RO-DBT with Compassionate Counseling St. Louis Therapist, Samantha Ferrara, MSW, LCSW

Samantha Ferrara, MSW, LCSW

At Compassionate Counseling St. Louis, Samantha Ferrara, MSW, LCSW provides counseling to kids, teens and college students as well as parent coaching.

Continually increasing her skills and knowledge is important to Samantha, which is why she has recently been certified as a RO-DBT Level 1 provider and she is here to tell us more about what that means for her clients!

Counseling in St. Louis That’s Tailored To Your Needs

At Compassionate Counseling St. Louis, we know that no two kids, teens, or families are exactly alike—which is why we tailor our approach to fit your unique needs. Whether your child benefits most from Cognitive Behavioral Therapy (CBT) to manage anxious thoughts, St. Louis play therapy informed interventions to express big emotions, Acceptance and Commitment Therapy (ACT) to build resilience, or Radically Open DBT (RO-DBT) for emotional regulation, our experienced therapists are here to help. Our goal is to create a safe, supportive space where your child can explore their feelings, develop coping skills, and gain confidence—all while making real progress. If you’re looking for compassionate, expert counseling in St. Louis, we’re here to guide you and your family every step of the way.

What is Radically Open Dialectical Behavior Therapy (RO-DBT)?

RO-DBT focuses on symptoms of over-control seen in people struggling with high anxiety and perfectionism. Individual RO-DBT looks at root causes of behaviors (or maladaptive coping), while learning skills to overcome expectations and rule-governed behavior.

How does RO-DBT differ from traditional DBT in treating anxiety?

RO-DBT is therapeutic intervention that uses behavioral principles and a dialectical philosophy similar to DBT. However, it focuses on challenges related to over-control and learning skills to overcome expectations and rule-governed behavior.

This usually looks like teens and adults who have low openness, poor social signaling, and are described as "aloof." RO-DBT focuses on the use of social signaling to increase openness, connectedness, and vulnerability.

Social signaling is the way people use actions, words, or body language to communicate their intentions and feelings to others.

This differs from DBT due to its focus on under control behaviors, focusing on emotion regulation, gaining control over impulses, and increasing distress tolerance.  

How does RO-DBT help anxious teens and young adults who struggle with perfectionism, rigidity, or emotional over-control?

RO-DBT works to decrease unhelpful coping skills that we often see in people struggling with perfectionism and high anxiety. Some of these unhelpful coping skills include insincere or fake emotional expression, hyper focused on details, overly cautious behavior, rigid and rule-governed behavior, and high social comparison, envy, and bitterness.

Within individual RO-DBT therapy, clients learn to practice mindfulness in attempts to participate without planning and encourage flexible thinking. Additionally, clients will practice using radical openness, to actively engage in situations that they may tend to avoid. 

In what ways can RO-DBT support parents of anxious teens in understanding and managing their child’s emotional needs?

Within the first few sessions of RO-DBT, clients explore both biological and situational traits that they have learned over time or that have been passed down through generations (this includes parenting styles!).

Image Credit: Unsplash, Eye for Ebony @eyeforebony

Parents who have teens engaging in RO-DBT can learn more about how family, culture, and social influences relate to over-control behaviors. By learning more about these factors, parents can increase their ability to better understand reactions and responses, while tweaking their parenting approaches to help lower anxiety and increase connectedness. 

What are the key skills taught in RO-DBT, and how do they help anxious individuals build flexibility and resilience in social situations?

RO-DBT uses skills surrounding social signaling to increase flexibility and resilience. These skills involve behavior modifications, such as posture and eye contact, as well as thought modifications through self-enquiry and curiosity.

Clients work to link social signaling to valued goals, for example, when using DBT skills like Flexible Mind is DEEP, you might notice that your eye roll that indicates disgust can get in the way of your value of connection with your child. RO-DBT also focuses on mindfulness to stay in the present and increase connection, flexibility, and resilience.  

Can RO-DBT be effective for both anxiety and anger management in teens and young adults, and how does it promote emotional openness and connection?

Clients who identify with over-control are not always outwardly angry. They often feel internal frustration, jealousy, or experience high comparison. By putting less focus on the inner experience, clients learn to become receptive and open to new experiences, increased flexible control to adapt to change, and increase intimacy and connectedness with at least one other person encouraging emotional openness and connection.

What does a RO-DBT session look like?

In the first few sessions, we focus on education around over-control, discussing concepts and relationships as well as identifying valued goals and skills. We also talk about change and how change happens. Then we spend time working on skills and working on putting our new knowledge and skills into practice. These sessions are structured and follow a flexible schedule.

What ages are best for RO-DBT?

Adolescents and up typically find the most benefit from RO-DBT.

What types of concerns do you focus on most when using RO-DBT?

I focus on working with people who experience anxiety, depression and avoidant attachment concerns.

How did you become interested in RO-DBT and why do you like practicing it?

I first became interested in RO-DBT due to its connection with high anxiety and perfectionism. Many of the anxiety reduction skills seen are not always helpful with those with over-control due to the internal nature of symptoms. 

RO-DBT focuses on symptoms of overcontrol often seen in high anxiety and perfectionism. Individual RO-DBT reviews root causes of behaviors, while learning skills to overcome expectations and rule governed behavior.

Curious to learn more about getting treatment for anxiety? Wondering if you need to connect with a therapist in St. Louis? Contact Compassionate Counseling St. Louis to set up a free 15-minute phone consult. We’ll talk about what’s going on and best next steps! Not sure if you want in-person counseling or online therapy? We offer both and will help you decide which is the best option for you!

Curious to learn more about anxiety and anxiety-driven anger? Reach out to us at hello@compassionatecounselingstl.com. As child anxiety experts, we love working with kids, teens, college students and parents to help manage their anxiety, stress, and anger. Compassionate Counseling St. Louis is located in Clayton, MO and works with families by offering both in-person counseling and online therapy throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Couer, Kirkwood, Richmond Heights, and Brentwood. We also provide online therapy Missouri -wide to teens and college students. You can set up your first free consult on this website, on our consultation page.