Mode deactivation therapy

Domain II · Behavioural & cognitive · Jack A. Apsche · 2000

What it is

Mode deactivation therapy (MDT) was developed by Jack A. Apsche from the early 2000s. It was built for adolescents, mainly males aged about 14–18 in residential and outpatient care, with conduct, oppositional, mood or emerging personality problems, often alongside trauma, aggression, substance use…

Format

• MDT is a manualised individual or family therapy. It is not a group programme. The 2015 book describes it as a step-by-step methodology delivered in the following order.
• Assessment (roughly the first four sessions): a semi-structured clinical interview, the MDT Client Typology Survey, the Fear Assessment (Strength of Fears) and the Compound Core Beliefs Questionnaire (CCBQ). Goal: a full picture of history, abuse and trauma, offending, family, substance use and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Overclaiming. Let the youth draw the conclusion himself.
• Re-escalation while retelling. Ground the youth first if needed.
• Using the continuum as a trap to prove him wrong. Keep it exploratory.
• Slipping into disputation. If the youth bristles, go back to validation.
• Defusion being heard as "your thought is wrong". Keep validation in front.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.