Radically Open Dialectical Behavior Therapy (RO-DBT) is a state-of-the-art, evidence-based behavioral treatment for teenagers and adults who cope with their emotions by exercising excessive self-control. While many individuals value their ability to exert self-control, a growing body of research suggests that too much control can create impairments in functioning, especially when it comes to social relationships.
Patients who are overcontrolled in their behaviors and thoughts tend to struggle with the flexibility required to make and sustain healthy relationships and tend to be overly focused on perfection and achievement in their lives. RO-DBT teaches individuals how to break free of rule-governed behavior with the aim of increasing openness and receptivity with others, as well as increasing adaptation to changing environmental circumstances.
In order to increase flexibility, patients first need to learn how to become mindfully aware that they are thinking, acting, and/or signaling to others in a manner that is closed and rigid. Over time, they identify the areas of their lives that they find uncomfortable and are prone to avoid. When this mindful awareness is combined with practical skills, these overly “type A” teenagers and young adults develop and use the tools to respond flexibly to life.
This approach has helped teenagers and young adults who struggle with any or all of the following:
Rigid, rule-governed behavior and excessive self-control (for example, generating and following extreme rules such as restrictive eating)
Trouble adapting to changing environmental circumstances
Trouble making and/or deepening current friendships
Excessive delay of gratification
Perfectionism, disciplined behavior, and a hyper-focus on achievement
Hiding or avoiding experiencing and expressing emotions
Issues with intimacy and connectedness
Self-injurious and/or suicidal behaviors
Depression and/or anxiety, especially when these issues are not resolved with therapeutic interventions such as Cognitive Behavioral Therapy (CBT)
Over-tolerance of negative emotions
Loneliness, isolation from others
Envy and bitterness
Considerable research has been conducted on RO-DBT, and multiple randomized controlled research trials have demonstrated its effectiveness for over-control symptoms in many diagnoses, including treatment resistant anxiety and depression, autism, obsessive-compulsive personality styles, and anorexia nervosa. At the Child Mind Institute, we treat many young people who struggle with over-control and help them increase social connectedness and flexibility. RO-DBT is an excellent option for families who want a comprehensive treatment for emotional over-control.
RO-DBT Skills Training
Increase self-awareness, and expand one’s ability to recognize and adopt alternative points of view
Decrease inhibited and disingenuous emotional expression
Reduce hyper-detailed focused and overly cautious behavior
Address and loosen rigid and rule-governed behavior
Decrease aloof and distant styles of relating
Decrease high social comparison and envy/bitterness
RO-DBT Treatment Approach and Services
All new patients to the Child Mind Institute will be given a comprehensive diagnostic evaluation by one of our team clinicians, in part to determine if RO-DBT is the best therapeutic intervention for them. Full diagnostic feedback and treatment recommendations will be given as part of the evaluation. Current patients will participate in consultation for the same purpose.
Participants in the adolescent and young adult RO-DBT programs agree to commit to the following core components for 6 months of treatment, with an option to repeat.
Available for teens and young adults
Weekly for 90 minutes
Patients learn core RO-DBT skills in a class format. Separate RO-DBT parent consultation is available.
RO-DBT Individual Therapy
Meeting 1 session each week, participants work on specific problem behaviors and apply techniques learned in the skills class to their goals.
Our clinicians meet regularly as a consultation team to support one another and think creatively about the best ways to help young people and their families.
Treatment may be accompanied by medication management as needed.