The Empirical Status of Mode Deactivation Therapy

Abstract

Paradoxically, the more mainstream a psychotherapy approach becomes, the more likely it is that evidence-based support has become lacking along the way, especially with a rapid spread in practices across cultures, ages, genders, and diagnostic profiles. The definition of “evidence-based” can be considered in two basic ways, namely that (1) an approach to therapy emphasizes the pursuit of evidence on which to base its theory and techniques, as well as encourages its patients or clients to consider evidence before taking action; or (2) an approach to therapy is supported by research findings, and those findings provide evidence that it is effective. Although the difference between these two approaches seems subtle, there are important considerations. Typically, as was the case with Mode Deactivation Therapy (MDT) and other derived therapies, the theoretical conceptualization and framework was based on a synthesis of existing theoretical and practical components that were already empirically tested and established, to a lesser or greater extent. Development of the practical methodology followed, but was applied in tandem with well-planned and designed research experiments to determine the actual effectiveness of the treatment for the target population, including comparisons with treatment-as-usual (TAU) control groups. In addition to providing a treatment service, there are always associated demands for demonstrable results, cost monitoring, and accountability that have to ensure cost-effectiveness and viability. It is a thorough and painstaking process to scientifically validate any new therapeutic methodology, which has to be based on sound theoretical, methodological, and statistical principles, and expanded for each structural change, application, and new population. As is the case with most developing therapies, MDT remains largely developer-driven at this time, although the practice is proliferating at an increasing pace to independent practices and facilities. In addition, independent research has also been conducted and a new international study is currently underway at an Iranian medical university. Here, some comments are relevant to note. Firstly, the rapid growth in MDT practice and research is testament of its empirical status as an evidence-based practice. Secondly, it seems as if a tipping point is being approached, where the available evidence presents a strong enough case to warrant larger independent investment in funding and resources to expand treatment protocols and research to other applications and independent facilities. Current research is also expected to provide a valuable insight in the cultural robustness of MDT as a treatment methodology for youth. However, at this time, the focus will remain on studies that have already been completed.