Thomas R. Lynch - The Skills Training Manual for Radically Open Dialectical Behavior Therapy: A Clinicians Guide for Treating Disorders of Overcontrol

Radically open dialectical behavior therapy (RO DBT) is a truly innovative treatment, developed through translation of neuroscience into clinical practice, integrating various influences from dialectical behavior therapy (DBT), mindfulness-based approaches, emotion, personality and developmental theory, evolutionary theory, and Malamati Sufism. RO DBT is applicable to a spectrum of disorders characterized by excessive inhibitory control or overcontrol (OC). This is the first treatment that directly targets social signaling and nonverbal aspects of communication not only in clients but also in therapists.

Mima Simic, MD, MRCPsych, joint head of the child and adolescent eating disorder service, and consultant child and adolescent psychiatrist at the Maudsley Hospital in London, UK

A new and comprehensive statement from one of the more creative minds in evidence-based clinical intervention today, RO DBT brings together a contemporary focus on a limited set of key transdiagnostic processes, with new assessment and intervention techniques for moving them in a positive direction. Emphasizing flexibility, openness, connection, and attention to social signaling, RO DBT specifies the details that can matter, from how you arrange your consulting room furniture to how nonverbal cues signal social information. RO DBT seems destined to make an impact on evidence-based care in many corners of clinical work. Highly recommended.

Steven C. Hayes, PhD, codeveloper of acceptance and commitment therapy (ACT); Foundation Professor of psychology at the University of Nevada, Reno; and author of Get Out of Your Mind and Into Your Life

RO DBT offers an intriguing reconceptualization of traditional views of internalizing and externalizing disorders, and provides the clinician with valuable new tools to address a number of problems that have been particularly resistant to standard CBT approaches. I will definitely include RO DBT theory and techniques in my graduate-level intervention class. I know beginning clinicians in particular will be grateful to have a systematic way to approach these slow-to-warm-up clients who are difficult to establish rapport with. Their early termination from therapy and failure to respond to traditional approaches often leaves clinicians befuddled and critical of their own skills. RO DBT provides a compassionate way for clinicians to view this type of resistant client, as well as to work on some areas that are likely to benefit them. A very welcome addition to any clinicians toolbox.

Linda W. Craighead, PhD, professor of psychology and director of clinical training at Emory University, and author of The Appetite Awareness Workbook

Publishers Note

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.

Distributed in Canada by Raincoast Books

Copyright 2018 by Thomas P. Lynch

Context Press

An imprint of New Harbinger Publications, Inc.

5674 Shattuck Avenue

Oakland, CA 94609

www.newharbinger.com

Image in handout 8.3: Have You Heard? Let Justice Be Done!, Jackson, Peter (19222003) / Private Collection / Look and Learn / Bridgeman Images.

Who Makes These Changes? from THE ESSENTIAL RUMI by Jalal al-Din Rumi, translated by Coleman Barks. Copyright 1997 by Coleman Barks. Used by permission.

Cover design by Amy Shoup; Acquired by Catharine Meyers; Edited by Xavier Callahan; Indexed by James Minkin

All Rights Reserved

Library of Congress Cataloging-in-Publication Data

Names: Lynch, Thomas R. (Professor of clinical psychology), author. | Complemented by (work): Lynch, Thomas R. (Professor of clinical psychology). Radically open dialectical behavior therapy

Title: The skills training manual for Radically open dialectical behavior therapy : a clinicians guide for treating disorders of overcontrol / Thomas R. Lynch.

Description: Oakland, CA : New Harbinger Publications, Inc., 2018. | Companion volume to Radically open dialectical behavior therapy / Thomas R. Lynch. 2018. | Includes bibliographical references and index.

Identifiers: LCCN 2017040505 (print) | LCCN 2017043166 (ebook) | ISBN 9781626259324 (pdf e-book) | ISBN 9781626259331 (ePub) | ISBN 9781626259317 (paperback)

Subjects: | MESH: Behavior Therapy--methods | Compulsive Personality Disorder--therapy | Behavior Therapy--education | Self-Control--psychology

Classification: LCC RC489.B4 (ebook) | LCC RC489.B4 (print) | NLM WM 425 | DDC 616.89/142--dc23

LC record available at https://lccn.loc.gov/2017040505

This book is dedicated to the the most important people in my lifemy wife Erica and our daughter Kayleigh

If I know anything, it is that I dont know everything and neither does anyone else.

Michael P. Lynch, True to Life: Why Truth Matters

List of Radical Openness Handouts and Worksheets xvii

Chapter 1 Basic Principles, Treatment Overview, and Global Structure of Skills Training Classes 1

What Is Overcontrol? 1

Four Core Deficits 3

RO DBT Therapeutic Stance 3

Basic Assumptions 4

The Primary Mechanism of Change: Social Signaling 5

Treatment Structure and Targets 6

Individual Therapy Treatment Target Hierarchy 7

RO Skills Training: Global Aims and Targets 8

Orienting OC Clients to RO Skills Training 9

Structuring RO Skills Training Classes 11

Composition of RO Skills Training Classes 13

Think Nondiagnostically to Enhance Class Size 13

Maximize Learning by Maximizing the Physical Environment 14

Teach Directly from the Manual 16

Summary 17

Chapter 2 Dialectics, Radical Openness, and Self-Enquiry 18

Why Dialectics? 18

Why Radical Openness? 22

Why Self-Enquiry? 25

Summary 27

Chapter 3 Managing Problematic Behaviors in RO Skills Training Classes 29

When a Classroom Goes Quiet 29

Use Heat-On and Heat-Off Strategies to Shape Desired Behaviors 34

Maladaptive Social Signals That Cannot Be Ignored in Class 35

Protocol for Therapeutic Induction of Social Responsibility 42

Managing Alliance Ruptures and Repairs 45

Managing Suicidal Behavior 45

Summary 46

Chapter 4 Using the RO Skills Training Manual 47

Deciphering an RO Lesson Plan 47

Additional Instructions for Using the Skills Manual 48

Chapter 5 The RO DBT Lesson Plans 50

Lesson 1 Radical Openness 51

Main Points for Lesson 1 51

Materials Needed 51

(Recommended) Mindfulness Practice: Mindfulness of Ambiguity 52

(Required) Class Exercise: Our Perceptual Biases: How We Become Closed to New Information 53

(Required) Teaching Points: Perceptual Biases 53

(Required) Teaching Points: What Is Psychological Health? 54

(Required) Teaching Points: To Be Open or Closed? That Is the Question! 55

(Recommended) Class Exercise: Myths of a Closed Mind 56