Question 1

What is RO DBT?

Thomas Lynch · Accepted Answer

Radically Open Dialectical Behavior Therapy (RO DBT) is an evidence-based treatment targeting a spectrum of disorders characterised by excessive self-control, often referred to as overcontrol (OC). It is supported by 25+ years of clinical experience and translational research and differs significantly from other treatment approaches, most notably by linking the communicative functions of emotional expression to the formation of close social bonds and via skills targeting social-signalling and changing neurophysiological arousal. RO DBT treatment involves both individual treatment sessions and skills training classes. You can read more here https://www.radicallyopen.net/about-ro-dbt/

Question 2

What does RO DBT do that DBT doesn't?

Thomas Lynch · Accepted Answer

RO DBT treats overcontrolled disorders (e.g., chronic depression, anorexia, obsessive compulsive personality disorder) whereas DBT treats undercontrolled disorders, with borderline personality disorder being the quintessential undercontrolled disorder. The differences between the two treatments include (but are not limited to) a new mechanism of change, significantly different treatment targets and 30 new skills not used in DBT. You can sign up for our mailing list and watch a free video explaining the major differences between the two here (and you can always unsubscribe later)
https://www.radicallyopen.net/join-our-mailing-list/

Question 3

What are overcontrol disorders?

Thomas Lynch · Accepted Answer

Examples include obsessive compulsive personality disorder, paranoid personality disorder, avoidant personality disorder, dependant personality disorder, anorexia nervosa, schizoid and schizotypal personality disorder, autism spectrum disorders, chronic depression, treatment resistant anxiety and internalising disorders in general. More information can be found here
https://www.radicallyopen.net/overcontrol/

Question 4

If people have learned over control and hiding inner emotions to survive trauma, is it better for them to do trauma work or an approach like this?

Thomas Lynch · Accepted Answer

The amount a person leans to overcontrol is determined by a mixture of temperament (genetics) and environmental influences. Overcontrolled problems can be exacerbated by trauma but without a thorough assessment of the individual, it is difficult to provide a definitive answer. If a person leans heavily towards overcontrol we recommend they begin with RO DBT, whereupon the therapist can make a determination of how to best address trauma issues within the context of treating overcontrol. Preliminary results with veterans in the US using RO DBT has shown a significant decrease in trauma related symptoms with over controlled clients who had previously not responded to other trauma treatments.

Question 5

Would RODBT be appropriate for maladaptive perfectionism, particularly for college and middle/high school students? I am a school counsellor.

Thomas Lynch · Accepted Answer

Yes, we have a lot of school/college counsellors using RO DBT with great success, targeting hyper-perfectionistic students.

Question 6

How can RO DBT address NSSI when the function is communication of need or depth of emotion to others?

Thomas Lynch · Accepted Answer

Apologies, this question needs more space than permitted to answer fully. With regard to NSSI, the RO DBT text book (Lynch 2018) covers how RO DBT treats suicidal and non-suicidal self-injury (pages 109 – 118 and 401 – 404).

Question 7

I'm wondering if radically open DBT has even been used to help people who are controlling in their romantic relationships?

Thomas Lynch · Accepted Answer

We don’t have any research data on this topic as of yet, although I am in the process of writing a book that is focussed on how to adapt RO DBT for couples therapy. A little openness in a relationship is not a bad thing!

Question 8

How can DBT work with OCPD ?

Thomas Lynch · Accepted Answer

RO DBT considers OCPD a quintessential overcontrolled disorder and the rigid rule-governed behavior that characterises OCPD is a core target in the treatment. Further information can be found on our website https://www.radicallyopen.net/self-control/

Question 9

I was wondering if your content on social signalling would be useful for people who are really socially anxious and come across as cold, aloof and unfriendly?

Thomas Lynch · Accepted Answer

Yes, socially anxious and aloof and distant responding is a core target in RO DBT and are 
prototypical difficulties that respond well to RO DBT

Question 10

Do you have a treatment manual for therapists?

Thomas Lynch · Accepted Answer

Yes, there are actually two; the RO DBT textbook (Lynch 2018) provides a guideline for individual therapy whereas the RO skills manual provides the complete set of RO skills (30 lessons) with user friendly handouts and worksheets. 
https://www.radicallyopen.net/books/

Question 11

I feel like I am subtly punished by everyone when I express negative emotion? Am I warped in perceiving others reaction to me or am I just an unlikeable person? I observe others being accepted for being vulnerable. I saw that this treatment can help with feeling like an outsider. Would you recommend it for me? Does it have to be done in a group setting or can it be done one-on-one?

Thomas Lynch · Accepted Answer

Although I am not able to answer personal clinical questions, I can say
that RO DBT is designed to help people who feel ostracised and lonely – using a mixture of individual therapy and training in new skills.