Frequently Asked Questions
How is Radically Open-Dialectical Behavior Therapy (RO-DBT) different from Dialectical Behavior Therapy (DBT)?
This is a common question that many people have. I have been trained and have expertise in both of these effective models. Although they have some overlap, they target different types of challenges on the temperament spectrum.
RO-DBT treats overcontrolled disorders like chronic depression, chronic anxiety, autism spectrum disorders, anorexia and personality disorders such as avoidant, paranoid, and obsessive compulsive.
DBT helps stop dramatic, impulsive, or out-of-control behaviors through skills training primarily focused on: emotion regulation, distress tolerance, mindfulness, and relationship skills. Examples of under-control issues include: borderline personality disorder, substance abuse, and binge eating.
What is the temperament spectrum?
According to Thomas Lynch, the RO-DBT model developer: from a young age (4-5 years old) people seem to have a core temperament. Everyone falls on a spectrum of temperament. This can be envisioned as a bell curve of control.
The first side is under-controlled and the other side is over-controlled. Most people land in the flexible or optimal control range which is in the middle of the bell curve. This means in any given situation optimal behavioral control expression can be demonstrated--a bit under-control or over-control. At a party, under-control disinhibited behavior fits the situation, but you wouldn’t want to be wildly disinhibited in your behavioral expression while getting a speeding ticket. The farther you land on either end of the spectrum, the more likely challenges faced will exceed your coping mechanisms and may lead to chronic mental health disorders.
We will identify and discuss how your temperament leanings impact your daily life during our consultation.
What is a dialectic, and why is it important?
A dialectic is a synthesis or integration of opposites. Marsha Linehan talks about the core of the DBT model being able to hold acceptance and change together. This has been a transformative way of looking at approaching the world for me as a clinician and for my clients. We often get caught in the idea that to hold one truth we must reject another, leading to dysregulation and all or nothing thinking.
RO-DBT and DBT are forms of Cognitive Behavioral Therapy (CBT)
Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views, beliefs and behaviors in their life.
Do you provide both DBT and RO-DBT therapy in your teletherapy practice?
Yes. I am focusing my current practice on delivering RO-DBT therapy, but would be willing to explore DBT service delivery if the person I am working with has strong social support in place. DBT therapy often requires more accessibility to the clinician for “in the moment” skills coaching.
As a solo provider in private practice I may not be able to meet that need in as timely of a way as necessary for the health and safety of the client without a comprehensive support system.
What should I expect tele-therapy to be like?
Therapy will be conducted over a HIPAA compliant platform. Clients agree to disclose their location, phone number, and emergency contact at the beginning of each appointment. Like an in person therapy appointment, clients and clinicians are both responsible for maintaining a safe, private location for the therapy to be conducted. Tele-therapy has been shown to be an effective form of service delivery. It allows greater flexibility, access to specialty care outside your community, and convenience to the person seeking assistance.
How do I know if this will work for me?
As a clinician, I am invested in making sure that our work together is going to move you toward your goals. Please schedule a complementary 30 min screening for us to meet and decide if your concerns match with the model of service to be provided and if there is a good interpersonal match. Research has shown that 40% of the success of therapy depends on the relationship “goodness of fit” between the client and therapist.
How does confidentiality and therapy work?
In general, what you choose to share with your therapist stays private. When I need to communicate with another provider about your care I will have you sign a release of information (ROI) to specify what can be shared. Exceptions to confidentiality include: subpoenas, court orders, or disclosure of: danger to self, danger to others, child abuse/neglect (including domestic violence in front of children), and elder abuse.
I want to get over my past, will therapy work?
It depends what you intend...therapy does not make the past go away. In therapy, people work at skills and strategies to live alongside their past difficulties and find focus in the here and now.
RO-DBT and DBT have been shown to produce improved outcomes as compared to other types of therapy.
What age groups do you work with?
I work primarily with adults at this time.