What is radically open dialectical behaviour therapy

Radically open dialectical behaviour therapy (RO-DBT) is a therapy for people with an over-controlled coping style and with a treatment-resistant disorder such as depression and anorexia. RO-DBT helps address emotional loneliness and teaches useful skills for increasing awareness of how social signalling affects relationships as well as how to be more open and receptive to the environment in order to learn. RO-DBT has a robust evidence base with five published trials to date (e.g. Lynch, Hempel, & Dunkley, 2015).

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There are four components of RO-DBT:

  • skills training group
  • individual treatment
  • RO-DBT phone coaching
  • and consultation team.


RO-DBT skills training class is focused on enhancing clients' capabilities by teaching them behavioural skills. The class facilitator teaches the skills and assigns homework for clients to practise using the skills in their everyday lives. Classes meet on a weekly basis for approximately 2.5 hours and it takes 28 weeks to complete the full skills curriculum.


RO-DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to enhance social connections in their lives. In the standard RO-DBT model, individual therapy takes place once a week for as long as the client is in therapy and runs concurrently with skills classes.


RO-DBT therapist consultation team offers supervision and support to RO-DBT providers in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help therapists remain adherent to the model so they can provide the best treatment possible. Teams meet weekly and are composed of individual therapists and class facilitators who share responsibility for each client's care.

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What skills are taught in RO-DBT?


The RO-DBT programme at IPTS consists of weekly skills classes of 2.5 hours for 28 weeks and weekly individual session for 31 weeks.


The main three skills that RO-DBT teaches are:

 

  1. Receptivity and openness to new experience and feedback in order to learn. This can be done through ‘self-enquiry’ which consists of noticing when we feel energy or curiosity about something, asking ourselves questions to stay with this energy and curiosity to understand what it may be about, then ultimately learning from this.
  2. Flexible control which enables you to adapt to an ever-changing environment. This is explored by looking at the different states of mind – fixed, fatalistic, and flexible – and how they can make us become rigid and set in our own ways without always realising it. Mindfulness is an integrated part of RO-DBT and practised at the start of each class. It helps us gain better insight into our own thoughts and body and teaches us how to ‘let go’ of inflexibility.
  3. Social connectedness and intimacy which lead to close bonds with others and allow for mutual work in groups or ‘tribes’. Social signalling plays a key role in this component by helping us become aware of what we are signalling to others through our verbal and non verbal behaviour. Class participation enhances the confidence in our social skills and provides a safe place to practise social signalling. This can then help us understand how such types of signalling affect our relationships with family, friends, colleagues, and professionals.


What does Radically Open mean?


Radical Openness is a way of behaving, but it is also a state of mind informed by the central premise that emotional well-being involves the interaction and use of the above three components. As a state of mind, Radical Openness involves actively seeking our personal unknown in order to learn from the environment. Radical Openness also enhances relationships because it models humility and the willingness to learn from what the world has to offer.


What if I have an issue in therapy?


We encourage all clients to discuss any difficulties they may experience with their individual/group therapist to seek a resolution.
 

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Intensive Psychological Therapies Service (IPTS)