Radically Open Dialectical Behavior Therapy vs. Traditional Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a well-established and evidence-based treatment for individuals with borderline personality disorder (BPD) and other severe emotional dysregulation issues. DBT focuses on teaching patients skills related to mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness to help them manage their intense emotions and improve their relationships.

Radically Open Dialectical Behavior Therapy (RO-DBT) is a relatively new form of DBT developed to treat individuals with disorders characterized by excessive self-control, such as obsessive-compulsive personality disorder, chronic depression, and treatment-resistant anxiety disorders. RO-DBT places a greater emphasis on openness, flexibility, and social connectedness.

In this article, we will compare and contrast the core principles, therapeutic strategies, and target populations of traditional DBT and RO-DBT to provide a better understanding of the unique features and benefits of each approach.

Core Principles: Traditional DBT vs. RO-DBT

Traditional DBT is rooted in dialectical philosophy, emphasizing integrating opposing perspectives to achieve balance and harmony. The primary goal of traditional DBT is to help patients build a life worth living by learning new skills and strategies to manage their emotions, tolerate distress, and navigate interpersonal relationships effectively.

RO-DBT is based on the concept of "radical openness," which involves being receptive to new experiences, ideas, and feedback from others. The primary goal of RO-DBT is to help patients develop greater emotional and behavioral flexibility and enhance their social connectedness and sense of belonging.

While both traditional DBT and RO-DBT emphasize the importance of mindfulness, emotion regulation, and interpersonal effectiveness, each approach's specific techniques and strategies may differ. For example, traditional DBT often teaches patients how to validate their emotions and communicate their needs assertively, while RO-DBT may focus more on promoting openness, curiosity, and empathy in social interactions.

Therapeutic Strategies: Traditional DBT vs. RO-DBT

Traditional DBT employs a multimodal treatment approach that includes individual therapy, skills training groups, phone coaching, and therapist consultation teams. Individual therapy sessions focus on helping patients apply the skills they learn in group settings to their daily lives, while phone coaching provides additional support in times of crisis.

RO-DBT, in contrast, utilizes a similar structure with individual therapy and skills training groups, but the content and focus of the sessions are tailored to address the specific needs of individuals with excessive self-control. RO-DBT sessions may include exercises designed to increase openness and flexibility, such as practicing nonjudgmental curiosity, challenging rigid beliefs, and engaging in novel or unfamiliar activities.

Both traditional DBT and RO-DBT emphasize the importance of the therapeutic relationship and the therapist's role in modeling effective coping strategies, validating, and reinforcing patients' efforts to apply the skills they learn in therapy.

Target Populations: Traditional DBT vs. RO-DBT

Traditional DBT was initially developed to treat individuals with BPD and has since been adapted for use with a wide range of populations, including those with substance use disorders, eating disorders, and trauma-related disorders. Traditional DBT is particularly effective for individuals who struggle with emotional dysregulation, impulsivity, and interpersonal difficulties.

RO-DBT, in contrast, is specifically designed for individuals with disorders characterized by excessive self-control, such as obsessive-compulsive personality disorder, chronic depression, and treatment-resistant anxiety disorders. RO-DBT is well-suited for individuals who tend to be overly rigid, restrained, or perfectionistic in their thinking and behavior.

Depending on their specific needs and challenges, some individuals may benefit from combining traditional DBT and RO-DBT strategies. A skilled therapist can help determine the most appropriate treatment approach for each client based on a comprehensive assessment of their symptoms, personality traits, and treatment goals.

Outcomes and Efficacy: Traditional DBT vs. RO-DBT

Traditional DBT has been extensively researched and has consistently demonstrated its effectiveness in reducing self-harm behaviors, suicidal ideation, and hospitalizations and improving overall functioning and quality of life for individuals with BPD and other severe emotional dysregulation issues. Numerous studies have also shown that the skills learned in traditional DBT can be maintained over time, leading to long-lasting improvements in emotional and interpersonal functioning.

Research on RO-DBT has demonstrated its effectiveness in reducing symptoms of depression, anxiety, and excessive self-control and improving social functioning and well-being for individuals with disorders characterized by overcontrol. RO-DBT, while newer and less extensively researched than traditional DBT, has shown promising results in preliminary studies. As more studies are conducted, the evidence base for RO-DBT will likely continue to grow and expand.

Ultimately, the choice between traditional DBT and RO-DBT will depend on the individual's specific needs, challenges, and treatment goals. Both approaches have unique benefits and can provide valuable support for individuals struggling with emotional and behavioral difficulties.

Choosing the Right Approach

Traditional DBT and RO-DBT are distinct yet related forms of dialectical behavior therapy, each designed to address specific emotional and behavioral challenges. While traditional DBT focuses on helping individuals with severe emotional dysregulation, RO-DBT targets issues related to excessive self-control and social disconnectedness.

The decision to pursue traditional DBT or RO-DBT will depend on the individual's unique needs, symptoms, and goals for therapy. A skilled mental health professional can help determine the most appropriate approach based on a thorough assessment and understanding of the client's challenges and strengths.

Regardless of the chosen approach, dialectical behavior therapy offers valuable tools and strategies for helping individuals develop greater emotional and behavioral flexibility, improve their relationships, and enhance their overall well-being. With the support of a skilled therapist and a commitment to practicing the skills learned in therapy, both traditional DBT and RO-DBT can lead to meaningful and lasting change.

Grouport Offers Online DBT Skills Groups

If you're looking for an online group therapy session to practice dialectical behavior therapy, the Grouport DBT series by Grouport Therapy is the perfect solution. Our 12-week program equips participants with new skills to replace negative behaviors and emotions that can cause daily life and relationship issues.

Our group meets once a week at a scheduled time, and you'll receive access to session links via email after enrolling and paying for the program. By joining our DBT skills group, you can improve relationships, manage anxiety, and reduce emotional suffering, regaining hope for the future.

Don't hesitate to take the first step towards a better life. Our next session is waiting for you. Join our Grouport DBT series today and start improving your mental health alongside a supportive group of individuals.