Radically open dialectical behaviour therapy adapted for adolescents: a case series.

Area of Science:

• Clinical Psychology
• Adolescent Psychiatry
• Transdiagnostic Mental Health Treatments

Background:

• Overcontrol is a transdiagnostic trait cluster linked to excessive psychological, behavioral, and social inhibition.
• It is associated with depression, restrictive eating disorders, and obsessive-compulsive personality disorder.
• Radically Open Dialectical Behaviour Therapy (RO-DBT) is a transdiagnostic treatment for maladaptive overcontrol.

Purpose of the Study:

• To evaluate an adolescent adaptation (RO-A) of Radically Open Dialectical Behaviour Therapy.
• To assess RO-A's effectiveness for a transdiagnostic group of overcontrolled adolescents.
• To examine changes in overcontrol characteristics, relationship quality, and mental health symptoms.

Main Methods:

• A consecutive case series of 28 adolescents referred for RO-A from specialist mental health services.
• Baseline and discharge self-report measures assessed overcontrol, attachment, depression, and eating disorder symptoms.
• Treatment involved a mean of 18 group skills classes and 21 individual sessions over 34 weeks.

Main Results:

• Adolescents presented with high rates of depression (78.6%), self-harm (64.3%), and eating disorders (78.6%), often with multiple diagnoses.
• Significant improvements were observed in cognitive flexibility, risk aversion, reward processing, and emotional expression suppression.
• Participants reported reduced social withdrawal, increased connection, and greater confidence and comfort in attachment relationships; depression, eating disorder symptoms, and self-harm rates also significantly improved.

Conclusions:

• Preliminary data suggest RO-A may be an effective treatment for adolescents with overcontrol and comorbid moderate-to-severe mental health disorders.
• RO-A demonstrated improvements in overcontrol management, relationship quality, and mental health symptoms.
• Further rigorous evaluation is warranted due to the small sample size and methodological limitations, particularly for underweight adolescents with eating disorders.