As DBT is used to treat disorders of undercontrolled coping and difficulties with emotion regulation, RO-DBT is a treatment for disorders of overcontrol. Through research, we know that too much self-control can actually lead to social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems, such as anorexia nervosa, autism spectrum disorders, chronic depression, and obsessive-compulsive personality disorder (not OCD, but more related to perfectionism, orderliness, and control).

People who engage in overcontrolled coping tend to be serious about life, set high personal standards, work hard, behave appropriately, and frequently will sacrifice personal needs in order to achieve desired goals or help others; yet inwardly they often feel "clueless" about how to join in with others or establish intimate bonds. In other words, overcontrol works well when it comes to sitting quietly in school or building a rocket, but it creates problems when it comes to social relationships. 

NCFWC offers RO-DBT Skills Classes and Comprehensive RO-DBT both led by Jennifer Biddle, LPC-MHSP who is intensively trained in RO-DBT through its founder's training program. 



NCFWC offers RO DBT Skills Class for ages 16 and up who are enrolled in Comprehensive RO DBT as well as for those seeking only the RO DBT Skills Class to supplement other therapy. There are three 10-week long modules. For current pricing, please contact us using the RO-DBT Request button below. 

Monday's 6:30-7:30/8pm (in-person at Nashville Office)

Led by: Jennifer Biddle, LPC-MHSP

Spots Available Now!



Radically Open Dialectical Behavior Therapy (RO-DBT) is an evidence-based treatment developed specifically for problems of overcontrol. Radical openness is the core philosophical principle and core skill in RO-DBT. The term “radical openness” means there are three important aspects of emotional well-being: openness, flexibility, and social connectedness. RO-DBT differs from other treatments by focusing on helping with deficits in social-signaling that reduce social connectedness.

RO-DBT targets indirect, hidden, and constrained social signaling as the main source of emotional loneliness, isolation, and misery over problematic internal experiences (e.g., negative emotions, harsh self-judgment, distorted thinking) and treatment strategies are designed to enhance social connectedness; including new skills to activate areas of the brain associated with the social-safety system and signal cooperation by deliberately changing body postures and facial expressions (e.g. raising eyebrows when stressed), encourage genuine self-disclosure, and break down overlearned expressive inhibitory barriers (via skills designed to encourage playful behavior and candid expression). 

Thus, when it comes to long-term health, what a person feels or thinks inside is considered less important in RO-DBT, whereas how a person communicates or socially signals their private experience to others and its impact on social connectedness is given priority. When you are lonely it’s hard to feel happy, no matter how much you try to accept or change your circumstances, think more positively, keep busy, exercise, practice yoga, or distract yourself. Revealing intentions and emotions to other members of our species was essential to creating the types of strong social bonds that are the cornerstone of human tribes. In the long run, we are tribal beings, and we want to share our lives with other members of our species. Essentially, when we feel part of a tribe, we naturally feel safe and worry less. RO-DBT is designed to help emotionally lonely overcontrolled clients learn how to make this a reality. 



This treatment approach has helped teenagers and adults who struggle with any or all of the following:

  • Rigid, rule-governed behavior and excessive self-control (for example, generating and following extreme rules such as restrictive eating)

  • Trouble adapting to changing environmental circumstances

  • Trouble making and/or deepening current friendships

  • Excessive delay of gratification

  • Perfectionism, disciplined behavior, and a hyper-focus on achievement

  • Hiding or avoiding experiencing and expressing emotions

  • Issues with intimacy and connectedness

  • Self-injurious and/or suicidal behaviors

  • Depression and/or anxiety, especially when these issues are not resolved with therapeutic interventions such as Cognitive Behavioral Therapy (CBT)

  • Over-tolerance of negative emotions

  • Loneliness, isolation from others

  • Envy and bitterness



Taught in Skills Class and Applied in Therapy


Receptivity and openness to new experience and feedback in order to learn. This can be done through ‘self-enquiry’ which consists of noticing when we feel energy or curiosity about something, asking ourselves questions to stay with this energy and curiosity to understand what it may be about, then ultimately learning from this.


Flexible control which enables you to adapt to an ever-changing environment. This is explored by looking at the different states of mind – fixed, fatalistic, and flexible – and how they can make us become rigid and set in our own ways without always realizing it. Mindfulness is an integrated part of RO-DBT and practiced at the start of each class. It helps us gain better insight into our own thoughts and body and teaches us how to ‘let go’ of inflexibility.


Social connectedness and intimacy which lead to close bonds with others and allow
for mutual work in groups or ‘tribes’. Social signaling plays a key role in this
component by helping us become aware of what we are signaling to others through our verbal and non-verbal behavior. Class participation enhances the confidence in our social skills and provides a safe place to practice social signaling. This can then help us understand how such types of signaling affect our relationships with family,
friends, colleagues, and professionals.



Outpatient Comprehensive RO-DBT has four components delivered over an average of 30 weeks. The first three components are specific to patients and the final component is specific to the RO-DBT therapist. 

  1. Weekly individual therapy (45-50 minutes) 

  2. Weekly skills-training class (90 minutes in duration) 

  3. Telephone consultation/coaching between session (optional) 

  4. Therapist participation in RO DBT consultation meetings