Lynch Thomas R, Hempel Roelie J, Dunkley Christine
School of Psychology, University of Southampton, Highfield Campus, Southampton, UK.
Am J Psychother. 2015;69(2):141-62. doi: 10.1176/appi.psychotherapy.2015.69.2.141.
Radically Open-Dialectical Behavior Therapy (RO-DBT) is a transdiagnostic treatment designed to address a spectrum of difficult-to-treat disorders sharing similar phenotypic and genotypic features associated with maladaptive over-control-such as anorexia nervosa, chronic depression, and obsessive compulsive personality disorder. Over-control has been linked to social isolation, aloof and distant relationships, cognitive rigidity, high detailedfocused processing, risk aversion, strong needs for structure, inhibited emotional expression, and hyper-perfectionism. While resting on the dialectical underpinnings of standard DBT, the therapeutic strategies, core skills, and theoretical perspectives in RO-DBT often substantially differ. For example, RO-DBT contends that emotional loneliness secondary to low openness and social-signaling deficits represents the core problem of over-control, not emotion dysregulation. RO-DBT also significantly differs from other treatment approaches, most notably by linking the communicative functions of emotional expression to the formation of close social bonds and via skills targeting social-signaling and changing neurophysiological arousal. The aim of this paper is to provide a brief overview of the core theoretical principles and unique treatment strategies underlying RO-DBT.
激进开放辩证行为疗法(RO-DBT)是一种跨诊断治疗方法,旨在治疗一系列难以治疗的疾病,这些疾病具有与适应不良的过度控制相关的相似表型和基因型特征,如神经性厌食症、慢性抑郁症和强迫型人格障碍。过度控制与社交孤立、冷漠疏远的人际关系、认知僵化、高度专注于细节的处理、风险规避、对结构的强烈需求、情感表达抑制以及过度完美主义有关。虽然RO-DBT基于标准辩证行为疗法的辩证基础,但它的治疗策略、核心技能和理论观点往往有很大不同。例如,RO-DBT认为,由于开放性低和社交信号缺陷导致的情感孤独是过度控制的核心问题,而非情绪失调。RO-DBT也与其他治疗方法有显著差异,最明显的是它将情感表达的沟通功能与亲密社会关系的形成联系起来,并通过针对社交信号和改变神经生理唤醒的技能来实现。本文旨在简要概述RO-DBT背后的核心理论原则和独特治疗策略。