What is RO DBT?
Developed by Dr. Thomas Lynch and informed by over 25 years of research, Radically Open Dialectical Behaviour Therapy (RO DBT) is an evidence-based transdiagnostic treatment for individuals who have problems associated with excessive self-control, often referred to as an emotionally overcontrolled coping style. Features of an overcontrolled coping style can include:
- Inhibited emotional expression
- Overly cautious, hypervigilant behaviour
- Aloof and distant style of relating
- Highly self-critical
- High personal standards
- Perfectionism
- Rigid, rule-bound behaviour
These features of an overcontrolled coping style can often lead to emotional loneliness, where an individual can have difficulties joining in with others and establishing intimate bonds. An overcontrolled coping style is thought to underlie many difficult to treat mental health problems, including treatment resistant depression and anxiety disorders, anorexia nervosa, as well as avoidant, paranoid, and obsessive-compulsive personality disorders.
What is Overcontrolled Coping?
RO DBT believes that many individuals are born with a biological predisposition or temperament characterized by a high sensitivity to threats, low sensitivity to rewards, and high capacity for control. When people with this tendency grow up in an environment that places a high value on structure, self-control, and performance, problems can arise as an overcontrolled coping style often makes it difficult to be open to new experiences, think and respond flexibly to change, and build and maintain connection with others. Those with an overcontrolled coping style also tend to be self-critical and have high personal standards, which while helpful at times, can also leave them feeling isolated and lonely.
How does RO DBT work?
RO DBT assumes that overcontrolled coping is too much of a good thing. That is, RO DBT recognizes that we live in a society that often reinforces working harder, being more efficient, and in control of our emotions. Rather than “fixing” or “correcting” problems associated with overcontrolled coping, RO DBT teaches skills to increase openness and become more flexible in order to learn, adapt to change, and create more opportunities for joy and fun.
RO DBT targets emotional loneliness by welcoming overcontrolled individuals back to the tribe and teaching skills to interact with others in ways that foster connection and close relationships.
RO DBT involves learning skills associated with three core features of psychological health and well-being:
- Receptivity and openness to new experiences
- Flexible-control in order to adapt to change
- Intimacy and social-connectedness to form more long-lasting relationships
What does RO DBT involve?
RO DBT typically involves weekly 50-minute individual treatment sessions plus a weekly 2-hour group skills class over the course for approximately 30 weeks. Clients learn relevant theory and concepts regarding how social signaling impacts relationships and emotional well-being, identify their individual coping styles and habitual responses and develop new skills to think and behave more flexibly and enhance social connectedness.
RO DBT skills class
The DBT Centre of Vancouver is offering a 30-week long, 2-hour weekly RO DBT skills class. This class is for people 18 years and older.
Over the 30 weeks, clients will learn:
- Understand overcontrolled coping style
- Enhance openness and social connectedness
- Radical openness to learn from an ever-changing environment
- Mindful self-enquiry to learn from uncomfortable experiences
- Different functions of emotions
- Spontaneous participation in new experiences
- Increase opportunities for joy
The RO DBT skills class does not replace individual therapy. All clients participating in the RO DBT class at the DBT Centre of Vancouver are required to be under the care of a primary mental health treatment professional who they can see on an individual basis for a minimum of one hour per month and who is responsible for their clinical care while participating in the RO DBT-informed skills class. The therapist can be someone through the DBT Centre of Vancouver (if available) or someone in the community. Persons with anorexia nervosa should have a medical team in place to assist them with managing associated nutritional and physical complications.
Each group session starts with a mindfulness exercise followed by homework review. After a 10-minute break, the new skill is taught, and homework is assigned for the following week.
Prior to starting the RO DBT skills class, all clients will need to complete an intake assessment with a clinician from the DBT Centre of Vancouver to confirm their coping style and best fit for services.
The next RO DBT skills class is Tuesdays from 5:30pm – 7:30pm, via Zoom. The fee for each class is $130 per week*. One cycle of class is 30 meetings (~6.5 months).
*We do not have a cancellation policy for class: if the client is not able to make a class meeting for any reason–whether they are sick or travelling, whether they let us know in advance or not–the fee for the class is still charged. If they decide for any reason that they will no longer be attending the class, they can withdraw and no more class fees will be charged.
Space in the RO DBT class is limited. Referral is not required.
Next steps
If you are interested in participating in our RO DBT skills class, please email info@dbtvancouver.com.
Frequently Asked Questions
1. What is the difference between RO DBT and regular DBT?
RO DBT is both similar and dissimilar to DBT. RO DBT uses dialectical and behavioural therapy principles, in different ways.
Dialectical principles are used in RO DBT to help overcontrolled clients to think and behave more flexibly. An example of dialectical thinking can be seen in the RO DBT mindfulness skill of self-enquiry. Self-enquiry requires willingness to question one’s beliefs, perceptions, action urges, and behaviors without falling apart or simply giving in. The dialectical tension involves balancing trusting versus distrusting oneself. The synthesis in RO DBT involves being able to listen openly to criticism or feedback, without immediate denial (or agreement), and a willingness to experience new things with an open heart, without losing track of one’s values.
Behavior therapy principles are used to explain how certain maladaptive overcontrolled social signaling are intermittently reinforced over time (for example, pouting is reinforced when it blocks unwanted feedback) and to therapeutically support adaptive responses that aid in making and strengthening close social bonds (such as vulnerable self-disclosure and candid expression of emotion).
Excerpt from https://www.abct.org/fact-sheets/radically-open-dialectical-behavior-therapy
2. Is RO DBT for people that have borderline personality disorder?
RO DBT was developed for people with an overcontrolled coping style, such as people with anorexia nervosa, chronic depression, and obsessive-compulsive personality disorder. These would be people whose emotions are often directed inward or who don’t show their emotions at all.
DBT was developed for people with an undercontrolled coping style, such as people with borderline personality disorder, bipolar disorder, or difficulties with substance use. These would be people whose emotions often are directed outward, openly expressed, and can appear disruptive to others.
3. Should I do regular DBT or RO DBT?
If you are interested in learning more about whether you have an overcontrolled or undercontrolled coping style, and whether you would benefit from DBT or RO DBT, you can contact our centre for an intake assessment by a trained clinician. An assessment involves completion of questionnaires and an interview to distinguish between these two coping styles and receiving recommendations about which service might best suit your needs and goals.
Additional Resources
To learn more about RO DBT, please visit http://www.radicallyopen.net/.