A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents

The recent rapid proliferation of “new wave” treatments, also loosely referred to as the third wave cognitive-behavioral therapies, has renewed interest in their comparative performance, scientific validity, and theoretical and methodological integrity. However, critics are also expressing concerns that these therapies are not well enough supported and “getting ahead of the data”. This article engages the literature on a small selection of modern therapy approaches, namely Mode Deactivation Therapy (MDT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), and more specifically compared to Cognitive Behavioral Therapy (CBT). On the one hand, it challenges the assumption that third wave therapies in general, but more specifically in reference to MDT, ACT, and DBT, have little new to offer by way of superior performance, often in reference to populations that are usually deemed as difficult-to-treat in traditional approaches such as CBT. While, on the other hand, it investigates claims that third wave treatments are more part of a CBT family of approaches rather than distinct treatments. It draws from the conceptualizations, practices, and experiences of the respective developers themselves to argue for the distinct value and prospects that these third wave therapies offer in terms of scientifically established treatment outcomes. For example, it is difficult and unwise to dismiss the superior results that MDT has established in treating severe multi-problem adolescents, a population that has inarguably an extremely high human and economic impact in the long run. By an improved understanding and differentiation of the third wave therapies, their proliferation can be accelerated without compromise to harness their potential more effectively and focused.