
Radically Open Dialectical Behavior Therapy
Description
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Based on over twenty years of research, radically open dialectical behavior therapy (RO DBT) is a breakthrough, transdiagnostic approach for helping people suffering from extremely difficult-to-treat emotional overcontrol (OC) disorders, such as anorexia nervosa, obsessive-compulsive disorder (OCD), and treatment-resistant depression. Written by the founder of RO DBT, Thomas Lynch, this comprehensive volume outlines the core theories of RO DBT, and provides a framework for implementing RO DBT in individual therapy.
While traditional dialectical behavioral therapy (DBT) has shown tremendous success in treating people with emotion dysregulation, there have been few resources available for treating those with overcontrol disorders. OC has been linked to social isolation, aloof and distant relationships, cognitive rigidity, risk aversion, a strong need for structure, inhibited emotional expression, and hyper-perfectionism. And yet-perhaps due to the high value our society places on the capacity to delay gratification and inhibit public displays of destructive emotions and impulses-problems linked with OC have received little attention or been misunderstood. Indeed, people with OC are often considered highly successful by others, even as they suffer silently and alone.
RO DBT is based on the premise that psychological well-being involves the confluence of three factors: receptivity, flexibility, and social-connectedness. RO DBT addresses each of these important factors, and is the first treatment in the world to prioritize social-signaling as the primary mechanism of change based on a transdiagnostic, neuroregulatory model linking the communicative function of human emotions to the establishment of social connectedness and well-being. As such, RO DBT is an invaluable resource for treating an array of disorders that center around overcontrol and a lack of social connectedness-such as anorexia nervosa, chronic depression, postpartum depression, treatment-resistant anxiety disorders, autism spectrum disorders, as well as personality disorders such as avoidant, dependent, obsessive-compulsive, and paranoid personality disorder.
Written for mental health professionals, professors, or simply those interested in behavioral health, this seminal book-along with its companion, The Skills Training Manual for Radically Open Dialectical Behavior Therapy (available separately)-provides everything you need to understand and implement this exciting new treatment in individual therapy-including theory, history, research, ongoing studies, clinical examples, and future directions.
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Content
- Intro
- Contents
- Acknowledgments
- Key Terms
- Introduction
- Overview of Core RO DBT Tenets
- Overview of the Book's Contents
- In RO DBT, Silliness Is No Laughing Matter
- Chapter 1
- Radical Openness and Disorders of Overcontrol
- Self-Control: Can You Have Too Much of a Good Thing?
- Basic Postulates of RO DBT
- Treatment Development and Efficacy Research
- Chapter 2
- A Neurobiosocial Theory for Disorders of Overcontrol
- A Novel Neuroregulatory Model of Socioemotional Functioning
- A Biosocial Theory for Disorders of Overcontrol
- Social Signaling: A Novel Mechanism of Change
- Chapter 3
- Assessment Strategies
- Assessing Overcontrol: A Conceptual Framework
- Common Errors and Problematic Assumptions
- The OC Diagnostic Protocol: Diagnosing Overcontrol, Step by Step
- Future Directions
- Chapter 4
- Overview of Therapy Assumptions, Structure, and Targets
- RO DBT Core Assumptions
- Overview of Treatment Structure and Targets
- Chapter 5
- Maximizing Client Engagement
- Enhancing Client Engagement via the Physical Environment
- Enhancing Client Engagement via Orientation and Commitment
- Commitment Problems Unique to Overcontrol
- Enhancing Engagement Through Sequencing
- Chapter 6
- Social Signaling Matters: Micromimicry, Mirror Neurons, and Social Connectedness
- Social Bonds, Mimicry, and Mirror Neurons
- One Size Does Not Fit All
- Eye Contact
- The "Deer in the Headlights" Response
- Heat-Off Strategies
- Heat-On Strategies
- Therapeutic Use of Cooperative Social Signaling
- The Therapist as Tribal Ambassador
- Managing Maladaptive OC Social Signaling
- Tribe Matters
- Chapter 7
- Radical Openness and Self-Enquiry: Personal Practice, Therapeutic Modeling, Supervision, and Team Consultation
- Openness Is Tribal Glue
- Openness, Collaboration, and Compliance
- Openness, Tribes, and Learning
- One Secret of Healthy Living Is the Cultivation of Healthy Self-Doubt
- What Is Radical Openness?
- Practicing Self-Enquiry and Outing Oneself
- RO DBT Team Consultation and Supervision
- Using a Consultation Team to Enhance Supervision and Treatment Outcomes
- Chapter 8
- The Therapeutic Alliance, Alliance Ruptures, and Repairs
- The RO DBT Therapeutic Stance
- The Therapeutic Alliance
- Alliance Ruptures and Repairs
- Prevention of Premature Treatment Dropout
- Chapter 9
- Treatment Targeting and Intervention: Prioritizing Social Signaling
- Kindness First and Foremost
- Radically Open Living: Developing a Life Worth Sharing
- Structuring Sessions with the RO DBT Treatment Target Hierarchy
- Targeting In-Session Social Signaling: Basic Principles
- Monitoring Treatment Targets with Diary Cards
- Valued Goals, Themes, and Targets
- From Targeting to Intervention: An Overview of Treatment Strategies
- Chapter 10
- Dialectical and Behavioral Strategies
- Why Dialectics?
- Behavioral Principles and Strategies
- Chapter 11
- Final Remarks, Practical Questions, and Treatment Adherence
- Some Commonly Asked Questions
- Final Remarks
- Appendix 1: Assessing Styles of Coping: Word-Pair Checklist
- Appendix 2: The Clinician-Rated OC Trait Rating Scale
- Appendix 3: The Overcontrolled Global Prototype Rating Scale
- Appendix 4: RO DBT Semistructured Suicidality Interview
- Appendix 5: Targeting Indirect Social Signals: In-Session Protocol
- Appendix 6: Setting the Stage for Effective RO DBT Chain Analysis: In-Session Protocol
- Appendix 7: Using RO DBT Chain and Solution Analysis: Principles and In-Session Protocol
- Appendix 8: RO DBT Adherence: A Self-Assessment Checklist
- Endnotes
- References
- About the Author
- Index
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