Academic journal article The International Journal of Behavioral Consultation and Therapy

Conceptualizing Mode Deactivation Therapy as a Moodle-Based Online Program for Adolescents and Adults to Relieve Belief-Oriented Distress

Academic journal article The International Journal of Behavioral Consultation and Therapy

Conceptualizing Mode Deactivation Therapy as a Moodle-Based Online Program for Adolescents and Adults to Relieve Belief-Oriented Distress

Article excerpt

MODE DEACTIVATION THERAPY (MDT) is a third wave cognitive behavioral therapy that has proven effective in multiple randomized controlled trials for the treatment of adolescents with complex problems (Swart & Apsche, 2014b). A meta-analysis that combined the results of 12 different studies with a combined number of 699 participants found that MDT consistently produced statistically significant improvement in the symptomatology of subjects. The MDT protocol is based on the core principles of mindfulness, acceptance, cognitive defusion, and redirection. It utilizes the unique process step Validation-Clarification-Redirection, or VCR, as major therapeutic change element. In VCR the client's unhelpful core beliefs are validated as reasonable and logical in the realm of their circumstances and experiences. By exploring the "grain of truth" in the client's beliefs, private experiences (e.g. thoughts, feelings, memories, and moods), and behaviors, its context and impact is clarified. The client is guided to develop functional alternative beliefs instead and coaxed to redirect their cognitions accordingly. This approach has proven successful even among resistant clients with complex comorbidity.

Traditionally the MDT program is conducted during individual or family face-to-face sessions that usually extends over about 18 sessions. The purpose of this paper is to examine two questions that will have important implications for the continued development and improvement of a new delivery mode and applications of MDT.

Can the MDT protocol be delivered effectively in an assisted online mode?

MDT's logical basis was developed by Dr. Jack Apsche in the late 1990s using the cognitive principles set forth by Drs. Aaron Beck and Albert Ellis from the 1950s onward. He conceptualized the link between core beliefs and behavior as the primary basis of psychological distress. Based on this understanding the need for mindfulness, validation, and redirection was identified and evolved into a structured methodology that is both robust in application, but specific in delivery. As an effective treatment for troubled adolescents was much needed at the time, MDT was established within this population, proving to be an effective evidence-based approach in many empirical research studies. But, especially in the past decade, the need for brief, accessible, and robust treatments for behavioral and mood disturbances at all ages has become even more apparent.

With the Internet now used by almost 40 percent of the world population and more than three of every four people in the developed world, the realization has come that it could be a viable modality to deliver mental health services cost-effectively and without geographical limitations for providers and patients. Research has already demonstrated success in various modes of "e-therapy", often with little distinction in outcomes compared to face-to-face deliveries. It is reasonable to assume that MDT will realize equally positive results through an online mode, and the potential benefits warrant exploration.

Is MDT expected to be effective as a treatment approach for adults with behavioral, personality, and mood-related issues?

In the traditional face-to-face modality MDT has proven to be more effective than treatment-as-usual and other cognitive behavioral protocols when treating adolescents with behavioral and complex comorbid conditions. The theory is based on cognitive principles of modes and schemas that are underpinned by deep-seated core beliefs. By creating a mindful awareness MDT targets problematic beliefs and modes in order to redirect them to functional alternatives. This is the premise of MDT in a nutshell, and it is logical to conclude that the same philosophy is valid for adults with behavioral, personality, and mood-related issues, at least to the point that invite further work.

Therefore, this paper is to be considered as the first step in a process to adjust and expand the Mode Deactivation Therapy methodology to be able to provide a cost-effective psychotherapy service to more people in need. …

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