Academic journal article The International Journal of Behavioral Consultation and Therapy

A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

Academic journal article The International Journal of Behavioral Consultation and Therapy

A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

Article excerpt

Abstract

This treatment research study extended the results of Apsche, Bass, Jennings, Murphy, Hunter, and Siv (2005), from behavioral data to standard measures of psychological distress. In Apsche, et. al. (2005) results suggest that Mode Deactivation Therapy (MDT) was more effective than Cognitive Behavior Therapy (CBT) and Social Skills Therapy (SST) in reducing the overt behavior of adolescents diagnosed with conduct and personality disorders. The results of this extension of the Apsche, et. al. (2005) study suggest that MDT was superior to CBT and SST in reducing external and internal psychological distress as measured by the Devereux Scale of Mental Disorders (DSMD) and child behavior check list (CBCL).

Keywords: CBT, MDT, Social Skills Training, Conduct Disorder, Aggression, Personality Disorder.

Introduction

In a treatment research study examining only behavior data, sexual abuse and physical aggression, Apsche, et. al. (2005) demonstrated that MDT was more effective that CBT and SST in reducing these aberrant behaviors. This treatment research study examines the effects of MDT, CBT, and SST on measures of internal and external distress as measured by the DSMD and CBCL.

MDT is a methodology designed to treat conduct disordered youths who have cooccurring personality disorders or traits. The methodology is completed in individual groups and Family Therapy. There is a Clinician's manual and a client work book to assure adherence to the MDT methodology in individual, group and family therapy. MDT requires an intensive two week training that included didactic and applied learning objectives in all areas of MDT. To reach competency the trainee must complete a written and practicum exam.

MDT includes and requires completing the following sub areas in sequence:

1. MDT Assessment

2. Case Conceptualization

3. Deactivation / functional treatment

4. Validation Strategy/ validate, clarify, redirect (VCR)

5. MDT mindfulness-awareness of trust, fear, perception and avoidances

6. Complete the conglomerate of beliefs and behaviors and learn to balance their beliefs (COBB)

7. Family MDT

All three conditions in this study had equal training in the individual specialized areas.

Clients were selected by the availabilities of the therapists. The lengths of stay for the clients were not controlled by the completion of materials; rather they are controlled by the availability of community placements for the residents by their referral sources. The quality of the therapists and their training were equal in all areas and were controlled for by the standards of clinicians, by the facility policies, and the state regulations, which govern the facility.

SST was chosen as a control because it was the treatment as usual for part of the residents at the residential treatment center and an accepted method of intervention at many facilities (Apsche, et. al., 2005).

METHOD

Sample Characteristics

A total of 60 male adolescents participated in the study. All subjects were referred to the same residential treatment facility for the treatment of aggression and/or sexual aggression. In this study, subjects were randomly assigned to one of the three treatment conditions at the time of admission based on available openings in the caseload of the participating clinicians. The three 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 the one of the three treatment curriculums/methods. The average length of residential treatment across all conditions was 11 months.

Condition one: Cognitive Behavioral Therapy (CBT): A total of nineteen male adolescents were assigned to the CBT condition. …

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