Radically Open Dialectical Behavior Therapy
Theory and Practice for Treating Disorders of Overcontrol
By: Thomas R. Lynch
Hardcover | 15 February 2018
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520 Pages
26.5 x 18.5 x 3.5
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orBased 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.
Industry Reviews
—Mima Simic, MD, MRCPsych, joint head of the child and adolescent eating disorder service, and consultant child and adolescent psychiatrist at the Maudsley Hospital in London, UK
Key Terms xi
Introduction 1
Overview of Core RO DBT Tenets 1
Overview of the Book’s Contents 2
In RO DBT, Silliness Is No Laughing Matter 4
1. Radical Openness and Disorders of Overcontrol 7
Self-Control: Can You Have Too Much of a Good Thing? 7
Basic Postulates of RO DBT 11
Treatment Development and Efficacy Research 19
2. A Neurobiosocial Theory for Disorders of Overcontrol 33
A Novel Neuroregulatory Model of Socioemotional Functioning 33
A Biosocial Theory for Disorders of Overcontrol 46
Social Signaling: A Novel Mechanism of Change 66
3. Assessment Strategies 69
Assessing Overcontrol: A Conceptual Framework 69
Common Errors and Problematic Assumptions 70
The OC Diagnostic Protocol: Diagnosing Overcontrol, Step-by-Step 76
Future Directions 83
4. Overview of Therapy Assumptions, Structure, and Targets 85
RO DBT Core Assumptions 86
Overview of Treatment Structure and Targets 88
5. Maximizing Client Engagement 97
Enhancing Client Engagement via the Physical Environment 97
Enhancing Client Engagement via Orientation and Commitment 100
Commitment Problems Unique to Overcontrol 137
Enhancing Engagement Through Sequencing 140
6. Social Signaling Matters: Micromimicry, Mirror Neurons,
and Social Connectedness 145
Social Bonds, Mimicry, and Mirror Neurons 146
One Size Does Not Fit All 149
Eye Contact 149
The “Deer in the Headlights” Response 151
Heat-Off Strategies 153
Heat-On Strategies 155
Therapeutic Use of Cooperative Social Signaling 156
The Therapist as Tribal Ambassador 161
Managing Maladaptive OC Social Signaling 170
Tribe Matters 175
7. Radical Openness and Self-Enquiry: Personal Practice,
Therapeutic Modeling, Supervision, and Team Consultation 177
Openness Is Tribal Glue 178
Openness, Collaboration, and Compliance 180
Openness, Tribes, and Learning 181
One Secret of Healthy Living Is the Cultivation of Healthy Self-Doubt 184
What Is Radical Openness? 186
Practicing Self-Enquiry and Outing Oneself 190
RO DBT Team Consultation and Supervision 192
Using a Consultation Team to Enhance Supervision and Treatment Outcomes 198
8. The Therapeutic Alliance, Alliance Ruptures, and Repairs 209
The RO DBT Therapeutic Stance 209
The Therapeutic Alliance 211
Alliance Ruptures and Repairs 213
Prevention of Premature Treatment Dropout 223
9. Treatment Targeting and Intervention: Prioritizing Social Signaling 229
Kindness First and Foremost 230
Radically Open Living: Developing a Life Worth Sharing 232
Structuring Sessions with the RO DBT Treatment Target Hierarchy 233
Targeting In-Session Social Signaling: Basic Principles 240
Monitoring Treatment Targets with Diary Cards 257
Valued Goals, Themes, and Targets 267
From Targeting to Intervention: An Overview of Treatment Strategies 270
10. Dialectical and Behavioral Strategies 297
Why Dialectics? 297
Behavioral Principles and Strategies 327
11. Final Remarks, Practical Questions, and Treatment Adherence 371
Some Commonly Asked Questions 371
Final Remarks 373
Appendix 1: Assessing Styles of Coping: Word-Pair Checklist 377
Appendix 2: The Clinician-Rated OC Trait Rating Scale 381
Appendix 3: The Overcontrolled Global Prototype Rating Scale 385
Appendix 4: RO DBT Semistructured Suicidality Interview 401
Appendix 5: Targeting Indirect Social Signals: In-Session Protocol 405
Appendix 6: Setting the Stage for Effective RO DBT Chain Analysis:
In-Session Protocol 415
Appendix 7: Using RO DBT Chain and Solution Analysis: Principles
and In-Session Protocol 419
Appendix 8: RO DBT Adherence: A Self-Assessment Checklist 433
Endnotes 453
References 461
Index 493
ISBN: 9781626259287
ISBN-10: 1626259283
Published: 15th February 2018
Format: Hardcover
Language: English
Number of Pages: 520
Audience: Professional and Scholarly
Publisher: New Harbinger Publications
Country of Publication: US
Dimensions (cm): 26.5 x 18.5 x 3.5
Weight (kg): 1.28
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