Radically Open Dialectical Behavior Therapy

Nashville Child and Family Wellness Center offers Radically Open Dialectical Behavior Therapy (RO DBT) and RO Skills class for adolescents and adults (15+).

Radically Open Dialectical Behavior Therapy (RO DBT) Services at Nashville Child & Family Wellness Center:

RO-DBT invites you to find a Life Worth Sharing

RO DBT is a type of cognitive behavioral therapy founded by Dr. Thomas Lynch to address symptoms, behaviors, and disorders of overcontrol (OC). Self-control is often praised in our society, as it is the ability to overcome urges, impulses, and behaviors in order to pursue and achieve other goals. While this may be beneficial in school or at work, excessive self-control, otherwise known as overcontrol, can be negatively impactful for interpersonal relationships and cause serious mental health challenges.  Those with overcontrolled personality types are often rigid, rule governed, perfectionistic, risk averse, and have low social connectivity, often feeling lonely. RO DBT is evidenced based for those with chronic depression, treatment-resistant anxiety, Anorexia Nervosa, Autism, as well as some personality disorders such as Obsessive Compulsive Personality Disorder. 

What are the goals of RO DBT?

RO uses social-signaling as a main target in therapy. A social signal is any behavior a person exhibits in the presence of another person, regardless of its intention. OC individuals tend to socially signal in a way that keeps them isolated due to their high threat sensitivity. RO teaches how to use non-verbal signaling to enhance connections and express emotions appropriately. Additionally, it teaches strategies to decrease the fight or flight response to activate parts of the brain for social safety.  Through Radical Openness, clients are taught how to increase flexibility in responses, express and communicate emotions to form desired connections, and increase openness to feedback to overcome rigidity. Radical openness encourages getting outside comfort zones, approaching the unknowns, a willingness to be wrong, and embracing humility in order to learn. 


Offered through a combination of individual therapy sessions and a skills class.

Roughly 30 weeks long following the treatment model.

For ages 15 and up.

The RO DBT Skills class is broken into three 10-week modules, with each class lasting 90 minutes, and targets the following areas:

Our Dialectical Behavior Therapy Offerings at Nashville Child & Family Wellness Center.

Meeting the Diverse Needs of Adolescents, Young Adults and Families

RO-DBT Skills Class

RO DBT Skills Class

Learning skills to enhance mindfulness, radical openness, social signaling and social connectedness.

NCFWC offers a RO DBT skills class that is implemented with fidelity to the model by the treatment developer, Dr. Thomas Lynch. The RO DBT skills class at NCFWC is split into three 10-week modules. The class meets weekly for 90 minutes in which participants will review homework of the skill(s) learned the week prior, as well as learn new skills and concepts.

Throughout the classes and modules, participants will learn skills, techniques, and concepts to increase receptivity and openness to feedback in order for new learning to occur, practice flexibility in responses, as well as enhance intimacy and connectedness within relationships. RO DBT considers these areas core features for psychological health and will help overcome compulsive overcontrol tendencies that are otherwise interfering with and impairing quality of life.

Frequently asked questions about RO DBT at NCFWC.

DBT related questions and information, answered and explained for you.

How do I know if I need DBT or RO DBT?

DBT is the recommended therapy for those with emotion regulation difficulties, mood disorders, suicidal ideation and/or self-harm, substance use, trauma, and some eating disorders, such as binge eating disorder. DBT is typically best for those with “undercontrolled” personality types: those who experience fast and intense emotions and act more impulsively or unpredictably. RO-DBT is typically recommended for those with “overcontrolled” personality types: those who may suppress emotions versus react, avoid risk taking, and are more perfectionistic. RO is evidenced based for treatment-resistant and chronic anxiety and depression, obsessive compulsive disorder, restrictive eating disorders, or those with rigid thinking patterns and behaviors.

What causes someone to be overcontrolled?

RO DBT has found that being overcontrolled has a great deal to do with our biotemperament. The OC biotemperament has four main components: heightened state of defensive arousal; reduced experiences for pleasure and excitatory arousal; extreme capacities for self-control, distress tolerance, and delayed gratification; as well as a high attention to detail. Biotemperament impacts us at a preconscious level. High threat sensitivity impacts OC people’s ability to activate social safety (relaxation, contentment, desire to approach others, tone of voice, facial expression). Instead, it activates the sympathetic nervous system, otherwise known as our “fight-or-flight.” OC individuals are often in fight-or-flight as they frequently perceive environments as threatening unless safety is obvious. Limited access and time spent in social safety, combined with OC’s tendency to mask emotions, continues to reinforce the need for excessive self-control, rigidity which decreases social bonds, leading to more social disconnection and loneliness.

Why do I have to participate in skills class if I am already in individual therapy?

Individual RO DBT will focus on your personal social signaling and overcontrol tendencies while identifying ways they may be directly working against your values and goals. Individual sessions will involve reviewing your diary card from between sessions, completing behavior chains, and working to align you closer with your valued goals. RO Skills class will teach all RO techniques, concepts and skills while also helping to practice social signaling in front of others for understanding, application of learned skills, and further growth.


Can I be in RO DBT skills class without being a RO client?

Yes! RO DBT skills class can be used to supplement other therapeutic work. There is a requirement to have an individual therapist in order to participate.

Dialectical Behavioral Therapy

Parent Child Interaction Therapy

Eating Disorder Therapy

Neurofeedback Therapy

Multidisciplinary Assessments

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Learn more about our radical dialectical behavior therapy in Nashville at NCFWC for adolescents, adults, and families.

At NCFWC, we are committed to providing comprehensive, evidence-based RO DBT treatment to adolescents. Our specialty program is designed to provide individuals and their families with the tools they need to succeed. Contact us today to learn more about our RO DBT services and how it can help you and your loved one.