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Mood Disorders Center

Radically Open Dialectical Behavioral Therapy

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

  1. Increase self-awareness, and expand one’s ability to recognize and adopt alternative points of view
  2. Decrease inhibited and disingenuous emotional expression
  3. Reduce hyper-detailed focused and overly cautious behavior
  4. Address and loosen rigid and rule-governed behavior
  5. Decrease aloof and distant styles of relating
  6. 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.

Skills Class

  • 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.

Consultation Team

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.

For more information, please contact Ruby Paisner by email at ruby.paisner@childmind.org or by phone 646.625.4367.

Para leer esta información en español, siga este enlace.

Our Team

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