RO-DBT and DBT are different types of treatment but we commonly receive phone calls for DBT when the client’s needs are actually RO-DBT. So, why use one or the other? What’s the same? What’s different?

People who contact us will frequently say they need DBT and say so because they have a friend or even another professional telling them so. DBT, simplified, is a therapy which utilizes behavioral skills to address symptoms of Under-Control, UC, of Emotions. Frequently this manifest as poor self-control of emotions, behaviors, expression of self, and frequent broken relationships due to this under-controlled emotional based behaviors. Both Sameera Malik, LCSW, and Whig Mullins, LCSW, spent years practicing DBT with clients who needed it and for whom it worked. However, there was also a group of clients who partially fit this highly sensitive group, and occasionally self-harm too. This second group of clients had some of the additional characteristics of high sensitivity to threat, insensitivity to reward, inhibited emotional expression, low sensation-seeking behaviors, perfectionism, and aloof or distant relationships. These clients are better described as Over-Controlled. They too occasionally self-harmed and have other behaviors which degrade relationships. Individuals described as having excessive self-control are often highly successful, risk intolerant, and have lower flexibility in thinking and receptivity, particularly where criticism is concerned.

Under Control of Emotions is frequently experienced in these diagnoses:

Borderline Personality Disorder

Antisocial Personality Disorder

Narcissistic Personality Disorder

Histrionic Personality Disorder

Conduct Disorder

Bipolar Disorder

Externalizing Disorders

Over Control is more frequently experienced in these diagnoses:

Obsessive Compulsive Personality Disorder

Paranoid Personality Disorder

Avoidant Personality Disorder

Schizoid Personality Disorder

Anorexia Nervosa

Chronic Depression


Treatment Resistant Anxiety

Internalizing Disorders

Under Controlled behaviors are best treated using Dialectical Behavior Therapy.

Over Controlled behaviors are best treated using Radically Open-Dialectical Behavior Therapy.

We can assist you to determine if you may need one and if so, which is best for you. We have specific short scientifically proven measures to help us determine the best fit as well as your own needs.