Established and new: a systematic review of an emerging transdiagnostic treatment and an exploration of change processes in an established treatment

Personality research suggests that there is a spectrum of inhibitory control, ranging from undercontrolled to overcontrolled. Traits at both ends of the specturm have been associated with mental health difficulties. Specifically, overcontrol has been associated with anorexia nervosa, anxiety disorders and “treatment resistant” depression. Radically Open Dialectical Behavioural Therapy (RO DBT) is an emerging transdiagnostic therapy aimed at improving mental health symptoms by reducing overcontrol and improving social connectedness. To date, no systematic critique of the literature has been completed. This systematic review aimed to synthesis the available quantitative findings of RO DBT transdiagnostically and across the lifespan. Five databases were included in the search, with terms covering RO DBT and overcontrol. Ten studies were identified and narrative analysis completed. Quality assessment rated all papers as good or fair. Synthesis found improvements in mental health symptoms, overcontrol traits and social connectedness. These were seen across the lifespan and transdiagnostically. This synthesis suggests there is a transdiagnostic benefit of RO DBT for improving mental health and overcontrol traits. There was considerable variation between studies in their delivery of RO DBT and the measures used to monitor mental health symptoms, overcontrol and social connectedness. Further research with cohesive approaches is warranted to better compare RO DBT transdiagnostically.