Radically Open Dialectical Behavior Therapy

What is Radically Open Dialectical Behaviour Therapy (RO-DBT)?

Radically Open Dialectical Behavior Therapy is a new treatment that targets over-controlled behavior. It has been used to treat some of the rigid responses and emotional inhibition thought to underlie many treatment-resistant conditions. RO-DBT has been informed by over 20 years of clinical and experimental research, and is a talking therapy that involves weekly individual therapy and class sessions. The duration of the therapy is ~30 weeks. The RO-DBT treatment typically involves a 1-hour weekly individual session and a 1.5-hour weekly class session.

Who is the Treatment For?

Patients who have a diagnosis of Chronic Depression, Treatment-Resistant Anxiety Disorders, Anorexia Nervosa, Avoidant, Paranoid and Obsessive Compulsive Personality Disorders and Autistic Spectrum Disorders.

A growing evidence base:

RO-DBT is now practised in the UK, Europe, and North America, and is increasingly recognised as effective for patients who exhibit emotional over-control. The efficacy of RO-DBT has been informed by experimental, longitudinal, and correlational research, including two randomized controlled trials (RCTs) of refractory depression with comorbid OC personality dysfunction that provided the foundation of the development of the RO-DBT treatment manual (Lynch et al., 2007; Lynch, Morse, Mendelson, & Robins, 2003), one non-controlled trial with adult anorexia nervosa inpatients (Lynch et al., 2013), a case series open-trial applying Radical Openness skills alone plus standard DBT with adult AN outpatients (Chen et al., under review), and one non-randomized trial targeting treatment resistant over-controlled adults (Keogh et al, in press), while the mechanisms of change and efficacy for treatment of refractory depression and comorbid OC personality disorders are being investigated via the large multi-site RCT ‘REFRAMED’ (www.reframed.org.uk Lynch).

What the treatment targets:

RO-DBT posits that high temperamental threat sensitivity, high temperamental constraint, and low temperamental reward sensitivity transact with early family experiences emphasizing mistakes as intolerable and self-control as imperative to result in an overcontrolled coping style that limits opportunities to learn new skills and exploit positive social reinforcers.
Robust research has confirmed that signalling matters when it comes to psychological well-being—e.g. chronic inhibition or disingenuous expression of emotion has been linked to social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems, such as anorexia nervosa, autism disorder, chronic depression, and obsessive-compulsive personality disorder.
Novel strategies are introduced in the treatment, targeting social connectedness and the reduction of unhelpful envy, bitterness, and revenge—including skills designed to activate neural substrates associated with social-safety and desires for affiliation, nonverbal social-signaling skills linked to the mirror neuron system and the establishment of trust, forgiveness of self and others, self-enquiry and openness, and breaking-down over-learned inhibitory barriers.

With patients’ permission, the sessions may be video-recorded, to help therapists with supervision and on-going training.

For more information contact:

Trent Codd
Cognitive-Behavioral Therapy Center of WNC, P.A.

Current skills classes:
Mondays from 12 noon to 2pm (Note: participants must meet with Trent Codd first to determine suitability for the program)