What is RO DBT?

RO DBT (radically open dialectical behavior therapy) is an evidenced-based therapy designed to manage diagnoses and symptoms that are associated with overcontrol. It is a fully manualized treatment and involves individual treatment sessions and skills training classes. Radical openness is the core component, and this means engaging and practicing openness, flexibility, and social connectedness. Rigidness and inflexibility can wreak havoc on your life simply because it is unrealistic to and often unhealthy to live rigidly. Those suffering from overcontrol often see new situations as dangerous or potentially threatening to their well-being rather than fun or rewarding (Association for Behavioral and Cognitive Therapies, 2022). Life is ever-changing, spontaneous, and often out of our control. It is important to accept these terms and apply them to become aware of the over-control patterns and interrupt them.

What Population is RO DBT For?

RO DBT has been developed for hard-to-treat disorders such as perfectionism, obsessive-compulsive personality disorder, chronic depression, and anorexia nervosa (Lynch, Hempel, Dunkley, 2015). There is also growing evidence that proves this treatment effective for Autism Spectrum Disorders (Cornwall, Simpson, Gibbs, and Morfee, 2021). Research also shows that this therapy is appropriate for kids and adults. If there are any symptoms of overcontrol, it may be worth investigating to see if RO DBT may be appropriate.

How is RO DBT Different than DBT?

So, you may have heard of DBT (Dialectical Behavior Therapy) and it is different from RO DBT in a few ways but also has some similarities. Some of the primary differences are that RO DBT emphasizes radical openness – actively seeking what one is avoiding. DBT emphasizes radical acceptance – letting go of fighting reality and turning intolerable suffering into tolerable pain. DBT focuses on internal processes involving emotional regulation, impulse control, distress tolerance skills, and interpersonal functioning. RO DBT has a stricter focus on social connectedness skills and social signaling. Another major difference lies in who each treatment is for. DBT’s target diagnoses are borderline personality disorder, substance use, and bipolar disorder. These diagnoses are defined by under control of emotions and behaviors and are often directed outwardly and typically appear as disruptive to others. RO DBT on the other hand is more appropriate for patients whose emotions are directed as inward or not expressed at all. In these cases, overcontrol is the primary issue and this is typically found in diagnoses mentioned earlier; Anorexia nervosa, obsessive-compulsive personality disorder, and chronic depression (Association for Behavioral and Cognitive Therapies, 2022). A similarity of both treatments is the dialectical thinking (two things being true at once) involved. Both treatments encourage flexibility in thinking and behaving by taking a “both/and “ approach versus an “either/or” style of thinking.

Delivering RO DBT and What to Expect as a Patient

Generally speaking, as a clinician you can expect to make use of the manual that’s available for this treatment ((Lynch, R.T. (2018). The Skills Training Manual for Radically Open Dialectical Behavior Therapy: A Clinician’s Guide for Treating Disorders of Overcontrol. Revo, NV: Context Press, an imprint of New Harbinger Publications)) to help clients manage overcontrol. In the outpatient setting as a client, you can expect an average of 30-weekly sessions that are about an hour in length and weekly 2.5-hour skill training classes with some integrated breaks. Your therapist may also do phone consultations with you. This is optional. The focus of your time spent as the client will be on being open and flexible and discovering how this impacts your social connectedness.

Overcontrol often impedes daily life and impairs functioning in one or multiple areas of your life.

If you are a mental health professional or would like to learn more about RO DBT, check out this upcoming training. https://www.pathlms.com/cbi/courses/45361/webinars/31076 - RO DBT for overcontrol, perfectionism, and rigid behaviors.

If you are a client struggling with any of the issues mentioned above, don’t hesitate to seek counseling with one of our trained professionals. New patients can utilize this form and someone will reach out to you https://www.papsychotherapy.org/resources/new-patient-form You can also call us at (724) 609-5002. We would love to help you on your journey to healing.


Association for Behavioral and Cognitive Therapies. (2022). Radically Open Dialectical Behavioral Therapy. Retrieved from https://www.abct.org/fact-sheets/radically-open-dialectical-behavior-therapy/

Cornwall, P., Simpson, S., Gibbs, C., & Morfee, V. (2021). Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: Effectiveness in people with autism spectrum disorders. BJPsych Bulletin, 45(3), 146-153. doi:10.1192/bjb.2020.113

Lynch TR, Hempel RJ, Dunkley C. (2015). Radically Open-Dialectical Behavior Therapy for Disorders of Over-Control: Signaling Matters. Am J Psychother. 69(2):141-62. doi: 10.1176/appi.psychotherapy.2015.69.2.141. PMID: 26160620.

By Brittany Steiner, Pre-licensed Therapist