Radically Open Dialectical Behavior Therapy (RO DBT) is an evidenced based treatment targeting a spectrum of disorders characterized by excessive self control, often referred to as overcontrol (OC).
The transdiagnostic nature of RO DBT has spurred new thinking and new research targeting a broad range of disorders and treatment settings. Current RO DBT research, training, and clinical work has extended to different age groups (adolescents, older adults, young adults), different disorders (anorexia, chronic depression, autism, OC personality disorders, treatment-resistant anxiety), different cultures and countries in Europe, North America, South America and Asia, and different settings (forensic, inpatient, outpatient). In addition, training has been extended to a wide range of providers (psychologists, nurses, social workers, psychiatrists, family therapists, occupational therapists), with development and application of a range of modalities (RO skills alone, multifamily training, RO couples therapy).
RO DBT is now recognized as an 'Empirically Supported Treatment' by the Society of Clinical Psychology, Division 12 of the American Psychological Association. Read more here.
Lynch et al., 2020: RO DBT leads to significantly greater improvements in depression symptoms after 7 months than treatment as usual, with a large effect size of 1.03!
RO DBT has been informed by over 25+ years of translational research, and is supported by experimental, longitudinal, and correlational research in a range of mental health disorders, including chronic depression, anorexia nervosa, and cluster A and C personality disorders.
Special Issue on RO DBT in the Behavior Therapist
In March 2018 a special issue of the Behavior Therapist was dedicated entirely to RO DBT.
List of articles:
- New Thinking About Old Ideas: Introduction to the Special Issue on Radically Open Dialectical Behavior Therapy
- Tribe Matters: An Introduction to Radically Open Dialectical Behavior Therapy
- Too Much Versus Too Little Control: The Etiology, Conceptualization, and Treatment Implications of Overcontrol and Undercontrol
- How to Differentiate Overcontrol From Undercontrol: Findings From the RefraMED Study and Guidelines From Clinical Practice
- Radically Open Dialectical Behavior Therapy: Shared Features and Differences With ACT, DBT, and CFT
- Radically Open Dialectical Behavior Therapy for Anorexia Nervosa: Connection, Openness, and Flexibility at the Heart of Recovery
- Group Radical Openness
- Not Everything Is as It Seems: RO DBT and Overcontrolled Disorders in Forensic Settings
- The Implementation of RO DBT in Clinical Practice
A selection of peer-reviewed journal papers
- Gilbert, K., Codd, R. T. III, Hoyniak, C., Tillman, R., Baudinet, J., Pires, P. P., Hempel, R., Russell, I., & Lynch, T. R. (2023). Processes of change in a randomized clinical trial of radically open dialectical behavior therapy (RO DBT) for adults with treatment-refractory depression. Journal of Consulting and Clinical Psychology, 91(2), 71-81. https://doi.org/10.1037/ccp0000795
- 2. Johnson, L.N., Fierstein, R., Cahn, S.C., Hoch, A. L. & Twardzik, L. N. (2023). Implementation of Radically Open Dialectical Behavior Therapy in a University or College Counseling Setting: A Case Study, Journal of College Student Psychotherapy, https://doi.org/10.1080/87568225.2023.2191879
- Gilbert, K., Sudit, E. et al. (2022). Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms. Res Child Adolesc Psychopathol. https://doi.org/10.1007/s10802-022-00953-x
- Baudinet, J., Stewart, C., Bennett, E. et al.(2021). Radically open dialectical behaviour therapy adapted for adolescents: a case series. BMC Psychiatry 21, 462. https://doi.org/10.1186/s12888-021-03460-3
- Lenz, A.S., James, P., Stewart, C. et al. (2021). A Preliminary Validation of the Youth Over- and Under-Control (YOU-C) Screening Measure with a Community Sample. Int J Adv Counselling. https://doi.org/10.1007/s10447-021-09439-9
- Stanton, M., Rushbrook, S. C., Swales, M. A., & Lynch, T. R. (2021). A case study and practitioner perspective on the application of Radically Open Dialectical Behaviour Therapy (RO DBT). Quaderni Di Psicoterapia Cognitiva - Open Access, (48). https://doi.org/10.3280/qpc48-2021oa12138
- Isaksson, M., Ghaderi, A., Wolf-Arehult, M., Ramklimt, M.(2021). Overcontrolled, undercontrolled, and resilient personality styles among patients with eating disorders. Journal of Eating Disorders 9: 47. https://doi.org/10.1186/s40337-021-00400-0
- Isaksson, M., Ghaderi, A., Ramklimt, M., Öster, C., Wolf-Arehult. M. (2021). Sharing and connecting with others - patient experiences of radically open dialectical behavior therapy for anorexia nervosa and overcontrol: a qualitative study. Journal of Eating Disorders, 9: 29. https://doi.org/10.1186/s40337-021-00382-z
- Isaksson, M., Ghaderi, A., Ramklimt, M., Wolf-Arehult. M. (2021). Radically open dialectical behavior therapy for anorexia nervosa: A multiple baseline single-case experimental design study across 13 cases. Journal of Behavior Therapy and Experimental Psychiatry, 71, epub ahead of print. https://doi.org/10.1016/j.jbtep.2021.101637
- Cornwall, P., Simpson, S., Gibbs, C., & Morfee, V. (2020). Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: Effectiveness in people with autism spectrum disorders. BJPsych Bulletin, 1-8. DOI: https://doi.org/10.1192/bjb.2020.113
- Little, J.N. & Codd, R.T. III. (2020). Radically Open Dialectical Behavior Therapy (RO DBT) in the treatment of perfectionism: A Case Study. Journal of Clinical Psychology, epub ahead of print. DOI: https://doi.org/10.1002/jclp.23062
- Baudinet, J., Simic, M., Stewart, C., Griffiths, H., Donnelly, C., Goddard, E. (2020). Targeting maladaptive overcontrol with radically open dialectical behaviour therapy in a day programme for adolescents with restrictive eating disorders: an uncontrolled case series. Journal of Eating Disorders, 6:68.
- Gilbert, K., Perino, M. T., Myers, M. J. & Sylvester, C. M. (2020). Overcontrol and neural response to errors in pediatric anxiety disorder. Journal of Anxiety Disorders, 72, https://doi.org/10.1016/j.janxdis.2020.102224
- Gilbert, K., Hall, K., Codd, R. T (2020). Radically Open Dialectical Behavior Therapy: Social Signaling, Transdiagnostic Utility and Current Evidence. Psychology Research and Behavior Management, 13, 19-28. https://doi.org/10.2147/PRBM.S201848
- Lynch T. R., Hempel R. J., Whalley B., Byford S, Chamba R., Clarke P., Clarke S., Kingdon D., O'Mahen H., Remington B., Rushbrook S. C., Shearer J., Stanton M., Swales M., Watkins A. & Russell I. T. (2020). Refractory depression - mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms. The British Journal of Psychiatry, 216(4), 204-212. doi:10.1192/bjp.2019.53
- Shearer J., Lynch T. R., Chamba R., Clarke S.,Hempel R. J., Kingdon D., O'Mahen H., Remington B., Rushbrook S. C.,Russell I. T., Stanton M., Swales M., Watkins A., Whalley B. & Byford S. (2019). Refractory depression - cost-effectiveness of radically open dialectical behaviour therapy: findings of economic evaluation of RefraMED trial. BJ Psych Open, DOI: https://doi.org/10.1192/bjo.2019.57
- Gilbert, K., Barch, D. M., & Luby, J. L. (2019). The Overcontrol in Youth Checklist (OCYC): Behavioral and Neural Validation of a Parent-Report of Child Overcontrol in Early Childhood. Child Psychiatry & Human Development, published online 29 June 2019. https://doi.org/10.1007/s10578-019-00907-3
- Lynch T. R., Hempel R. J., Whalley B., Byford S, Chamba R., Clarke P., Clarke S., Kingdon D., O'Mahen H., Remington B., Rushbrook S. C., Shearer J., Stanton M., Swales M., Watkins A. & Russell I. T. (2018). Radically open dialectical behaviour therapy for refractory depression: the RefraMED RCT. Efficacy and Mechanism Evaluation, 5(7), https://doi.org/10.3310/eme05070.
- Hempel, R.J., Vanderbleek, E., Lynch, T.R. (2018). Radically Open DBT: Targeting Emotional Loneliness in Anorexia Nervosa. Eating Disorders: The Journal of Treatment and Prevention, 26(1), 92-104.
- Lynch, T. R., & Hempel, R. J. (2016). Signaling Matters: Radically Open-Dialectical Behavior Therapy for Anorexia Nervosa. In T. Wade (Ed.), Encyclopedia of Feeding and Eating Disorders (pp. 1-10). Singapore: Springer Singapore.
- Keogh, K., Booth, R., Baird, K., & Davenport, J. (2016). A Radically Open DBT informed group intervention for over-control: A controlled trial with 3-month follow-up. Practice Innovations, 1(2), 129-143.
- Lynch, T.R., Hempel, R.J., Dunkley, C. (2015). Radically Open-Dialectical Behavior Therapy for Disorders of Over-Control: Signaling Matters. American Journal of Psychotherapy, 69(2), 141-162.
- Lynch, T.R., Whalley, B., Hempel, R.J., Byford, S., Clarke, P., Clarke, S., Kingdon, D. , O'Mahen, H., Russell, I. T., Shearer, J., Stanton, M., Swales, M., Watkins, A. and Remington, B. (2015). Refractory depression - Mechanisms and Evaluation of radically open Dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial. BMJ Open,5, doi:10.1136/bmjopen-2015-008857
- Chen, Eunice Y., Segal, Kay, Weissman, J., Zeffiro, Thomas A., Gallop, R., Linehan, Marsha M., Bohus, Martin, Lynch, Thomas R. (2014). Adapting dialectical behavior therapy for outpatient adult anorexia nervosa—A pilot study. International Journal of Eating Disorders, Article first published online: 27 OCT 2014 (doi: 10.1002/eat.22360).
- Lynch, T.R., Gray, K.L.H., Hempel, R.J., Titley, M., Chen, E.Y., O'Mahen, H.A. (2013). Radically Open-Dialectical Behavior Therapy for adult Anorexia Nervosa: Feasibility and outcomes from an inpatient program. BMC Psychiatry, 13,
- Lynch TR, Cheavens JS, Cukrowicz KC, Thorp SR, Bronner L, Beyer J. (2007). Treatment of older adults with co-morbid personality disorder and depression: A dialectical behavior therapy approach. International J of Geriatric Psychiatry, 22(2), 131-143.
- Lynch TR, Morse JQ, Mendelson T, Robins CJ. Dialectical behavior therapy for depressed older adults: A randomized pilot study (2003). American J of Geriatric Psychiatry, 11(1), 33-45.
A selection of book chapters
- Gilbert, K., & Codd, R. T. (2022). Radically Open Dialectical Behavior Therapy: Theory, Assessment and Case Conceptualization. In W. O'Donahue & A. Masuda (Eds.), Behavior Therapy: First, Second, and Third Waves (1st ed.). Switzerland: Springer.
- Hamilton, L., Bacon, L. & Longfellow, E. (2021) Radically Open Dialectical Behaviour Therapy: a new treatment of people with maladaptive overcontrol who offend. In Winder, B., Blagden, N., Hamilton, L. & Scott, S. (Eds) Forensic Interventions for Therapy and Rehabilitation:Case Studies and Analysis. Routledge.
- Bacon, L., Longfellow, E. & Hamilton, L.J. (2020) Don't Get Mad, Get Even!: Overcontrol and Multiple Victim Violence. In G.A Crews (Eds) Handbook of Research on Mass Shootings and Multiple Victim Violence (pp.193-200), Hershey, PA, IGI Global.
- Lynch, T. R., & Hempel, R. J. (2016). Signalling Matters: Radically Open-Dialectical Behaviour Therapy for Anorexia Nervosa. In T. Wade (Ed.). Encyclopaedia of Feeding and Eating Disorders. Springer: Heidelberg, Germany.
- Lynch, T.R., Seretis, D., & Hempel, R.J. (2016). Radically Open-Dialectical Behaviour Therapy for Overcontrolled Disorders: including Refractory Depression, Anorexia Nervosa, and Obsessive Compulsive Personality Disorder. In Alan Carr & Muireann McNulty (Eds.). Handbook of Adult Clinical Psychology, 2nd edition.
- Lynch, T.R., Hempel, R.J., Clark, L.A. (2015). Promoting Radical Openness and Flexible Control. In John Livesley, Giancarlo Dimaggio, & John Clarkin (Eds.), Integrated Treatment for Personality Disorder. New York: Guilford Publications, Inc.