Introductory Training

Course Description

Self-control, the ability to inhibit competing urges, impulses, or behaviors is highly valued by most societies. However, excessive self-control has been linked to social isolation, aloof interpersonal functioning, maladaptive perfectionism, constricted emotional expressions, and difficult-to-treat mental health problems, such as anorexia nervosa, obsessive compulsive personality disorder and refractory depression.

The aim of this workshop is to introduce clinicians to the theoretical foundations and new skills underlying Radically Open-Dialectical Behavior Therapy (RO DBT) for disorders of overcontrol (Lynch, in press). RO DBT is fully manualized and supported by three randomized controlled trials (RCTs) for refractory depression, two open-trials targeting adult Anorexia Nervosa, and one non-randomized trial targeting treatment resistant overcontrolled adults.

While resting on many of the core principles of standard DBT, the therapeutic strategies in RO-DBT are often substantially different. For example, RO-DBT contends that emotional loneliness represents the core problem for overcontrol, not emotion dysregulation. The biosocial theory for overcontrol posits that heightened threat sensitivity and diminished reward sensitivity transact with early family experiences emphasizing “mistakes as intolerable” and “self-control as imperative” to result in an overcontrolled coping style that limits opportunities to learn new skills and exploit positive social reinforcers. A novel thesis linking the communicative functions of emotional expression to the formation of close social bonds will be introduced, as well as new skills emphasizing receptivity, self-enquiry and flexible responding. New approaches designed to activate a neurobiological-based social-safety system, signal cooperation, and encourage genuine self-disclosure will be introduced using slides, handouts, video clips, and role plays.

Learning Objectives

Upon completion of this one-day training, participants will be able to:

1. Explain a new biosocial theory for OC
2. Describe the RO DBT treatment structure
3. Describe new RO DBT treatment strategies designed to enhance willingness for self-inquiry and flexible responding.
4. Describe the RO DBT treatment hierarchy
5. Describe a novel treatment mechanism positing open expression = trust = social connectedness
6. List examples of strategies designed to improve pro-social cooperative signaling via activation of the parasympathetic nervous system’s social-safety system

Example of Typical Training Schedule

The following is an indicative schedule for one-day training events. The exact running order may be subject to amendment and change, but this timetable gives a good feel for  the material covered during the day.

08:30 – 09:00 Registration and Sign-In

09.00 – 10:00 RO-DBT – an empirically based treatment

10:00 – 11:00  The problem of too much self control

11:00 – 12:30  The neuroregualtory  model and bio-social theory

12:30 – 13:30  Lunch Break

13:30 – 14:30  Signalling matters and Radical Openness

14:30 – 15:30  Assessing overcontrol

15:30 – 16:30  Treatment Structure, overview of RO skills and an example of targeting OC maladaptive behavior