RO-DBT is a highly structured Evidence Based Treatment (EBT) protocol with an emphasis on helping individuals with excessive self-control. It has been used to treat some of the rigid responses and emotional inhibition thought to underlie many treatment-resistant conditions. RO-DBT was developed by Dr. Thomas R. Lynch and emphasizes emotional openness, flexibility, and social connectedness as central components of emotional wellness.

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. Radical openness involves a willingness to doubt or question ourselves and our convictions without falling apart.

Excessive self-control or overcontrol is a type of personality or coping style that can be identified in early childhood and can lead to social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems.

Some diagnoses associated with excessive self control (or over-control) include: chronic depression, treatment resistant anxiety disorders, anorexia nervosa, obsessive compulsive personality disorder, avoidant personality disorder, paranoid personality disorder, and autism spectrum disorder.

Individuals who have developed an overcontrolled coping style tend to be serious about life, set high personal standards, work hard, behave in ways they deem most appropriate while also expecting others to do the same, and frequently will sacrifice personal needs in order to achieve desired goals or help others. Inwardly, however, they often feel overwhelmed and disoriented with regard to how to join in with others or establish intimate bonds. Thus, 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, preventing the individual from having joyful, spontaneous, and connected life experiences. Overcontrolled people are often responsible and conscientious without feeling much reciprocity or reward.

RO-DBT aims to help individuals develop the skills necessary to navigate their internal emotional experience and external social signaling more effectively so that they may experience more enjoyable and functional interpersonal relationships.

Core principles of RO DBT include:

openness to new experiences

flexibility in thinking and behavior

social connectedness

The treatment is delivered in both weekly, hour long individual therapy sessions, weekly, one and a half hour long skills classes, and daily practice. This combined treatment delivery allows individuals to explore and identify their emotions, observe thought patterns that may be keeping them stuck, and develop new coping strategies to improve their experiences.

Skills classes allow participants to learn evidence-based techniques for managing emotions, improving relationships, and increasing the felt sense of joy and connectedness in everyday life. RO DBT is typically delivered over 35 weekly sessions.

Yes, Obsidian offers a virtual RO DBT skills class on Wednesdays at 3:00 PM to 4:30 PM Eastern Time.

The RO DBT skills class is designed to have rolling entry - that is, participants may join at any point and benefit from class content. Class #1 is scheduled for Wednesday, February 18, 2026 from 3:00 PM to 4:30 PM and subsequently continues on Wednesdays from 3:00 PM to 4:30 PM.

Participants who are
-above the age of 16 years old;

-residing in North Carolina, South Carolina, or Vermont;

-who are currently participating in weekly RO DBT or have previously completed a full course of RO DBT

are welcome to enroll in the Wednesday afternoon RO DBT skills class. Upon enrollment, individuals will receive a binder (or two) with the skills classes and their content so that they have hard copies of and may complete weekly RO DBT skills homework.

Inquiries, requests, or suggestions for additional skills classes (e.g. for adolescents, for disordered eating, in person classes) are welcome. We are open to forming additional skills classes as needed.

The fee for RO DBT is $250 per weekly session. Any person inquiring about RO DBT skills class will either need to be in individual therapy at Obsidian with an RO DBT trained provider or meeting with their own RO DBT trained therapist weekly.

Individuals attending weekly RO DBT sessions are expected to attend skills classes. The cost of the 1.5 hour skills class is included in the weekly individual session cost. (There is a total of 2.5 hours of treatment per week).

For those individuals who would like to attend only the skills class, the cost is $100 per 1.5 hour class.

Phone coaching sessions, when they are requested, are included in the cost of weekly sessions.

RO DBT may be reimbursed or partially reimbursed by your insurance provider. Check your out of network benefits on the Mentaya benefits checker below.

Because RO DBT is a specialized treatment modality including at least 2.5 hours of care each week, it is not covered by Obsidian’s Monthly Enrollment Plans.

If you are interested in receiving more information or seeking any of these services for yourself or your child (14+), please reach out to our practice by completing the form accessed by the Request an Appointment button on the top right hand side of each page of our website. A provider from Obsidian Care Collective will respond to you and schedule a no cost phone consultation to discuss these options with you.

If you believe RO DBT may be a good fit for a person you care about, please direct them to submit a New Client Inquiry on our website or share our email info@obsidiancarecollective.com or phone number (910) 317-8310‬.