The Behavior Therapist's RO DBT Special Issue
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association for behavioral and ISSN 0278-8403 ABCT cognitive therapies s VOLUME 41, NO. 3•MARCH 2018 the Behavior Therapist SPECIAL ISSUE RADICALLY OPEN New Thinking About Dialectical Behavior Therapy Old Ideas: Introduction to the Special Issue on Special Issue Editor: R. Trent Codd, III Radically Open R. Trent Codd, III, and Linda W. Craighead Dialectical Behavior New Thinking About Old Ideas: Introduction to the Special Therapy Issue on Radically Open Dialectical Behavior Therapy ● 109 Thomas R. Lynch R. Trent Codd, III, Cognitive- Tribe Matters: An Introduction to Radically Open Dialectical Behavioral Therapy Center of Behavior Therapy ● 116 Western North Carolina, P.A. Emily Vanderbleeck and Kirsten Gilbert Too Much Versus Too Little Control: The Etiology, Linda W. Craighead, Conceptualization, and Treatment Implications of Overcontrol Emory University and Undercontrol ● 125 Roelie J. Hempel, Sophie C. Rushbrook, Heather O’Mahen, IT’SNOT OFTEN THATWEGET TO WITNESS the and Thomas R. Lynch launching of a new psychotherapy. The aim of How to Differentiate Overcontrol From Undercontrol: this special issue is to introduce Radically Open Findings From the RefraMED Study and Guidelines From Dialectical Behavior Therapy (RO DBt)—a Clinical Practice ● 132 new scientifically supported treatment targeting Jason B. Luoma, R. Trent Codd, III, and Thomas R. Lynch a spectrum of disorders characterized by exces- sive inhibitory control or overcontrol (OC). Radically Open Dialectical Behavior Therapy: Shared Features The treatment is fully manualized (see Lynch, and Differences With ACT, DBT, and CFT ● 142 2018a, 2018b) and the feasibility, acceptability, Ellen Astrachan-Fletcher, Alexia Giblin, Mima Simic, and efficacy of RO DBT are evidence-based, and Julianna Gorder supported by more than 20 years of clinical Radically Open Dialectical Behavior Therapy for Anorexia translational research. It is intended for clini- Nervosa: Connection, Openness, and Flexibility at the Heart cians treating clients with such chronic prob- of Recovery ● 149 lems as refractory depression, anorexia nervosa, and obsessive-compulsive personality disorder. Richard Booth, Rachel Egan, and Jennifer Gibson The publication of this special issue of tBT Group Radical Openness ● 154 coincides with the seminal publication of the RO DBT textbook and separate RO DBT skills Laura Hamilton, Lee Bacon, Emma LongFellow, training manual (see Lynch, 2018a, 2018b). Yet, and Allison Tennant this is not the central reason we describe the Not Everything Is as It Seems: RO DBT and Overcontrolled treatment as “new.” In our opinion, RO DBT is Disorders in Forensic Settings ● 157 “new” primarily because it introduces some Roelie J. Hempel, Richard Booth, Alexia Giblin, Laura Hamilton, new theoretical perspectives and treatment Amy Hoch, James Portner, Nathan Tomcik, Sophie C. Rushbrook, approaches not found elsewhere. For example, Mima Simic, Katrina Hunt, and Martina Wolf-Arehult it is the first treatment in the world to prioritize The Implementation of RO DBT in Clinical Practice ● 161 [Contents continued on p. 110] [continued on p. 111] March • 2018 109 the Behavior Therapist Contents, continued Published by the Association for Behavioral and Cognitive Therapies 305 Seventh Avenue - 16th Floor At ABCT New York, NY 10001 | www.abct.org Leadership & Elections, 2018 ● 131 (212) 647-1890 | Fax: (212) 647-1865 52nd ANNUAL CONVENTION Editor: Kate Wolitzky-Taylor Preparing to Submit an Abstract ● 174 Editorial Assistant: Bita Mesri Call for Papers (General Sessions) ● 175 Associate Editors Understanding the ABCT Convention ● 176 RaeAnn Anderson Continuing Education Opportunities ● 177 Katherine Baucom ABCT Comment on Initiative Regarding Full Range of Career-Level Sarah Kate Bearman Representation in Convention Symposium Abstract Review Criteria ● 179 Shannon Blakey Angela Cathey Trent Codd David DiLillo Lisa Elwood Clark Goldstein David Hansen Katharina Kircanski Richard LeBeau Angela Moreland Stephanie Mullins-Sweatt Amy Murell Alyssa Ward Tony Wells Stephen Whiteside Monnica Williams INSTRUCTIONS Ñçê AUTHORS ABCT President: Sabine Wilhelm Executive Director: Mary Jane Eimer The Association for Behavioral and Cog- Submissions must be accompanied by a Director of Communications: David Teisler nitive Therapies publishes the Behavior Copyright Transfer Form (which can be Therapist as a service to its membership. downloaded on our website: http://www. 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Please also All items published in the Behavior Therapist, includ- ited to approximately 3 double-spaced include, as an attachment, the completed ing advertisements, are for the information of our read- manuscript pages. copyright transfer document. ers, and publication does not imply endorsement by the Association. 110 INTRODUCTION TO THE SPECIAL ISSUE: RO DBT social-signaling as the primary mechanism DBT is that innate perceptual and regula- A further distinguishing characteristic of change based on a transdiagnostic, neu- tory biases make it impossible for a person is that RO DBT parses emotion regulation roregulatory model linking the commu- to achieve heightened self-awareness in into three transacting temporal elements: nicative function of human emotions to the isolation; we need others to point out our (1) perceptual encoding factors (sensory establishment of social connectedness and blind spots. receptor regulation) that precede (2) inter- well-being. Plus, RO DBT contends that RO DBT has many other distinguishing nal modulatory factors (central-cognitive one of the core reasons so many individuals features. For example, RO DBT challenges regulation), which then result in (3) exter- fail to respond to adequately delivered linear assumptions regarding the nature of nal behavioral expressions and overt interventions may be because the majority self-control—i.e., that one can never have actions (response selection regulation). of treatment approaches are based on the too much self-control—by offering a devel- Separating external regulation from inter- erroneous assumption that categories of opmental trajectory that accounts for both nal regulation helps explain why a person disorders are homogeneous in nature quadratic and linear relationships. The can “feel” anxious inside yet not display (Lynch, 2018a). For example, an estimated model contends that optimal self-control is any “overt” signs of anxiety on the outside. 40% to 60% of unipolar depressed clients an emergent capacity requiring receptivity The RO DBT approach to mindfulness meet the criteria for comorbid personality or openness and the capacity to flexibly is also unique. In particular, it can be dis- disorder (PD; Fava et al., 2002; Klein et al., adapt to changing environmental contin- tinguished from other mindfulness-based 1995; Riso et al., 2003), and PDs of over- gencies. approaches via its emphasis on radical control are at once the most common PDs RO DBT also contends that core geno- openness principles and self-enquiry prac- and the ones least likely to respond to treat- typic/phenotypic differences between indi- tices. ment (Fournier et al., 2009). Thus, from an viduals necessitate