MDT goes deeper than the standard cognitive approach, which deals strictly with distorted thoughts as the root of irrational action. The conceptual idea here is that the pathological world of the juvenile offender is based on distorted mental subsystems ("modes") that are largely unknown to the youngster. They exist in the world of the subconscious and are the result of past abuse and violence that gets reinforced by social norms and ideas. The point of MDT is to make offenders aware of these subsystems. In general, this approach is used when cognitive techniques fail, and the offenders are violently resistant to any treatment. It is not meant for everyone.
The primary method of treatment is the use of both imagery and relaxation therapy to relax the powerful defenses the pathological subsystems have created. Ultimately, the therapy is long-term and based around lecture tapes and workbooks that have as their purpose the identification of the pathological subsystems and the responses they generate. Relaxation, imagery and self-hypnosis are necessary, both to disarm the subject's defense mechanisms and permit the pathology to show itself in a controlled environment. This is similar to cognitive therapy in that it is thought that matters. It differs from cognitive therapy in that the causes of the distortion are much deeper than verbalized thoughts, but exist from trauma. Such trauma then affects perception and interpretation, which distorts the external world into a violently hostile place that demands a proportionate reaction.
MDT is not generally designed for grammar school drug prevention unless it is used on hard-core drug users who have a history of violence or sexual abuse (as both victim and perpetrator). For these youths, MDT is promising. Relaxation and imagery is central, since the defense mechanisms here are well developed and go to the very root of the thought process, manifesting in both thought and action, but are deeper than either. The purpose of the therapy is the creation of a relaxed environment that disarms the child and permits the pathology to manifest itself in tightly controlled ways. This is necessary, since cognitive therapy has failed and has produced little more than violent or hostile results. Therefore, deeper forms of relaxation, including a semi-hypnotic state caused by the use of imagery, can be used to both eliminate hostile responses and permit the pathologies to manifest themselves for the individual to identify and eventually alter. This is a very difficult methodology to utilize, and is only meant for the hardest of hard cases.
Mode Deactivation Therapy (MDT) is a therapeutic technique developed by Dr. Jack Apsche beginning in the 1990s, which continues to evolve. It is geared toward the most serious juvenile offenders, especially the most violently aggressive and those who have been traumatized by sexual abuse, and who carry out such crimes themselves. Apsche specializes in the hardest of the hard cases. Therefore, the application of MDT to elementary school drug prevention would either have to be radically altered or aimed solely at the hardest core drug abusers in a school population.