Radically Open Dialectical Behaviour Therapy (RO-DBT) is an adapted version of standard DBT geared towards helping those with Anorexia Nervosa. RO-DBT is a ‘skills’ based approach and your therapist will teach and explore with you various skills for particular situations that you may struggle with associated with anorexic behaviour. The skills will be adapted to suit your particular needs and you and your therapist might use a diary card to track the things you’d like to work on. Your therapist might role play scenarios with you to help you understand and get used to putting the skills into practice in your everyday life.

The aim of the skills is to help you to explore your self-esteem, your own style of relating, to help you to identify and understand your emotions, offer alternative, more effective ways of managing and tolerating distress and to gently challenge any rigidity and perfectionism that anorexia tends to impose.

An RO-DBT therapist understands that anorexia can be a very isolating illness and so there is much emphasis in this approach on social connectedness. Improving the quality of relationships seems to be highly valued by people as they recover from their eating disorder and it is understood that relationships can be become strained and sufferers may withdraw from those close to them and avoid new environments and meeting new people, as it may not feel safe to do so.

RO-DBT invites you to be curious about your relationship with control and avoidance and offers alternative methods of experimenting with new ways of communicating your needs. RO-DBT can include practising mindfulness to help you to pause and notice what is happening for you in the moment and practice tolerating whatever that may be in order to learn about your experiences and embrace them rather than avoiding or distracting yourself from your needs. RO-DBT aims to empower you to gain confidence and control of your life without anorexia.


Written by Lucy Bethan