RO-DBT: General Description

A new evidenced-based treatment for those suffering from excessive self-control, Radically Open Dialectical Behavior Therapy (“RO-DBT”) builds upon the success of traditional DBT to treat a unique spectrum of symptoms. Individuals suffering from disorders of over-control, such as anorexia nervosa, obsessive compulsive disorder, chronic depression, chronic avoidance, perfectionism, treatment-resistant anxiety, and paranoia may be able to find relief from this new approach.

Noticing youself or your loved one…

  • Always overthinking?

  • Hyper-detailed focused

  • Overly cautious?

  • Unable to connect with others?

  • Having difficulty expressing emotions?

RO-DBT Can Help:

  • Build openness to new experiences

  • Nurture flexibility

  • Build intimacy and social connection


Could RO-DBT be a good fit for me?

Individuals who could benefit from this form of therapy often have difficulty expressing genuine emotions, can be aloof and inhibited, can have trouble forming meaningful connections with others, and tend to be “over-thinkers” and perfectionistic. They may tend to take life very seriously and have difficulty “playing”, relaxing, being silly, and laughing at their mistakes with kindness. They are often suffering just as much as an “under-controlled” person but are simply unable to show it.

Questions to ask yourself (or a loved one) include:

  1. Do I believe it is important to do things “properly” or “right”?

  2. Am I a perfectionist?

  3. Do I prefer order, structure, and rules to spontaneity?

  4. Am I quiet, restrained, or reserved by nature?

  5. Does it take time for people to get to know the “real” me?

  6. Is it difficult for me to try new things without overthinking/planning everything that could potentially go wrong?

  7. Do I find it very difficult to be kind to myself when I make a mistake or something goes wrong in my life? 

If you (or a loved one) think that RO-DBT could  be a good fit for you, please contact DBT Eastside for an intake appointment. Every effort will be made to provide an accurate assessment as to which group may be the best choice for you.


What is the difference between standard DBT and RO-DBT?

Standard DBT therapy was initially developed to treat disorders of “under control”. It teaches skills to help individuals gain control of dysfunctional and potentially dangerous behaviors by learning how to regulate emotions, tolerate distress, and communicate more effectively with the people in their lives. A more specialized offshoot of DBT is RO-DBT, which was developed in an attempt to treat disorders of “over-control” rather than “under control”.

Traditionally, having the ability to control one’s urges and exhibit high degrees of self-control has been looked at favorably. These are traits highly valued in many societies and these individuals are often seen as the doers, planners, and  high-achievers of the world. However, for those exhibiting excessive self-control, their greatest strength can often become a great weakness. Too much control can deplete the very resources needed to find alternative coping mechanisms (e.g. expressing emotions and distress effectively, asking for help, self-soothing). Individuals can often begin to feel trapped, as their natural tendency to inhibit their emotions makes it difficult for loved ones to know that they are in distress and need help.

The primary therapeutic focus of RO-DBT is overcoming four core deficits found in over-controlled individuals:

  1. Low openness to and avoidance of novel or unplanned experiences;

  2. Compulsive needs for structure and order;

  3. Context-inappropriate or insincere expressions of emotion; and

  4. Low social connectedness and intimacy with others.

The skills taught in this type of therapy work to enhance receptivity, openness, and flexibility while building greater social connectedness. The core idea is that over controlled clients will gain more out of therapy when it prioritizes the value of seeking pleasure and other experiences that tend to be avoided, relaxing control, and joining with others rather than traditional DBT approaches to achieve goals.

RO-DBT Program FAQ’s

1. How long is the program?

The RO-DBT Program is a 30-week program that meets once a week on Wednesdays at 3:30pm (teens) and Wednesdays at 5:30pm (adults). As with our other groups, we allow rolling enrollment and clients can start at anytime.

2. How much does it cost?

Group sessions are $75 each. Please see our main FAQs regarding billing practices.

3. If the client is a teen, are parents required to attend?

For the RO-DBT group, parent attendance is not required.

4. What if I miss a group session?

Due to the targeted skills development offered in RO-DBT, clients are unable to ‘makeup’ a missed group in the way our standard DBT clients may. If a client misses a group session, they can work with the facilitators to discuss best next steps. This may include additional fees depending on the arrangements made.

5. What if I want to cancel my contract?

As with our standard DBT program, clients may withdraw at anytime. However, all clients will be charged our standard 4-no show charges before your contract is cancelled. Please visit our main FAQs for more information.