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 Oscar F. Hills, MD.

We all struggle with our lives from time to time, some more than others, and most of us are able to find some help along the way. But sometimes when people have more trouble than the usual, they find themselves under the care of experts. Those experts tend to direct their lives.

Here at Riggs, we treat patients as competent adults. It's not quite the same thing as giving direction. People have their own voice, but many times people having significant trouble have not found that voice or how to use it. We promote that here at Riggs.

For some patients, outpatient therapy is enough. For others, their difficulties with disorganization or behavior or substance abuse are such that they require treatment in a locked setting in order to maintain their safety.

Riggs patients fall somewhere in between those two extremes. Outpatient therapy isn't quite enough, but they're not having such difficulty that they require a locked setting. That is the person who belongs at Austen Riggs. That person is also committed to trying to find some perspective and a way of understanding their lives that they were not so easily able to do before Riggs.

One is the open setting where patients can come and go as they please, participate in the Stockbridge community, and live life. Another, though, is responsibility. Patients have a responsibility to each other in the community, but they also have a responsibility to themselves, which they exercise in the process here at Riggs.

A third still, but not unrelated, is relationships. Patients have relationships with their therapist, with each other, with their treatment team. These are all part and parcel of what makes Riggs a unique experience. Patients at Riggs often cover a wide range of classical diagnoses, whether that be psychosis, mood disorders, so-called personality disorders.

Some people have had treatment at many other institutions and facilities and may come to Riggs labeled as treatment-resistant. We don't think of treatment resistance as residing in the patient. We think of this as their not having yet encountered the right treatment.

The Riggs treatment model is unique along a number of dimensions. One of them is intensive individual therapy. This is a four times a week psychodynamic psychotherapy with a trained doctoral-level clinician.

In addition to the four times a week psychotherapy, there are also multiple groups, maybe as many as 30 per week, and these are frequently run by the patients themselves.

Another very important dimension of the Riggs experience is the therapeutic community. This is the Riggs version of the world stage on which people's life experience is expressed.

The therapeutic community is a place where people's relationships are front and center. They include capacities people might not have known they had in them, things that they've learned about how they relate to other people that they can put into practice in the therapeutic community. This is one of the great features of the Austen Riggs community.

These three pillars of the Austen Riggs experience, that is psychodynamic psychotherapy, group therapy, and the therapeutic community, gives the patient the opportunity for a level of integration that they likely had not experienced before coming to Riggs.

Another important element in the Riggs experience is the so-called continuum of care. This has to do with tapering down the level of dependent care and fostering independence on the part of the patients. The highest care takes place in the Inn Residence Program.

There you have a high level of care, including nursing around the clock. But as you progress, you can move to apartment living, in which, in conjunction with others, you make your own meals and take care of yourself with a good deal more independence than in the inn. The next step after that is outpatient treatment.

By that time, you've likely moved off the campus altogether, and you come here for your outpatient therapy, but your functioning is autonomous otherwise.

What is the outcome of treatment at Riggs? We are very interested in that question and have tracked this for a very long time. We've done follow-along studies that have revealed that patients after their treatment at Riggs have experienced significant increase in reason for living, in resilience, and a decrease in suicidal ideation and emotional pain and anguish.

In thinking about what it takes to come to Riggs and to benefit from it, the first is a personal commitment to examining one's life in depth and trying to achieve more coherence than before Riggs. But also, this kind of work is time-consuming and requires considerable resources. Riggs is private pay, but you might be eligible for some benefits from your insurance company, and we do offer some financial assistance.

We know that mental health difficulties are complex problems and do not yield easily to short-term solutions. They require time and commitment to begin to solve and to help people get onto a path that makes sense to them. Whether you're a patient, a family member of a patient, or a referrer, we know that this is a difficult time and that it's very difficult to make a decision as to whether Riggs is right for you. This question cannot be answered in a simple video. We encourage you to give us a call. Call our admissions office where people are happy to engage with you in an extended conversation about the details of what we offer here at Riggs to help you make an informed decision as to whether this is the right treatment for you, your loved one, or your patient.