by Thomas R. Lynch


Radically Open Dialectical Behavior Therapy: Theory and Practice for Treating Disorders of Overcontrol, written by Thomas R. Lynch, introduces a new treatment that focuses on disorders of emotional overcontrol. The intended audience for the book is clinicians treating disorders such as refractory depression, anorexia nervosa, and obsessive-compulsive disorder. These disorders tend to be more chronic in nature and this book offers clinicians a resource to address these hard-to-treat disorders. Although radically open dialectical behavior therapy (RO DBT) is considered a new treatment, it has over 20 years of research backing the modality, having been based on dialectical behavior therapy (DBT), mindfulness-based therapy, cognitive behavioral therapy (CBT), Gestalt therapy, and motivational interviewing, just to name a few.

Reading this book was a pleasant surprise. The manual is easy to read and the writing style is engaging, which made the content fascinating. Terms are explained beautifully to help a clinician who is new to the approach understand the given information. The book provides valuable new tools to help clinicians deal with disorders that have historically been resistant to traditional CBT and even DBT. One of the most enjoyable chapters of this book was the chapter on maximizing client engagement. In this chapter, the clinician is given transcripts to read through and is also given word-for-word questions to ask the client to improve engagement. This chapter alone makes the book irreplaceable, especially for a new clinician who is trying out this modality for the first time. In addition, the chapter can be modified to fit many other client presentations and not just those of overcontrol.

Dr. Lynch teaches clinicians to encourage self-inquiry for clients rather than focusing solely on changing unpleasant emotions. The tendency for a “quick fix” in therapy is also addressed. The manual breaks down how therapy sessions should flow and offers steps to move the client forward. RO DBT addresses loneliness and alienation, which is not something that I have run across in other treatment modalities—this feature alone is invaluable.

A strength of this book is the plethora of resources that are provided. The book includes an appendix of assessments to help clinicians determine the needs of their clients and decide the correct intervention strategies to use. Not only are there assessments geared toward the client, but there are also assessments for the clinician, to ensure that they are delivering quality services and an adequate delivery of their specific approach. In addition to the assessments, Dr. Lynch offers insight on social signaling and even how to arrange the clinical room.

Overall, this is a very helpful book. It offers hope to a large group of clients who have typically not been able to find treatment that effectively addresses their complex needs. The book is an excellent resource for clinicians treating clients who are slow to warm up to therapy and have trouble with social relationships. This manual is great for those who are wanting to stay abreast of cutting-edge treatment modalities. It is an excellent primer and becomes even more beneficial when used along with the skills training manual, handouts, and worksheets that are available.


Lynch, T. R. (2018). Radically Open Dialectical Behavior Therapy: Theory and Practice for Treating Disorders of Overcontrol. New Harbinger.

Reviewed by: LaShanna S. Stephens, MS, NCC, CCMHC, LPC, Sound Advice Counseling, LLC

The Professional Counselor