What is RO DBT?

RO DBT stands for Radically Open DBT. Like standard DBT it is built on dialectical philosophy which teaches us that we can hold and synthesize opposing viewpoints. Perhaps the most basic example of this is how we can simultaneously accept ourselves for who we are today while also recognizing the need for change. Where DBT is oriented to individuals who seek more emotional control, RO DBT is oriented towards those who sometimes exert too much control over their emotions.  RO DBT calls this “overcontrol,” and it can get in the way of one’s mental health.

RO DBT was created by Dr. Lynch who previously studied with Dr. Linehan, the creator of DBT. He discovered that standard DBT did not work optimally for individuals who were overcontrolled. Candidates for the treatment are sometimes seen as being perfectionistic, rigid, overly serious, and unable to relax. This can lead to feelings of loneliness, and shy behavior. They may mask their inner feelings, or be unable to be spontaneous. Dr. Lynch developed RO DBT 20 years ago specifically for these individuals, extensive research has since shown the approach to be significantly more effective than traditional treatments. 

Radical openness is defined as the combination of three capabilities that are critical to emotional well-being, these include openness, flexibility, and social connectedness. Let’s discuss each of these starting with openness:

Openness is focused on developing tolerance for, and even appreciation for, new unexpected, or disconfirming feedback. It counteracts a tendency to avoid uncertainty or unplanned risks. Where a natural inclination exists for suspiciousness, and hyper-vigilance for potential threats it allows overcontrolled individuals to consider critical feedback that they might otherwise dismiss. 

Flexibility is focused on strategically loosening up the need for structure and order, perfectionism, one's sense of duty, and social obligation. It counteracts a tendency to overthink things, compulsively plan, and adhere to processes in a fundamentalist manner. It allows overcontrolled individuals to recognize that there are often a myriad of ways to achieve a goal and that being open to diversity of approaches improves outcomes and resilience. 

Finally, social connectedness is focused on our awareness of others’ emotions as well as how we represent our own emotions to others. It enhances awareness of emotions as a critical part of communication and it helps reduce the discomfort overcontrolled people may feel when expressing emotions—in fact, this discomfort can often cause overcontrolled people to misrepresent their emotions in ways that are confusing for all parties involved. Building social connectedness allows overcontrolled individuals to engage in closer relationships that foster emotional connection and enhance self awareness and perspective. 

RO DBT treatment is grounded in 30 lessons that can be taught through individual treatment sessions, skills groups, and through on-demand skills coaching, or what DBT calls phone coaching. These are the key components of RO DBT, but not all clients need all components. Most clients will benefit from the skills group but some will also benefit from individual therapy and on-demand skills coaching. When you start therapy, your therapist will propose a treatment plan that is personalized to your needs and goals. 

One other aspect of RO DBT that really resonates with our clients is that it’s not intended to be an open ended treatment like traditional psychoanalysis. Not only is it more grounded in research but clients are statistically likely to get the desired outcome in a relatively short period of time. Most clients complete their course of RO DBT in eight months if they participate in a weekly skills group.