There Radically Open Dialectrical Behavior Therapy (RO DBT) is a structured transdiagnostic treatment for patients who have excessive self -control levels.
With the term self -control, we refer to the ability to inhibit impulses, desires, behaviors and to delay gratification in view of distant goals over time.
Excessive levels of self -control (i.e. the presence of hypercontrolle) are generally associated with characteristics such as:
- poor emotional awareness
- Inhibition of affective expression
- rigidity in the way of thinking and behaving
- increased sensitivity to the threat
- reduced ability to process rewards
- poor social connection and intimacy
- risk aversion
- perfectionism
- rigid behavioral conduct and ruled by rules
Consequences of hypercontrollo
Hypercontrol can also be associated with a lack of interpersonal functioning and social isolation.
Also, precisely due to the intrinsic characteristics of the phenomenon, the extent of the suffering experienced by the people who present hyper -control, may not be evident outside, as they are adequately hidden by the inhibitory mechanisms typical of the mechanism.
This can have an impact on the fact that patients arrive in treatment very late.
Hypercontrolle can be associated with the presence of serious and resistant psychological disorders. The Ro-DBT, dealing with disorders in which hypercontrollo is a central mechanism, has been proposed for the treatment of:
chronic depression
Eating disorders such as Anorexia Nervosa
obsessive compulsive personality disorder
anxiety disorders resistant to treatment
clinical perfectionism
This proved to be useful to improve the effectiveness of therapy and reduce relapse rates.
Ro-DBT principles
The RO-DBT deals with the treatment of hypercontrolle by working on psychological inflexibility typically associated with hypercontrolle and interpersonal functioning.
Therapy target is the inhibitory control Excessive behavioral and emotional. Basic concept and therapeutic objective pursued in Ro-DBT is theradical openingthat is, a mental state and a way of behaving that is based on three main characteristics: opening, flexibility and social connection.
The standard Ro-DBT protocol includes Both individual and group sessions oriented towards learning specific skills (skills training).
Effectiveness of the RO-DBT
In literature, the Ro DBT studies have mainly including adult population samples.
In this context, the Pilot qualitative study of Baudinet et al. (2022) It was proposed to evaluate the impact of a treatment based on the Ro-DBT in a population of teenagers.
In particular, the study is oriented to evaluate how much the treatment is considered relevant by this target of the population and how useful specific adaptations for the age group of interest of the study may be useful.
The investigation included teenagers with diagnosis of eating disorders, depression and/or anxiety. The teenagers were proposed the manualized Ro-DBT treatment, or 30 weekly skills training lessons and a weekly individual session.
However, the proposed protocol has been modified for the adolescent target, shortening the skill sessions at 90 minutes and including a group meeting for parents who provided information relating to the treatment model, the concept of hyper -control and the impact that this process can have on mental health.
The qualitative investigation was based on the analysis of transcriptions of interviews conducted with the patients who had concluded the entire protocol. The analysis was based on the investigation of some main themes and related sub-tests.
The results of the study on teenagers
The results that emerged appear encouraging:
- With regard to the possibility of taking on different perspectives, teenagers have said that, also thanks to group work, the treatment was perceived useful to expand their point of view, their prospects and their way of seeing the world. Also, the possibility of acquiring resources that did not only concern the symptoms of their disorder, but their life and their functioning in general was very appreciated.
- With regard to flexibility, the perception of having felt encouraged to let go of rigidity and excessive control emerges, to be more spontaneous.
- With regard to the connection, the sharing in groups and listening to others have been perceived useful in order to build a sense of union, as well as the acquisition of greater self -awareness. In particular, patients said they feel more skilled to identify what they feel and capable of understanding how the behavior and expression of this feel can have an impact on interactions with others. They therefore felt supported in building social connections with others, as well as helping you understand how to interact with others and report their emotions.
- Finally, in relation to the information provided, the teenagers reported that the treatment included many, dense and sometimes repeated. The proposed material was in fact perceived by many patients as excessive, both for quantities and complexity.
Conclusions
Therefore, in general, the Ro-DBT its large focus, have been perceived as useful for teenagers with dysfunctional levels of hyper-control, promoting their social and general functioning and promoting cognitive and behavioral flexibility.
The treatment proved to be useful to promote flexibility, social connection, the construction of trust and also the movement towards value -based objectives.
With reference to the comments relating to the information provided, the authors themselves of the study, however, invite the usefulness of evaluating the construction of specific material for treatment in this age group.
Bibliography
- Baudinet, J., Watson, C., Brothwood, PL, Parham, R., Smith, L., Snowden, N., Kntantallou, A., Hunt, K. & Simic, M. (2022). Adolescent Experience of Radically Open Dialectrical Behaviour Therapy: qualitative study. BMC Psychiatry, 22(1), 1-9.
- Lynch, TR (2018). Radically Open Dialectrical Behavior Therapy: Theory and Practice for Treating Disorders of overcontrol. New Harbinger Publications. (trad. it.: The Radically Open Dialectrical Behavior Therapy for the treatment of hyper -control disorders. Trento: Edizioni Centro Studi Erickson, 2021).
- Lynch, TR (2018). The Skills Training Manual for Radically Open Dialectrical Behavior Therapy: A Clinician’s Guide for Treating Disorders of Overcontrol. New Harbinger Publications. (Trad. It.: RO DBT Skills Training. The Radically Open Dialectrical Behavior Therapy for the treatment of hyper -control disorders. Operational cards and tools for the clinician. Trento: Edizioni Centro Studi Erickson, 2021).
