Research at Riggs
The Austen Riggs Center intensive clinical program for patients with treatment resistance also provides a unique opportunity to do clinical research to learn from our work. The Erikson Institute at Riggs provides intellectual and practical support for clinical staff interested in doing such research.
Past significant Riggs research studies include the 1980’s MacArthur Foundation-funded study by Richard Ford and Sidney Blatt that quantified the benefits of long-term, intensive, psychoanalytically informed treatment through psychological testing measures. This led to the publication Therapeutic Change: An Object Relations Perspective. In the 1990’s and into the 2000’s Riggs ran the Follow Along Study (FAS) which tracked a group of 226 Riggs patients between 1993 and 2001, both while in treatment at Riggs and beyond. This created a rich and extensive archive of data for asking a range of research questions.
A number of projects are currently ongoing or are in planning at Riggs, including the following:
Staff Psychiatrist Elizabeth Weinberg, MD: Studying a subset of FAS patients who were diagnosed as being treatment resistant, to assess their mood fluctuations over the years after they left Riggs. This study aims tell us something about the real-life long-term impact of the Riggs therapeutic approach on those patients deemed treatment resistant.
Staff Psychologist Marilyn Charles, PhD, Fellow in Psychology Jeremy Ridenour, PsyD, and Adelphi University collaborator Michael O’Loughlin, PhD: Studying a subset of the FAS group to study changes in reflective function – the ability to imagine mental states in self and others – over time of treatment as indicators of improvement. Another of Dr. Charles’ studies is an analysis of creativity capabilities and their relationship to emotional health. This utilizes the Rorschach test, which is part of the standard psychological testing for all Riggs patients.
Riggs clinical program utilizes a battery of psychological tests including the Rorschach and other assessments. Dr. Ridenour and Director of Psychological Assessment Christina Biedermann, PsyD are examining how Riggs’ psychological testing may have changed over the decades. The project is reviewing psychological testing reports from Riggs patients dating back to the 1940s to understand if and how these were interpreted differently over time. This study may help inform or even influence how we collect data and draw conclusions from psychological testing today and in the future.
Evelyn Stefansson Nef Director of the Erikson Institute for Education and Research Jane G. Tillman, PhD, Director of Training Jennifer Stevens, PhD, and former Riggs staff member Jill Clemence, PhD: Working with patients who have survived a suicide attempt, to understand state of mind immediately prior to the attempt. This complex study involves analyzing information drawn from in-depth interviews with the patients to identify markers which could represent predictors of suicide risk.
In collaboration with staff member Samantha Grzelak, Dr. Tillman is also developing a new instrument to survey lifetime experiences of bullying – whether as victim or perpetrator. There is increasing evidence that experiences of bullying or being bullied may contribute to later life mental health issues such as psychosis, substance abuse and suicidality. Most existing bullying surveys focus on one life segment. The instrument being developed at Riggs will provide a comprehensive lifelong assessment of bullying experience. Once validated could be of broad interest to many clinical, educational and research institutions.
Social Workers Thomas Lusignan, LICSW, Beth Turner, LICSW, David Rosenthal, LICSW and Director of Social Work Cathleen Morey, LICSW: Developing a tool for measuring family dynamics over time - essentially a ‘grid’ onto which behaviors can be ‘mapped’. The group hopes that this tool may be used in the future to provide a measure for changes in family dynamics over a patient’s time in treatment.
Fellow in Psychiatry Mark Elliot, MD: Study of ‘social dreaming’ which will analyze the patterns of patients dreams with their experiences in the broader therapeutic community.
Riggs collects a significant amount of clinical information from patients from admission to discharge. Staff Psychologist Steven Ackerman, PhD is spearheading an initiative to review and map out how this data is collected, how the process might be augmented and streamlined, as well as utilized in future research studies.
A key part of the Riggs program is the opportunity to engage in activities including arts and crafts, patient government and a work program. Therapeutic Community Program Staff member Mr. Peter Hummel is developing a study to explore how individual patients make use of these opportunities and how their engagement changes over a six-month timeframe of treatment. This aims to see if fluctuations in participation relate to the arc of recovery - an area unexplored in the clinical literature.
For all research studies, it is vital for Riggs to work in partnership with the patient community, without whom there can be no research. To better understand patient’s perspectives on research, Manager of Institutional Research Kim Hunter-Schaedle, PhD is conducting a survey of former and current Riggs patients. This will collect information on patients’ interest in, and willingness to participate in, research, as well as the types of research that patients feel would be most informative to them. For those patients who participate in the survey and are interested to do so, they will be invited to join the Erikson Institute Research Registry. Participants in this Registry will be notified of opportunities to participate in research studies as well as updated on the progress of research projects at Riggs.
To provide support for busy clinicians to conduct research, the Erikson Institute Research Department encourages research project discussions through a series of ‘lab meetings’ where research ideas can be discussed and results presented; has an Institutional Review Board chaired by Elizabeth Weinberg, MD, to ensure protection of human subjects; and helps investigators to develop their research proposals and seek research funding.
Riggs also has a roster of expert outside research consultants as listed below and is engaged in an ongoing process of consultations with members of this group to develop and refine both established and emerging research projects.
Linda Mayes, MD, Interim Director of the Yale Child Study Center and Special Advisor to the Dean of Yale School of Medicine is Chair of our Research Consultation Group and a Senior Consultant to the research program.
David Reiss, MD, former Erikson Scholar and currently on the staff of the Yale Child Study Center is a Senior Consultant to the research program.
Erikson Institute Research Consultation Group:
Linda Mayes, MD, Yale Child Study Center (Chair)
Jacques Barber, PhD, Adelphi University
John Clarkin, PhD, Cornell Weill Medical Center
Patrick Luyten, PhD, University of Leuven, Belgium
Kevin Meehan, PhD, Long Island University
Nancy Suchman, PhD, Yale Child Study Center
Mary Target, PhD, University College London
Robert Waldinger, MD, Massachusetts General Hospital