Written by: Abri Psychotherapy
Licensed mental health professionals in Portland, Oregon, and throughout Washington state supporting individuals who struggle with perfectionism, emotional inhibition, and disconnection through evidence-based therapies like RO DBT.
Updated: 06/17/26
The difference between RO DBT and DBT is the type of emotional regulation challenge each therapy is designed to address.
RO DBT (Radically Open Dialectical Behavior Therapy) helps people who struggle with emotional overcontrol, including perfectionism, rigidity, emotional suppression, and social disconnection.
DBT (Dialectical Behavior Therapy) was developed for emotional undercontrol, including impulsivity, emotional reactivity, mood swings, and difficulty tolerating distress.
In simple terms, DBT helps people gain greater emotional stability, while RO DBT helps people become more emotionally open, flexible, and connected with others.
Key Takeaways
The primary difference between RO DBT and DBT is the emotional coping style each treatment is designed to address.
RO DBT (Radically Open Dialectical Behavior Therapy)
Designed for emotional overcontrol, including:
- Perfectionism
- Rigid thinking
- Emotional inhibition
- Social isolation
- Difficulty expressing vulnerability
RO DBT teaches radical openness, flexibility, emotional expression, and social signaling skills that help individuals build stronger relationships and greater psychological well-being.
DBT (Dialectical Behavior Therapy)
Designed for emotional undercontrol, including:
- Impulsivity
- Emotional instability
- Self-destructive behaviors
- Difficulty tolerating distress
DBT teaches mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and radical acceptance to help individuals develop emotional stability.
Table of Contents
What Is the Difference Between RO DBT vs DBT?
The main difference between RO DBT and DBT is the emotional pattern each treatment targets.
RO DBT, developed by Dr. Thomas Lynch, was specifically created for individuals who struggle with excessive self-control. People with emotional overcontrol often suppress emotions, follow rigid internal rules, avoid vulnerability, and experience loneliness despite appearing highly capable and successful.
DBT, developed by Dr. Marsha Linehan, was designed to help individuals who experience intense emotions, impulsive behaviors, and difficulty regulating distress.
Although both therapies are evidence-based and share behavioral therapy principles, they address opposite ends of the emotional regulation spectrum:
- DBT increases emotional control and stability
- RO DBT increases emotional openness, flexibility, and social connection
For individuals whose challenges center around perfectionism, emotional inhibition, and chronic loneliness, RO DBT may provide a more targeted approach.
What Is RO DBT (Radically Open DBT)?
Radically Open Dialectical Behavior Therapy (RO DBT), according to the National Institutes of Health (NIH), is an evidence-based treatment designed specifically for emotional overcontrol.
Research suggests that excessive self-control can contribute to social isolation, chronic loneliness, treatment-resistant depression, and certain eating disorders. RO DBT was developed to address these challenges by helping individuals become more open, flexible, and socially connected.
RO DBT is commonly used for:
- Treatment-resistant depression
- Anorexia nervosa
- Obsessive-compulsive personality traits
- Chronic perfectionism
- Emotional inhibition
- Relationship difficulties related to emotional restraint
Rather than focusing on controlling emotions, RO DBT teaches radical openness, which encourages individuals to:
- Question rigid beliefs
- Remain open to feedback
- Express emotions more authentically
- Practice flexibility in uncertain situations
- Strengthen social bonds and connections
The goal is to increase psychological flexibility and improve meaningful interpersonal relationships.
What Is DBT (Dialectical Behavior Therapy)?
Dialectical Behavior Therapy (DBT) is an evidence-based treatment originally developed for individuals experiencing severe emotion dysregulation.
DBT teaches four core skill areas:
- Mindfulness
- Distress Tolerance
- Emotion Regulation
- Interpersonal Effectiveness
One of the most recognized DBT concepts is radical acceptance, which helps individuals accept reality as it exists in the present moment rather than increasing suffering through resistance or avoidance.
While DBT focuses on helping individuals manage overwhelming emotions and impulsive reactions, RO DBT focuses on helping individuals loosen excessive self-control and increase emotional openness.
What Are Overcontrolled Personality Traits?
Overcontrolled personality traits involve excessive self-control, emotional restraint, and rigid behavioral patterns.
People with overcontrolled tendencies often:
- Hide or suppress emotions
- Set extremely high standards for themselves
- Follow strict internal rules
- Avoid mistakes and uncertainty
- Have difficulty showing vulnerability
- Appear calm externally while struggling internally
While these traits can contribute to achievement, responsibility, and self-discipline, they can also increase the risk of:
- Chronic stress
- Perfectionism
- Emotional loneliness
- Social disconnection
- Relationship difficulties
Many individuals with overcontrolled traits appear highly successful externally while feeling isolated, misunderstood, or emotionally disconnected.
How Does Emotional Regulation Therapy Help?
Emotional regulation is the ability to understand, manage, and express emotions in healthy ways.
Therapies such as RO DBT and DBT help individuals improve emotional regulation through evidence-based skills and behavioral strategies.
- RO DBT helps increase emotional openness, flexibility, and social connectedness
- DBT helps reduce emotional overwhelm through distress tolerance and coping skills
Both approaches can improve communication, strengthen relationships, and support long-term emotional well-being. However, for individuals whose struggles stem from excessive self-control rather than impulsivity, RO DBT offers a specialized approach that directly targets overcontrol.
Which Therapy Is Right for You?
The best therapy depends on your emotional patterns, coping style, and treatment goals.
RO DBT may be a good fit if you:
- Struggle with perfectionism
- Follow rigid rules or routines
- Suppress emotions
- Avoid vulnerability
- Have difficulty receiving feedback
- Feel lonely or disconnected despite functioning well in other areas
DBT may be a good fit if you:
- Experience intense emotional reactions
- Feel emotionally overwhelmed
- Struggle with impulsive behaviors
- Have difficulty managing distress
A qualified therapist can help determine whether emotional overcontrol or emotional undercontrol better explains your experiences and which treatment approach may be most beneficial.
Frequently Asked Questions
Is RO DBT the same as DBT?
No. RO DBT and DBT were developed to address different emotional regulation styles. DBT focuses on emotional undercontrol, while RO DBT focuses on emotional overcontrol.
What does overcontrol mean in therapy?
Overcontrol refers to excessive self-control, emotional inhibition, perfectionism, and rigid thinking that can interfere with flexibility, relationships, and social connections.
Can RO DBT help with perfectionism?
Yes. RO DBT was specifically designed to address perfectionism, rigidity, and fear of making mistakes by increasing openness, flexibility, and willingness to learn from new experiences.
How long does RO DBT treatment take?
Many RO DBT skills programs last approximately 30 weeks and are often combined with individual therapy. Treatment length varies depending on individual goals and clinical needs.
About Abri Psychotherapy
Abri Psychotherapy provides evidence-based therapy for adolescents, adults, and couples seeking greater emotional balance, resilience, and connection.
Our clinicians specialize in helping individuals who struggle with perfectionism, emotional overcontrol, relationship challenges, anxiety, and depression through compassionate, individualized care.
We offer both in-person and telehealth therapy throughout Oregon and Washington, supporting lasting emotional growth, stronger relationships, and meaningful change.
Radically Open DBT Therapy in Portland Oregon
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