Radically Open DBT

Radically Open Dialectical Behavior Therapy

Guilford Counseling now offers Radically Open Dialectical Behavior therapy (RO DBT). This new treatment has been proven effective in treating a wide range of mental health conditions, including chronic depression, anorexia nervosa, treatment-resistant anxiety, Obsessive-Compulsive Personality Disorder, and others. We are excited to be the only provider in the Piedmont Triad to be offering this cutting-edge therapy.


What is RO DBT?

RO DBT is meant for clients who are overcontrolled. Overcontrol and undercontrol exist on a spectrum. Everyone falls somewhere along the spectrum. Individuals who fall closer to the extremes are more likely to experience mental health issues. Standard DBT treats conditions associated with undercontrol, while RO DBT treats conditions that are linked to overcontrol. Undercontrolled individuals struggle with self-control. Their behaviors are often emotion-dependent, which, when they are emotionally dysregulated, leads to behavioral problems. “[T]reatments targeting problems of undercontrol should emphasize interventions that enhance inhibitory control and reduce mood-dependent behavior.” Why Target Overcontrol?

Problems of overcontrol manifest quite differently. Many overcontrolled individuals suffer in silence, or worse, seek help but their conditions are not taken seriously. This occurs for several reasons. First, overcontrolled people often mask painful emotions. Sometimes this is effective, but when inhibiting painful emotions becomes a rule it leads to social isolation. Second, they generally do not express their emotions in dramatic ways. This causes others to underestimate the depths of their suffering. Finally, overcontrolled individuals excel at self-control—particularly inhibiting emotional expression and delaying gratification. Because most societies value self-control, “problems linked with excessive inhibitory control or ‘overcontrol’ have received little attention, or been misunderstood,” making it “difficult for clinicians to recognize such problems.” While self-control is a valuable trait, too much self-control can cause immense suffering, especially “social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems, such as anorexia nervosa, chronic depression, and obsessive-compulsive personality disorder (e.g., Lynch & Cheavens, 2008; Zucker et al., 2007).” Research on RO DBT

RO DBT has been successful in cases where other treatments have failed because, unlike many treatment modalities, it recognizes that “Treatments targeting problems of overcontrol require interventions designed to relax inhibitory control and increase emotional expressiveness, receptivity, and flexibility.” Why Target Overcontrol? Excessive self-control often leads to social isolation and loneliness. RO DBT helps clients find “a life worth sharing.”


What is Overcontrol?

Overcontrol is a function of both biology and environment. Research demonstrates that overcontrolled individuals show the following biotempermental characteristics:

  • high threat sensitivity
  • high detail-focused processing
  • high inhibitory control
  • low reward sensitivity

In other words, individuals with overcontrol tend to:

  • be more sensitive
  • experience less excitement
  • experience fewer positive emotions
  • excel in self-control
  • be perfectionists

Overcontrolled traits, especially self-control, are rewarded by society, as they are essential to any long-term accomplishment. But, as RO DBT stresses, overcontrolled clients suffer from too much of a good thing. The challenge for those who are overcontrolled is to learn how to take things less seriously, enjoy themselves, and cultivate close relationships.


Is RO DBT right for you?

At Guilford Counseling, we will assess whether you are more overcontrolled or undercontrolled. We will then work with you to decide whether standard DBT or RO DBT is a better fit for you.


What can I expect from Guilford Counseling’s RO DBT program?

Just as in standard DBT, RO DBT consists of weekly individual therapy, skills class, phone coaching, and clinician-team consultation. Skills classes will be held on Monday nights at 5:30.

Contact us if you are interested in learning more about this innovative new treatment. Stay tuned to our blog for more information about RO DBT.



About RO DBT. Radically Open. http://www.radicallyopen.net/about-ro-dbt/

Hempel, R.J., Vanderbleek, E., Lynch, T.R. (2018). Radically Open DBT: Targeting Emotional Loneliness in Anorexia Nervosa. Eating Disorders: The Journal of Treatment and Prevention, 26(1), 92-104. https://www.ncbi.nlm.nih.gov/pubmed/30561967

Lynch TR, Cheavens JS, Cukrowicz KC, Thorp SR, Bronner L, Beyer J. Treatment of older adults with co-morbid personality disorder and depression: a dialectical behavior therapy approach. Int J Geriatr Psychiatry. 2007;22(2):131–143. doi: 10.1002/gps.1703. https://www.ncbi.nlm.nih.gov/pubmed/17096462

Lynch, T.R., Hempel, R.J., Dunkley, C. (2015). Radically Open-Dialectical Behavior Therapy for Disorders of Over-Control: Signaling Matters. American Journal of Psychotherapy, 69(2), 141-162.

Research on RO DBT. Radically Open. http://www.radicallyopen.net/research-on-ro-dbt/