Family mode deactivation therapy (FMDT) mediation analysis.

Abstract

Youth behavioral disorders are not only considered widespread and costly in terms of financial, human, and societal impact into adulthood, but also resistant to interventions, especially when related to childhood trauma and accompanied by continued social distress and comorbid conditions such as personality, mood, and substance use disorders. Mode Deactivation Therapy (MDT), a third wave contextual therapy approach derived from cognitive therapy principles, was developed in recognition of the need for this population. The MDT theoretical framework and methodology contains elements of mindfulness, Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), but it is the unique Validation-Clarification-Redirection process (VCR) step that sets it apart from other contextual approaches. VCR is considered to be the core process component in MDT to affect therapeutic change by validating core beliefs as reasonable responses to past experiences, but exploring functional alternative beliefs. The main objectives of this study is to review evidence of the effectiveness of family-based MDT (FMDT) compared to standard treatment, and provide a preliminary randomized controlled group study of the mediation effects that VCR and other components have on the overall treatment mechanisms and outcomes. Recommendations for further study conclude the current scope.

A comparative treatment efficacy study of conventional therapy and mode deactivation therapy (MDT) for adolescents with conduct disorders, mixed personality disorders, and experiences of childhood trauma.

“…Since the meta-analysis, two independent studies were done, which confirmed the conclusions of previous studies that mdt consistently achieved better treatment outcomes than treatment as usual and delivered impressive results compared to the pre-treatment baseline of the adolescent sample (Thoder & Cautilli, 2011; Murphy & Siv, 2011). Subsequently, two other larger family-based mdt studies by the author also confirmed the same positive results (Apsche, Bass, & Backlund, 2012; Swart & Apsche, in press). The specifics of the most recent mdt research studies are summarized in Table 2 above…”

Mindfulness, mode deactivation, and family therapy: A winning combination for treating adolescents with complex trauma and behavioral problems.

“…The multiaxial system was removed in the DSM-5, and coding is now done on a single axis. Although the presence of personality disorders was not specifically noted during this study, similar previous MDT studies have shown a high prevalence, including multiple personality disorder diagnoses (Swart & Apsche, 2014a;Swart & Apsche, 2014b;Swart & Apsche, 2014c). These constellations of maladaptive personality traits that co-exist with mood, trauma, conduct, and substance use disorders are typical among problem youth.…”

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

“…Furthermore, DBT incorporates some of the training skills aspects of CBT in order to teach the adolescents how to change their behaviors and learn new and more efficient ones. Using these therapies together has given adolescent youth the opportunity to change their maladaptive behaviors and poor coping mechanisms while still accepting the truth and not discouraging or completely changing their belief system (Apsche, Bass, & Backlund, 2012; Swart & Apsche, 2014).…”

“…It is interesting to note that this has also been raised as a concern in terms of theoretical and therapist “drift” from established frameworks and protocols that tend to reduce cost effectiveness and integrity of the intended methodology. Of these, with a structured and sequential assessment and treatment process, MDT is considered to be the most procedurally strict (Swart & Apsche, 2014). Behavioral strategies: Where traditional CBT focuses on changing or modifying psychological events that people experience in order to achieve desired behavioral outcomes, third wave therapies instead focus on changing the function of these events.…”

“…It is interesting to note that this has also been raised as a concern in terms of theoretical and therapist “drift” from established frameworks and protocols that tend to reduce cost effectiveness and integrity of the intended methodology. Of these, with a structured and sequential assessment and treatment process, MDT is considered to be the most procedurally strict (Swart & Apsche, 2014).…”