Table 2 The Haldon unit RO-DBT treatment program

RO-DBT Functions & Modes

Motivating Commitment (‘structured yet flexible’): via weekly individual therapy & daily monitoring of target behaviors with diary cards

Enhancing Capabilities (‘learning to re-join the tribe’): via skills training classes; 3 RO-DBT skills training classes per week.

Skills Generalization (‘going opposite to stoicism’): via telephone coaching calls as needed when patient off-unit.

Support for Therapists (‘practicing radical openness ourselves’): via weekly RO-DBT staff consultation team meetings.

Enhancing Environmental Support: via RO-DBT informed family therapy sessions emphasizing radical openness and other DBT skills.

Ancillary groups informed by RO-DBT principles

Daily morning mindfulness and loving-kindness practices.

Weekly Target Setting Group: helping patients ‘look for roses not just thorns’ and practice the art of flexible-planning.

Weekly Meal Management Group: using RO-DBT skills to manage fears of food, urge surfing disgust/bloating sensations, negotiating meal planning using DBT interpersonal effectiveness skills.

Weekly Art Group: exposure to novelty, practicing tolerance of uncertainty, letting go of perfectionism.

Weekly Reflective Space: practicing radical openness skills designed to activate social-safety system; responding without rehearsal.

Weekly Body Image Discussion: observing rigidity and practicing openness to disconfirming feedback.

Themed Skills Application Week: every 2 months the normal Unit schedule is suspended. Staff and patients join together to practice radical openness skills, share community meals, and practice playful spontaneity (e.g., Taiko Drumming, Film Making, Fancy Dress, Pantomime).