Mode Deactivation Therapy (MDT) was developed as an alternative to standard Cognitive Behavioral Therapy for treating adolescents with behavioral and complex comorbid problems. MDT incorporates principles from CBT, DBT, ACT, and FAP. It is based on Beck's theory of modes and aims to overcome limitations of CBT by assessing and reconstructing adolescents' core beliefs using modes. MDT uses mindfulness, acceptance, and validation techniques to help adolescents manage fears, triggers and core beliefs that lead to maladaptive behaviors. A key part of MDT is developing therapeutic relationships and family support systems to encourage new coping skills and reduce anxiety.

1. 26
©2015, ALL RIGHTS RESERVED
ISSN: 1555–7855
INTERNATIONAL JOURNAL OF BEHAVIORAL CONSULTATION AND THERAPY
2015, VOL. 9, NO. 4
Mode deactivation therapy: A short review
Corliss Bayles and Jolene Van Nevel
Walden University
Abstract
During his work with adolescents with behavioral and complex comorbid problems,Dr.Apsche realized that standard
Cognitive Behavioral Therapy (CBT) and the underlying cognitive theory did not seem to be effective in treating
this population. The main objective of CBT is to alleviate distress by modifying cognitive content and process, in
the process realigning thinking with reality by directly challenging maladaptive thoughts (Longmore & Worrell,
2007). Dr. Aaron Beck (1996), who originally developed cognitive theory and its implementation in the practice of
cognitive therapy, suggested that there were some shortcomings in his theory of schematic processing, which
Dr. Aspche believed also may have influenced the effectiveness of its utilization in practice. With a few important
modifications in theory and approach, Mode Deactivation Therapy (MDT) was developed around the change of
the millennium and has since proven to be an effective modality for the treatment of adolescents with behavioral
and other complex problems.This article explains what led to the development of MDT and why it has become an
effective treatment of both adolescent and family therapy.
Keywords
mode deactivation, adolescent therapy, MDT, CBT, cognitive theory, conduct disorder, mindfulness
A
dolescence is no stranger to crime this
day and age. A major focus of Juvenile Justice
Research is on the association between delin-
quency and victimization. Those who researched
this area have discovered the association between the
two seem to overlap. Thus, the engagement of most
delinquents have been victims at one point in their
lives, and most victims have become delinquents as
a result of their victimization (Cuevas, Finkelhor,
Shattuck, Turner, & Hamby, 2013).
In 2011, a total of 1,470,000 adolescents were
arrested for criminal activity. This number includes
both male and female adolescents (under the age of
18). Twenty-nine percent of these youths were female,
27% were younger than age 15, and 66% were white.
For the purpose of this article, only the two offenses
that make up violent crimes will be considered. These
two offenses are: robbery, and aggravated assault.
The other offenses included, not considered violent
crimes, are sex offenses (other than prostitution and
forcible rape), and drug offenses (Puzzanchera, 2013).
These particular offenses were chosen because of the
number of youth involved in these types of crimes
and the severity of the punishment linked to these
types of crimes. Of robbery offenses, 23,800 was the
estimated number of juvenile arrests in 2011. Nine
percent of those were female, 19% were younger than
age 15, and 30% were white. Of aggravated assault
crimes, 40,700 were arrested in total. Twenty-five
percent were female, 32% under the age of 15, and 56%
were white. Sex offenses were less with 12,600 total
arrests, 11% female, 49% under age 15, and 70% white.
The largest category of adolescent criminal activity
is drug offense violations. Within this group 148,700
total arrests were estimated in 2011. Seventeen percent
were female adolescents, 17% were under age 15, and
74% were white. Youths under age 15 accounted for
57% of all the juveniles arrested for arson, and almost
40% of juveniles were arrested for simple assaults,
vandalism, and conduct disorder (Puzzanchera, 2013).
With those figures, it is clearly evident that youth
are growing up in an environment that was never
revealed to the general adult population 4 decades
ago. Youth of today face issues that many adults have
never encountered, yet some of these related issues
are caused by adults.
In 2009, Apsche cited longitudinal studies con-
ducted by Johnson, Cohen, Brown, Smailes, and
Bernstein (1999), suggesting that sexual, physical,
and emotional abuse strongly correlated to the
maladaptive personalities and conduct disorders
of adolescents. Apsche (2010) reported that youth
who were physically and sexually abused (neglect
and emotional abuse included) were more likely to
respond in ways that were consistent with personality
disorders and conduct disorders. This maladaptation
of personality development during early childhood
is a direct result of the situation or environment to
which the child is exposed. Kurt Lewin (1935) as
cited by Friedman and Schustack (2012), reported
that “behavior is a function of the person and envi-
ronment”, and can be summed up in the equation
B = f (P, E). Apsche (2010) confirmed that when
youth experienced any form of childhood abuse
and neglect, they were four times more likely to be
diagnosed with posttraumatic stress disorder (PTSD),
aggression (proactive and reactive), oppositional
disorder, anxiety, and depression due to a cognitive
vulnerability resulting from traumatic experiences.
„„ Beck’s theory of modes
In 1996, Beck hypothesized that modes were a
sub-organization of personalities. Beck saw modes
or schemas as integrated networks of cognitive,
affective, motivational, and behavioral components
initially developed as protective strategies or beliefs
in response to traumatic and abusive life experiences
(Jennings, Apsche, Blossom, & Bayles, 2013). These
modes become emotionally charged and become
ingrained in the adolescent as maladaptive auto-
matic responses to perceived threats (Jennings, et al,
2013). However, Apsche (2005) reported that Beck
noted flaws in the cognitive theory. According to
Apsche, Beck perceived that if there were flaws in
the cognitive theory, flaws must exist in the cognitive
therapy. Apsche proceeded to investigate the flaws
that Beck mentioned and considered it a possibility
that a more adaptive methodology was needed to
address the shortcomings in the schematic process-
ing theory (Apsche, 2005). Beck described 11 areas
that described the shortcomings of his Theory of
Modes (Apsche 2005). Apsche quoted Beck’s (1996)
schematic processing theory stating that this “theory
does not fully explain many clinical phenomena and
experimental findings” (pg. 52). Because of the flawed
clinical methodology described by Beck, Apsche set
out to examine the problems, described by Beck,
that were not adequately addressed by the model of
schematic processing (Apsche, 2005).
While reviewing and digesting the list of shortcom-
ings in the cognitive theory, Apsche pinpointed the
two most important features that were not considered
in the, then current, mode theory. Apsche noted that
the mode theory only related to the conscious pro-
cessing of information, but excluded the unconscious
processing of information. This acknowledgement
of unconscious processing explained why disorders
could be triggered with less intense experiences.
Apsche explained that unconscious triggers ignit-
ed activation of psychological reactions, prior to
negative thoughts. This was all related to conscious
and unconscious learning processes (Apsche, 2005).
„„ What is mode deactivation therapy and why use it?
Behavior therapy is a broad area that often lacks in-
tegration and understanding between the theoretical
and technological aspects of the field (Apsche, 2005).
In 2003, Apsche, Ward, and Evile began to expand
on Beck’s Mode model by including unconscious
experiences and cognitive structural processing.
Realizing that the flaws in the cognitive theory
pointed to the multiplicity of related symptoms,
Apsche (2005) believed that this blend of Axis I and
Axis II disorders may be the cause of the difficulty in
treating adolescents. For this specific type of adoles-
cent, Apsche (2005) operationalized Beck’s Theory
of Modes, into an applied methodology known as
Mode Deactivation Therapy (MDT).
Mode Deactivation Therapy is a behavioral therapy
that is a derivative of selected principles of Cognitive
Behavioral Therapy (CBT), Linehan’s (1993) Dialec-
tical Behavioral Therapy (DBT), and Hayes (1980s)
Acceptance and Commitment Therapy (ACT), and
Kolenberg and Tsai’s (1993) Functional Analytical
Therapy (FAP). Certain viewpoints of CBT does
not work for the adolescent topology that Apsche
treated. Because CBT argued the concept of cognitive
distortions, this method failed with this adolescent
population. The youth perceived the therapist as
someone who was trying to change their system of
defenses that they built to protect themselves (Apsche
& Ward, 2003).
FAP, on the other hand, focused on behavior
learned from past experiences that triggered uncon-
scious responses when the youth was faced with a
similar event that was perceived as a threat or harm.
Although FAP acknowledges cognition involvement,
the focus was deeper unconscious motivations that
resulted from past experiences (Apsche & Ward,
2003). According to FAP theory, people act based
on reinforcement contingencies (Apsche, Ward, &
Evile, 2003).

2. MODE DEACTIVATION THERAPY: A SHORT REVIEW 27
By addressing underlying perceptions, and re-
structuring core beliefs that may be responsible
for activating the mode related charge of aberrant
schemes, the behavior integration of DBT princi-
ples were enabled, especially in youth who were
aggressive and sexually offending (Apsche & Ward,
2003). DBT used principles of radical acceptance
and examining the “truth” in the client’s perception.
The methodology of finding a grain of truth in the
youth’s perception is the crux of MDT (Apsche &
Ward, 2003). MDT borrowed “radical acceptance”
from DBT which allows the youth to accept who he
is based on his beliefs. Another similarity with DBT
is the use of “balancing the dichotomous” (Apsche,
Ward, & Evile, 2003).
In addition to the incorporation of principles
from these four therapies, MDT includes the customs
and philosophy of the ancient Buddhist practice of
mindfulness (Jennings et al, 2013). MDT is designed
to overcome the limitation(s) of CBT by assessing
and reconstructing the adolescent’s core beliefs by
using Aaron Beck’s (1996) theoretical constructs of
Modes (Apsche, 2010). MDT is based on a theoret-
ical construct of Beck’s 1996 Theory of Modes that
suggested people learned through unconscious
experiential components and cognitive structural
components (Apsche, 2003). A single mode may
have multiple layers, and the potential to effect
multiple cognitive schemas which can activate the
different reactions in order to achieve the desired
outcome in the context of core beliefs (Young, 2003).
As cited by Young (2003), Beck’s model explained
that the sum of what is perceived, learned, and/or
discovered (cognitive content of a schema) manifests
as the core belief. Because the primary function of
modes and schemas is automatic, they are activated
when exposed to certain stressors relevant to the
individual’s predispositions in terms of cultural and
social beliefs, and genetic makeup (Young, 2003).
Unconsciously, the adolescent will internalize
a perceived threat or problem and a physiological
response system (affective schema or emotional
component) reacts with the adolescent externalizing
a response from the behavioral schema (expressed
behavior) in the form of aggression (attack), escape
(fear), or avoidance or non-contact (Swart & Apsche,
2014).
The mode deactivation process is where the
intervention takes place, in the following four areas:
(1) core beliefs, (2) perception of fear being the
main response (3) anticipation, and (4) avoidance
of triggers (Swart & Apsche, 2014). The framework
of Mode Deactivation uses case conceptualization
methodology where there is a team approach in
working with adolescents with reaction emotional
dysregulation, including parasuicidal acts, and
aggression (Apsche, 2003). Since there is such a con-
glomeration of personality disorders, this is a major
impediment to the treatment. Therefore, treatment
is consistently treated throughout the MDT process
systematically with case conceptualization (Apsche,
2003). In MDT, mode deactivation recognizes the
adolescent’s need to understand what is happening
to them, and helps them to effectively manage or
produce a positive outcome. If specific fears, triggers
and core beliefs can be activated via chain reaction in
response to their fears, triggers, and/or core beliefs,
MDT allows the youth to manage the deactivation
process (Swart & Apsche, 2014). This therapy allows
the youth to recall the traumatic event that is causing
them to stress or associate fear responses that have
been aligned with their core belief, and helps them to
slowly, effectively change these responses. It helps by
showing the adolescent how to identify the triggers,
and to see positive ways to change those triggers to
safe ways of coping, rather than the destructive ways
that the adolescent has come to know.
Treating the underlying fear and trauma is con-
ducted by using three key components: mindfulness,
acceptance/diffusion, and validate-clarify-redirect
(VCR) the functional alternative beliefs (Apsche,
2010). Using mindfulness helps the adolescent in
reducing their fears. This is done by reducing the
strength and intensity of their fear and anxiety (Ap-
sche, 2010). MTD, unlike the other therapies that can
be used to treat this group, uses the therapeutic rela-
tionship that is developed between the therapist and
the youth as the core foundation while including and
developing a family support system for the youth in
treatment. During this time, the youth is encouraged
to continue and practice the new skills that they are
developing to change their poor coping mechanisms
into positive, healthy mechanisms (Bayles, Blossom,
& Apsche, 2014). The youth are also encouraged at
this time to take the new practices outside of the
therapy sessions and continue to work on them on
their own. One practice that is encouraged for this is
the use of meditation as a supplementary technique.
This has been used in many types of therapies in
the past and has been proved to be highly effective
with MDT. This helps the youth by learning how to
relax, reduce their anxiety, and paying attention to
their interpersonal experience (Bayles et al., 2014).
„„ Using mindfulness in MDT
Dr. Apsche defined mindfulness in MDT as the
“awareness or being aware of your thoughts, feelings
and even bodily sensations to living a happy and
healthy lifestyle. Self-awareness is the first step in
being aware and empathetic of others feelings and
emotions. To be aware of other’s feelings and emotions
you must be aware of your own” (Apsche, 2010).
Although Mindfulness in psychology practice has
been around for about a century, it is becoming more
mainstream in the mental health world. As such,
it is in a very new developmental stage of treating
adolescents with problems such as those who have
been displaying Axis I and Axis II, including, (but
not limited to) sexual behaviors related to their
exposure to trauma and violence which most of the
adolescents who participate in MDT therapy present
(Apsche, 2005; Jennings et al., 2013). Mindfulness is a
core value that is used for the sole purpose of allowing
the adolescent to gain control of their immediate
awareness of six key aspects: sensation, emotions,
thought, perception, behavior, and bodily feelings
(Bayles et al., 2014; Jennings et al., 2013). The main
goal of using mindfulness in this treatment is to
reduce the strength of the behavioral manifestation
of the adolescent’s fear and anxiety that is causing
them to act out in a negative manner (Apsche &
DiMeo, 2010). Mindfulness is a skill that is achieved
through a series of exercises targeted specifically at
the adolescent and his emotions. Through meditation
and observation, the youth experiences a calming
moment that allows him to become fully aware of
the present moment, accept it for what it is and who
he is, and reflect on it without judgment (Jennings
et al, 2013). This gives the youth the ability to begin
taking control of his live in a positive way.
Apsche (2010) describes the adolescent as fully
aware of the immediate present experience and
accepting themselves as they are in the moment,
without judgment. Jennings et al. (2013) described
mindfulness, in MDT, as the intentional process of
observing, describing, and participating in reality
without being judgmental and putting personal bias
aside. In addition to meditation, specific exercises
are incorporated into the treatment regime. The
adolescent uses tools, such as a workbook, that is
individualized to fit that adolescent’s treatment
program that contain practice techniques that will
allow him to trust, reduce anxiety, and increase his
personal commitment to the program and treatment
(Murphy & Siv, 2011).
„„ Key components of MDT
In sum, the core components and key steps of MDT
are: mindfulness—being in the present moment,
acceptance—accepting oneself as who, what, and
where they are in life, cognitive diffusion—allow the
thoughts that imprisoned them to occur without
resistance and not to allow experiential avoidance
from painful thoughts, emotional diffusion—explore
and identify the exact area of pain and formulate
a complete description of the pain, numbness or
“nothingness”. The client describes exactly where and
when they feel emotional feelings that are attached to
painful thoughts (Apsche, Johnshon, & Slavit, 2012).
Next is to Validate, Clarify, and Re-direct (VCR).
Validation in VCR was first defined by Linehan (1993),
where the treating therapist’s ability to uncover the
validity of the adolescent’s belief (Apsche, 2010).
The concept of VCR has been utilized by Dr. Apsche
in MDT by using unconditional acceptance and
validation of the adolescent’s cognitive, unconscious
learning experience (Apsche, 2010; Apsche & DiMeo,
2010). Clarification offers the adolescent different
ways to explain the adolescent’s circumstances and
history, and redirect them to possible acceptance of
a different belief than their original belief system
(Apsche, 2010). MDT using this concept helps the
adolescent to change their original belief system to
a new system that allows them to accept their faults
and work through their pain. In re-directing these
beliefs, it is important to use radical acceptance
and have the adolescent examine the “truth” of
their perception using the methodology of finding
the “grain of truth” in perception (Apsche, 2010;
Apsche & DiMeo, 2010). Re-direction of VCR allows
the adolescent to consider responses that are different
from their current ones in order to help them develop
more effective coping mechanisms. VCR is unique
to MDT and it is considered the key component to
treating adolescents with complex problems (Apsche
& Swart, 2014).

3. BAYLES & VAN NEVEL28
„„ Family mode deactivation therapy
Mode Deactivation Therapy does not work with
adolescents alone. Family therapy is also a big part
of MDT. Family Mode Deactivation Therapy (FMDT)
works in conjunction with MDT and is concerned
with the family structure as a whole. Family research
was found to be directly responsible for youth’s
emotional, mental, and behavioral health (Swart
& Apsche, 2014). Literature evidenced the fact that
youth are exposed to or victims of violence (especially
domestic violence) on a daily basis which resulted in
an estimated three million youth being exposed to
trauma (Swart & Apsche, 2014). Past studies showed
that physical aggression and property destruction
was observed within the family unit. Family Mode
Deactivation Therapy involved face to face contact
of the entire family, with the treatment professional.
According to Apsche and Swart (2014), using the
same principles and methodology of MDT, FMDT
uses VCR assists the family to identify the irrational
and illogical beliefs that the family has in order to
help everyone adapt functional alternative behaviors
(FAB). By validating the family’s belief systems, clar-
ifying the circumstances surrounding those beliefs,
and re-directing those beliefs into FABs, the family as
a unit will learn to develop positive and productive
responses rather than the destructive responses they
originally exhibited (Swart & Apsche, 2014). Past
studies by Apsche, Bass, and DiMeo (2011) suggested
that verbal expressions of thoughts and feelings
by the youths were met with inconsistent support
by the family unit. FMDT teaches the family and
the adolescents how to communicate effective and
non-aggressively with each other. Follow-up studies
proved that, as a family unit, physical aggression
and property destruction was decreased and family
synchronization was increased (Apsche, Bass, &
DiMeo, 2011).
„„ Conclusion
MDT provides a framework through which ado-
lescents (and families) can examine the channels
through which their thoughts, feelings and behaviors
are directed. This is done within the context of an
adult therapeutic relationship that allows both the
youth (and the family unit) to reshape old belief
systems so that they can have more freedom of
choices in their everyday actions. Both youth and
family learns to develop a future different from the
trajectory that their past set for them. MDT and FMDT
have evidenced the capacity to provide a framework
for both, adolescents and family members, to put an
end to those ingrained responses, and destructive
behaviors (Hollman, 2010).
Mindfulness, in the present moment, focus can
be incorporated into any form of psychotherapy,
including the cognitive behavioral therapies to
increase the impact of the treatment interventions.
However, mindfulness as a principle modality and a
common underlying factor can be added to increase
the effectiveness of the treatment. When validation,
clarification, and redirection (VCR), along with rad-
ical acceptance and commitment to the treatments,
accompany mindfulness, remarkably measurable
outcomes occur. With more than 20 MDT research
studies reported over the years, MDT reported a
higher than 40% improvement rate from baseline to
treatment completion, where only 5% improvement
was reported from treatment as usual (TAU). The
results of MDT studies are consistent with previous
studies and provided evidence of the validity and
utility of MDT as an effective treatment modality to
treat adolescents cost-effectively. ■
„„ References
Apsche, J. A. (2005). Theories and modes. International Journal of
Behavioral Consultation and Therapy, 1 (1), 52-55.
Apsche, J. A. (2010). A literature review and analysis of mode deac-
tivation therapy. International Journal of Behavioral Consultation
and Therapy, 6 (4), 296-340.
Apsche, J. A. (2010). Mode deactivation therapy: The complete
guidebook for clinicians. Oakland, CA. New Harbinger.
Apsche, J. A., DiMeo, L. (2012). Mode deactivation therapy for
aggression and oppositional behavior in adolescents:An integrative
methodology usingACT,DBT,and CBT.Oakland,CA.New Harbinger.
Apsche, J. A., DiMeo, L. (2010). Application of mode deactivation
therapy to juvenile sex offenders. In D. Prescott, R. E. Longo
(Eds.), Current applications: Strategies for working with sexually
aggressive youth and youth with sexual behavior problems.
Holyoake, MA. NEARI Press.
Apsche,J. A.,Bass,C. K. DiMeo,L.(2010).Mode deactivation therapy
(MDT):Comprehensive meta-analysis.Journal of BehaviorAnalysis
of Offender and Victim Treatment and Prevention, 2 (3), 171-182.
Apsche, J. A., Bass, C. K. DiMeo, L. (2011). Mode deactivation
therapy (MDT):Comprehensive meta-analysis.International Journal
of Behavioral Consultation and Therapy, 7 (1), 47-54.
Apsche, J. A., Ward, B. (2003). Mode deactivation therapy: A
theoretical case analysis (Part I). The Behavioral Analyst Today,
4 (3), 342-353.
Apsche, J. A., Ward, S. R. (2003). Mode deactivation therapy and
cognitive behavioral therapy: A description of treatment results
for adolescents with personality beliefs, sexual offending, and
aggressive behaviors. The Behavior Analyst Today, 3 (4), 460-470.
Apsche, J. A., Ward, S. R., Evile, M. M. (2003). Mode deactivation:
A functionally based treatment, theoretical constructs. Behavior
Analyst Today, 3 (4), 455-459.
Apsche, J. A., Ward, S. R., Evile, M. M. (2003). Mode deactivation
therapy (MDT): Case conceptualization. Behavior Analyst Today,
4 (1), 47-58.
Apsche, J. A., Johnson, J., Slavit, L. (2012). The clinical practice of
mode deactivation therapy with adolescents. Paper presented at
the 31st
annual Association for the Treatment of Sexual Abusers
(ATSA) conference, Denver, CO.
Bass, C. K., Apsche, J. A. (2014). Update and review of mode
deactivation therapy family and individual meta-analysis. Interna-
tional Journal of Behavioral Consultation andTherapy. 9 (1),39-42
Bass, C. K.,Van Nevel, J., Swart, J. (2014).A comparison between
dialectical behavior therapy, mode deactivation therapy, cognitive
behavioral therapy, and acceptance and commitment therapy in
the treatment of adolescents. International Journal of Behavioral
Consultation and Therapy. 9 (2) 4-8
Beck, A. (1996). Beyond belief: A theory of modes, personality and
psychopathology. In P. Salkovaskis (Ed.), Frontiers of cognitive
therapy (pp. 1-25). New York, NY: Guilford Press.
Bayles, C., Blossom, P., Apsche, J. A. (2014). A brief review and
update of mode deactivation therapy. International Journal of
Behavioral Consultation and Therapy, 9 (1), 46-48.
Cuevas, C. A., Finkelhor, D., Shattuck, A., Turner, H., Hamby, S.
(2013, October). Children’s exposure to violence and the inter-
section between delinquency and victimization. Juvenile Justice
Bulletin, pp. 1-9.
Friedman, H. S., Schustack, M. W. (2012). Personality: Classic
theories and modern research (5th
ed.).Boston,MA:Allyn Bacon.
Hollman,J.(2010).Accentuating mode deactivation therapy (MDT):A
review of a comprehensive meta-analysis into the effectiveness of
MDT.International Journal of Behavioral Consultation andTherapy,
6 (4), 395-397
Jennings, J. L., Apsche, J. A., Blossom, P., Bayles, C. (2013). Using
mindfulness in the treatment of adolescent sexual abusers:
Contributing common factor or a primary modality? International
Journal of Behavioral Consultation and Therapy, 8(3-4), 17-22.
Longmore, R. J., Worrell, M. (2007). Do we need to challenge
thoughts in cognitive behavior therapy? Clinical Psychology Review,
27 (2), 173-187. DOI: 10.1016/j.cpr.2006.08.001
Murphy, C. J., Siv, A. M. (2011). A one year study of Mode Deac-
tivation Therapy: Adolescent residential patients with conduct
and personality disorders. International Journal of Behavioral
Consultation and Therapy, 7 (1), 33-40.
Puzzanchera, C. (2013). Juvenile arrests 2011. Juvenile Offenders
and Victims: National Report Series. Office of Juvenile Justice and
Delinquency Prevention, pp. 1-12.
Swart, J., Apsche, J. A. (2014). Family mode deactivation therapy
(FMDT) mediation analysis. International Journal of Behavioral
Consultation and Therapy, 9 (1), 1-13.
Swart, J., Apsche, J. A. (2014). A comparative treatment efficacy
study of conventional therapy and mode deactivation therapy (MDT)
for adolescents with conduct disorders,mixed personality disorders,
and experiences of childhood trauma. International Journal of
Behavioral Consultation and Therapy, 9 (1), 23-29
Swart, J., Apsche, J. A. (2014). Family mode deactivation therapy
(FMDT) as a contextual treatment. International Journal of Behavioral
Consultation and Therapy, 9 (1), 30-37
Young, J. E. (2003). Schema therapy: Conceptual model. In Schema
therapy: A practitioner’s guide (pp. 1-62). New York, NY: The
Guilford Press.