MDT was far superior to CBT and SST in reducing aggression, sexual aggression, and psychological distress as measured by the CBCL and DSMD. Further analysis suggests that MDT is superior in reducing recidivism over CBT and SST. Because of MDT's superior results, it is hypothesized that the effects of MDT are superior in generalization to the home environments of the adolescents. MEASURES The measures define how we collected data and checked for reliability in a treatment center. It is important to clarify that treatment research requires that all adolescents receive adequate treatment. There is no total control group, or no treatment, wait list group. A review of the key measures of physical and sexual aggression used in this study consisted of Daily Behavior Reports and Behavior Incident Reports. The Daily Behavior Reports were completed by all levels of staff, both professional and paraprofessional, across all settings of the residential treatment program (e.g., schoolroom, psycho educational classes, treatment activities, residential dormitories, etc.). The Behavior Incident Reports were only completed by staff following the occurrence of serious or critical incidents, namely, acts of physical and sexual aggression. Inter-rater reliability in the use of the measures was determined by independently totaling the number of physical and sexual aggression incidents on both the Daily Behavior Report cards and the Behavior Incident Report forms and calculating the percentage of agreement. The agreement for this study was at the 98% level, as reported by Apsche, et. al. (2005). The baseline (pre-treatment) measure of physical and sexual aggression consisted of the average number of incidents per week that occurred during the first 60 days following admission and the post-treatment measure was the rate of occurrence during the 60 day period prior to discharge. Two assessments were used to measure the behavior of the residents, which included the Child Behavior Checklist (CBCL; Achenbach, 1991) and the Devereux Scales of Mental Disorders (DSMD; The Devereux Foundation, 1994). The CBCL is a multi-axial assessment designed to obtain reports regarding the behaviors and competencies of 11 to 18 year olds. The means and standards are divided into three categories: internalizing (which measures withdrawn behaviors, somatic complaints, anxiety and depression), externalizing (which measures delinquent behavior and aggressive behavior), and total problems (which represent the conglomerate of total problems and symptoms, both internal and external). The DSMD illustrates level of functioning in comparison to a normal group, via behavioral ratings. …