Mode Deactivation Therapy (MDT): Case Conceptualization

The theoretical constructs of Mode Deactivation Therapy (MDT) are based on the Mode Model (Beck, 1996), suggesting that people team from unconscious experiential components and cognitive structural processing components. Therefore, to change behavior of individuals there must be a restructuring of the experiential components and a corresponding cognitive reformation of the structural components. MDT is an empirically based methodology that systematically assesses and restructures dysfunctional compound core beliefs. By restructuring these beliefs, MDT addresses underlying perceptions that may be applicable to setting in motion the mode related charge of aberrant schemas, that enable the behavior integration of Dialectic Behavioral Therapy (DBT) principles (Linehan, 1993) of treating of sex offending or aggressive behavior (Kohlenberg & Tsai, 1993). The Mode Deactivation framework also utilizes the case conceptualization methodology and emphasizes a team approach in working with clients; particularly those with reactive emotional dysregulation, which includes parasuicidal acts and aggression. The case conceptualization is systematically designed to provide functionally based treatment to complex emotional, thought, and behavior disorders. The following article demonstrates this comprehensive process and delineates the procedures used to develop the case within the mode deactivation theoretical perspective. INTRODUCTION The concepts of mode deactivation therapy (MDT) are derived from Beck (1996) and Alford & Beck (1997) and their conceptualizations of the expansion of cognitive behavioral therapy into more global constructs known as modes. The application of MDT from theory to practice included the adaptation of Linehan's (1993) application of dialectical behavioral therapy (DBT). The similarities of MDT and DBT are obvious. MDT treats the personality beliefs and behaviors with Linehan's notion of finding the grain of truth and validating the client's beliefs rather than challenging the cognitive distortions. Underlying the MDT methodology is the Problem Solving Case Conceptualization. Problem solving case conceptualization is a combination of Beck's (1996) case conceptualization and Nezu, Nezu, Friedman, Haynes (1998) problem-solving model, with several new assessments and methodologies recently developed. The goal is to provide a blueprint to treatment within the case conceptualization. The Case Conceptualization helps the clinician examine underlying fears of the resident. These fears serve the function of developing avoidance behaviors in the youngster. These behaviors usually appear as a variety of problem behaviors in the milieu. Developing personality disorders often surrounds underlying posttraumatic stress disorder (PTSD) issues. The Case Conceptualization method has an assessment for the underlying compound core beliefs that are generated by the developing personality disorders. Thus far, preliminary results suggest that our typology of youngsters have a conglomerate of personality disorder compound core beliefs. This conglomerate of beliefs, is the crux of why youngsters fail in treatment. One cannot treat specific disorders, such as sex offending and aggression, without gathering these conglomerate beliefs. It is also apparent that these beliefs are not cluster specific. That is to say that the Conglomerate of Beliefs and Behaviors contains beliefs from each cluster that integrate with each other. Because of this complex integration of beliefs, it makes treatment for this typology of youngster more complicated. The conglomerate of compound core beliefs represents protection for the individual from their abuse issues, which may present as treatment interfering behaviors. The attempt to use the usual didactic approaches to treatment, without addressing these beliefs amounts to treatment interfering behavior on the part of the Psychologist, or treating professional, is not an empirically supported and counter-initiated. …