RO-DBT

Radically Open Dialectical Behaviour Therapy (RO-DBT) has emerged as a groundbreaking treatment for mental health conditions characterised by overcontrol, including eating disorders, Autism Spectrum Disorder (ASD), chronic depression, and obsessive-compulsive disorder. This therapy's core philosophy centres around enhancing social connectedness and psychological flexibility.

Overcontrol refers to excessive self-discipline, rigid adherence to rules, and difficulty expressing emotions or being spontaneous. Whilst these traits can be adaptive, they become problematic when they interfere with social relationships and emotional wellbeing.

RO-DBT employs evidence-based techniques that foster emotional vulnerability, spontaneity, and direct communication – skills crucial for meaningful social connection. Research demonstrates significant improvements in emotional expression, social connectedness, and reduced symptoms across various overcontrolled presentations.

Despite its proven efficacy, RO-DBT remains one of the less widely available therapeutic modalities in Australia, with relatively few qualified practitioners compared to other mental health treatments. This scarcity makes access to specialised RO-DBT services particularly valuable for individuals with overcontrolled conditions.

In practice, our practitioners have witnessed transformative changes in clients with overcontrolled conditions. They have become more emotionally expressive, formed stronger relationships, and shown marked improvement in their ability to be spontaneous and socially engaged.

At ERS, we are committed to delivering this specialised therapy with the utmost care and professionalism. Our team is composed of highly skilled professionals, each a qualified RO-DBT practitioner with extensive training in this innovative therapeutic approach. Their expertise lies in tailoring interventions to meet the unique needs of each individual, ensuring that our clients receive the most effective and empathetic care.

RO DBT Referral Form

Research on RO-DBT treatment for ASD

Radically Open Dialectical Behavior Therapy (RO-DBT) is a therapeutic modality that is an evidence based intervention in treating individuals with Autism Spectrum Disorders (ASD). Here are some key findings:

RO-DBT has been found effective for people with ASD. A study reported a medium effect size of 0.53 for improvement in global distress among participants with ASD who completed the therapy, indicating significantly better outcomes than completing participants without an ASD diagnosis (Cornwall et al., 2020) https://doi.org/10.1192/bjb.2020.113

RO-DBT can lead to improvements in symptoms such as psychological flexibility, emotional coping, and reductions in psychological distress (Lynch et al., 2019) https://doi.org/10.1192/bjp.2019.53

This study highlighted the feasibility and acceptability of dialectical behavior therapy skills training (DBT-ST) in autistic adults. This suggests that DBT modalities, including RO-DBT, can be feasible and potentially beneficial for this population (Ritschel et al., 2021) https://doi.org/10.1017/S1352465821000370

Research on RO-DBT treatment for Eating Disorders

The below studies provide robust evidence for RO-DBT's effectiveness in treating eating disorders, particularly anorexia nervosa, across both adult and adolescent populations. The research consistently demonstrates improvements in eating disorder symptoms, weight restoration, psychological functioning, and social connectedness.

Primary Studies - Adult Anorexia Nervosa

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, 293. https://doi.org/10.1186/1471-244X-13-293

This landmark study found that 72% of participants completed treatment with substantial BMI increases (mean change = 3.57), and 90% achieved full or partial remission. The study demonstrated large effect sizes for eating disorder symptom reduction (d = 1.17) and quality of life improvements (d = 1.03).

Isaksson, M., Ghaderi, A., Ramklint, 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, 101637. https://doi.org/10.1016/j.jbtep.2021.101637

Isaksson, M., Ghaderi, A., Wolf-Arehult, M., Öster, C., & Ramklint, 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

Adolescent Studies

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, 8, 68. https://doi.org/10.1186/s40337-020-00338-9

This study of 131 adolescents found significant correlations between eating disorder symptoms and overcontrol factors, including social connectedness (r = −.67). Participants showed significant improvements in depression and eating disorder symptoms following RO-DBT treatment.

Baudinet, J., Stewart, C., Bennett, E., Konstantellou, A., Parham, R., Smith, K., Hunt, K., Eisler, I., & Simic, M. (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

Systematic Reviews

Hatoum, A. H., & Burton, A. L. (2024). Applications and efficacy of radically open dialectical behavior therapy (RO DBT): A systematic review of the literature. Journal of Clinical Psychology. https://doi.org/10.1002/jclp.23735

Additional Clinical Perspectives

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