What Makes Austen Riggs Different?

If you haven't found a psychiatric treatment to address your mental health challenges, the residential program at the Austen Riggs Center could possibly help. Find out what makes Austen Riggs different in this presentation by our Medical Director/CEO Edward R. Shapiro, MD.

Most of us struggle with our lives. Some of us can get out of it by ourselves with some help. Some of us need a lot more help. Very often with the treatment of patients who are in serious trouble, they're treated in settings with experts. Experts direct them in various ways. The Austen Riggs Center focuses on our patients as competent adults. They have a voice that many of them have not been able to use, and they have quite often surrendered to other people's authority. For many patients, outpatient therapy is enough. For some patients who are in real trouble because of the nature of their disorganization, or the nature of their behavior, or the intensity of their substance abuse, they find themselves in locked settings. Rigg's patients are somewhere in between there, where outpatient therapy is not enough because of the kind of trouble they get into in between therapy sessions, and they can't quite manage their lives with just the intervention of outpatient psychotherapy. They're not in enough disorganization, not in enough trouble to require a locked inpatient unit. And they have an additional resource. They're committed to gaining some perspective on a life that they can't make any sense of. That's the patient that belongs at the Austen Riggs Center.

Riggs has a continuum of care. Patients come in at our highest level of care for a six-week evaluation and treatment. That's an intense involvement where we do psychological testing, there's a history gathering, we meet with the families, they get involved in the therapeutic community, and at the end of six weeks there's a case conference that involves all of the staff and the patient is invited in to give their perspective on what they've been learning in those six weeks. After those 6 weeks, some patients choose to leave. That's enough for them. They've gotten some perspective on what they're struggling with. They want to continue the work in outpatient treatment. Some patients decide that this is just the beginning of their treatment. They found something that's opening up doors for them that they haven't opened before, and they decide to stay. When they stay, there are a range of step-down programs that they can begin to enter. That decision is theirs. One of the reasons that we negotiate step-down programs this way with the patients is core to our mission - to help patients develop their own authority for their lives. The step-down programs are graded down towards outpatient treatment with the same treatment team. This is key. The same therapist follows the patient all the way through. The same psychopharmacologist, the same social worker, all the way through our step-down programs. This enhances their authority, allows them to manage their resources, and gives them the direction out into the world where they can begin to apply what they have learned in our treatment.

When people's lives are in a snarl, it takes a serious commitment and a fair number of resources to get out of it. Some patients get what they need after 6 weeks, but many decide to stay longer. Nonetheless, at the end of the day, you should recognize that it's a serious commitment of time and resource to unpack a complicated life.