Radically Open Dialectical Behavior Therapy (RO-DBT)

You mostly repress your emotions, but sometimes they leak out in big ways.

It’s hard to be authentic. Emotional expression is rare or disingenuous.

You struggle to connect with others. You are aloof or distant in relationships.

Perfectionistic tendencies can contribute to intense, bitterness, envy, or social comparisons.

Radically Open Dialectical Behavior Therapy, or RO-DBT, is a treatment developed for people who experience “maladaptive over-control”. As compared to DBT which is for folks whose emotions are not controlled enough, RO-DBT is best for people exerting TOO much control over their emotions. This looks like four major areas of struggle.

1. Low receptivity and openness
2. Low flexible-control
3. Pervasive inhibited emotional expression and low emotional awareness
4. Low social connectedness and intimacy with others

Comprehensive RO-DBT treatment involves both individual treatment sessions and skills training classes. The goal of therapy to improve emotional well-being by teaching skills to increase openness, flexibility and social connectedness.

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Who does RO-DBT work for?

You don’t have to have any particular formal diagnosis for this treatment to be effective! If multiple of these experiences or behaviors sound familiar, RO-DBT could be right for you or your loved one.

There are a handful of specific diagnoses for which research is showing that RO-DBT to be effective. These could include:

• Autism
• Anorexia Nervosa
• Obsessive Compulsive Disorder
• Treatment resistant depression
• Treatment resistant anxiety
• Cluster A Personality Disorders
  • Paranoid Personality Disorder
  • Schizotypal Personality Disorder
  • Schizoid Personality Disorder
• Cluster C Personality Disorders
  • Avoidant Personality Disorder
  • Dependent Personality Disorder
  • Obsessive Compulsive Personality Disorder

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We Offer Both RO-DBT and DBT in Rockville, Maryland

We know that choosing the right approach for your mental health journey can feel overwhelming. That’s why we’re proud to offer both Dialectical Behavior Therapy (DBT) and Radically Open DBT (RO-DBT), two evidence-based treatments designed for different emotional and behavioral needs.

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How do you do RO-DBT Therapy?

RO-DBT Skills Classes

This is where clients learn about their over-controlled tendencies and learn specific skills to improve their lives. There are 30 skills in total that cover these topics:

• understanding emotions and enhancing openness
• mindfulness
• interpersonal integrity
• enhancing social connectedness
• learning from feedback 

Check out more info about the RO-DBT Skills Classes at Montgomery County Counseling Center.

Individual RO-DBT Therapy Session

While you learn skills in class, we use the hierarchy of treatment targets to determine what to focus on in individual therapy.

First and foremost, we will always address life-threatening behaviors, like self harm or suicidal behavior. After all, how can you continue treatment if you aren’t here. If you don’t have any life-threatening behaviors, or they’ve stabilized, then we move on.

Next, we’ll prioritize therapeutic alliance ruptures. Because authentic relationships and honest feedback are incredibly difficult for RO-DBT clients, relationship ruptures with your therapist is to be expected. Focusing on this is essential to preserving the rest of treatment. And it is also perfect practice for how to repair ruptures in your relationships outside of therapy.

Then comes everything else. For RO-DBT, this includes the maladaptive over-controlled behaviors and social signaling deficits. Essentially, this is everything that gets in the way of your goals and contribute to an unsatisfying life experience, in relationships or otherwise.

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