Academic journal article The International Journal of Behavioral Consultation and Therapy

Family Mode Deactivation Therapy (FMDT) as a Contextual Treatment

Academic journal article The International Journal of Behavioral Consultation and Therapy

Family Mode Deactivation Therapy (FMDT) as a Contextual Treatment

Article excerpt

Adolescent behavioral and conduct problems are widely associated with family-based issues such as marital problems, parental absence, domestic violence, substance abuse, child neglect and maltreatment, including physical and sexual abuse. Besides externalized problems such as aggression, violence, and criminal behavior, distress is also often internalized by the youth, causing anxiety, depression, substance abuse, social withdrawal, and suicide ideation. Furthermore, early onset of psychopathological symptoms is inarguably correlated with maturing persistent mental health problems in adulthood including depression, addiction, posttraumatic stress disorder (PTSD), personality disorders, as well as escalating criminality (Scott, Smith, & Ellis, 2010; Spataro, Mullen, Burgess, Wells, & Moss, 2004).

Earlier--pre-third wave--therapeutic approaches were either past- and disease-oriented (first wave therapies such as psychoanalysis and psychodynamic work), or exclusively present- and problem-oriented (second wave therapies such as behavioral, cognitive, and gestalt approaches). More recently there has been a move away from a focus on pathology and illness-- problems instead of solution--and the clinician's role became more collaborative and expertly. In the late 1950s and early 1960s, Albert Ellis and Aaron Beck started to realize that traditional psychoanalytic therapies lacked a focus on conscious thought and belief processes, which they deemed central in guiding emotional experience and behavior. From there behavioral techniques were incorporated in the cognitive therapy methodology and became known as Cognitive Behavioral Therapy (CBT), the underlying basis of third wave derivative approaches.

In the early 2000s Dr. Jack Apsche recognized shortcomings in cognitive behavioral approaches, especially pertaining to persistent and complex psychopathology presentations among adolescent populations. The main areas of concern were the focus on problems and dysfunction of the client seen as caused by faulty thinking, strong present orientation, and negation of unconscious thought processes and triggers. As a result Mode Deactivation Therapy (MDT) was developed by using CBT as a point of origin and incorporating elements and concepts from various other approaches and techniques, such as Functional Analytic Psychotherapy (FAP), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and mindfulness. MDT, as a "young" and developing therapy, has already demonstrated remarkable successes among troubled adolescent populations in individual and family settings, while much more potential scope exists to harness the methodology further--as I believe this work will clearly show.

* Core concepts of family mode Deactivation therapy (FMDT)

Mode Deactivation Therapy in family settings, or FMDT, utilizes several key concepts obtained from theorists and other therapeutic approaches that were adapted and incorporated into a treatment methodology to address the target population of adolescents with behavioral and conduct problems, which are often associated with comorbid child-onset mental health conditions and trauma-related distress. The three core concepts of experiential avoidance, defusion, and mindfulness are discussed below.

Experiential avoidance

Greco and Hayes (2008) viewed experiential avoidance as the opposite of acceptance, while it is also associated with behaviors that are inconsistent with personal values and goals (Bond, Hayes, Baer, Carpenter, Guenole, Orcutt, Waltz, & Zettle, 2011), persistent distress symptoms, and treatment interference (Hayes, Orsillo, & Roemer, 2010). O'Brien, Larson, and Murrell (2008) defined experiential avoidance as the situation that occurs when an individual is either unwilling or too fearful to remain in contact with painful emotions, situations, thoughts, or memories. Hayes, Wilson, Gifford, Follette, and Strosahl (1996) explained this process as a lack of acceptance of private events--an individual's thoughts and perceptions of happenings--as they occur in an uncontrolled and an unregulated manner. …

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