Mediation analysis of Mode Deactivation Therapy, (MDT).

Mode Deactivation Therapy (MDT) is the melding of key components of Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Functional Analytic Psychotherapy and Mindfulness, and Meditation from ancient Buddhist practices. MDT was developed to address complex presenting problems accompanying the treatment of male adolescents (Apsche, Bass, & Siv, 2006). Among the variety of adolescent disorders, MDT has proven to be efficacious in working with behavioral expressions of misaligned emotional states, including anxiety and traumatic stress (Apsche, Bass, & Siv, 2006; Apsche & Bass, 2006), physical aggression (Apsche, Bass, & Houston, 2007), and inappropriate sexual behaviors (Apsche, Bass, Jennings, Murphy, Hunter, & Siv, 2005). The MDT method suggests that the adolescent male develops beliefs, based on life experiences and interactions with others that he utilizes to inform his decisions and choices. Thus, MDT focuses on providing individuals with a new understanding of the beliefs that continue to contribute to unhealthy and misguided behaviors. For example, aggression is viewed as a maladaptive response to a belief that is unbalanced. It is reinforced by an immediate reduction in emotional arousal and/ or the environment's response (Apsche & DiMeo, in press). A key to opening the door to this innovative perception of the world is the Validation, Clarification and Redirection (VCR) intervention. VCR provides the adolescent with the feedback that his way of viewing his world is reasonable given his set of experiences (validation), but also provides that those experiences might have skewed his view of the world (clarification) and it is possible that a less extreme or more balanced approach is more realistic (redirection). MDT gains support as an efficacious intervention as evidence suggests that the tools developed via MDT sessions reduces the level and frequency of aggressive incidents, sexual behaviors, and emotional dysregulation (Apsche, Bass, & Siv, 2006; Apsche & Bass, 2006; Apsche, Bass, & Houston, 2007). These studies also demonstrate MDT exercises effectiveness across a wide variety of behavioral outcomes. Across these challenging behaviors, the development of the use of VCR appears to enable adolescents to make more balanced behavioral choices. The following analysis draws from the body of evidence, which supports the effectiveness of MDT to clarify which aspect of the intervention is effectuating change, focusing on the implementation of the VCR intervention. We attempted to follow Kazdin's (2007), and Kazdin & Nock's (2003) suggestions throughout our analysis of the MDT data in this article. There continues to be a consensus of agreement that it is imperative to systematically evaluate treatment approaches and the processes and components through which treatments have demonstrated their effect (Kazdin, 2007. The aforementioned consensus of agreement has resulted in research focusing on the processes of change involving mediation analysis (McKinnon, Fairchild, & Fretz, 2007). Henggeler, Letorneau, Chaptran, Bourdin, Schene & McCart (2009), examined specific interventions and evaluated whether changes in their actions were consistent with Kazdin's (2007) suggestions of examining the specific components that are necessary, sufficient, and facilitate therapeutic changes (Kazdin, 2003). MDT has been shown to be an effective treatment for a variety of adolescent disorders, (Apsche, Bass, & Siv, 2006) including oppositional and conduct disordered youth, (Apsche, Bass, & Murphy, 2004, adolescents who exhibit physical aggression, (Apsche, Bass, & Houston, 2007), sexual and offending behavior, (Apsche, Bass, Jennings, Murphy, Hunter, & Siv, 2005), as well as symptoms of anxiety and traumatic stress, (Apsche & Bass, 2006). Apsche and DiMeo (2010) presented a chapter that included a meta-analysis of MDT with individuals, families and a replication study. …