Who Should Consider Treatment at the Austen Riggs Center?

Samar Habl, MD, is the director of admissions and associate medical director at the Austen Riggs Center.

Our patient population is very diverse in terms of where people come from and what their troubles are. I think what's common often about most of our patients, not all of them but most of them, is that they come to us when outpatient treatment fails or when treatment as usual fails - the usual things that people go through. They get into outpatient therapy, they have a psychiatrist, they've been hospitalized a number of times for being suicidal, for example. They might have a substance abuse issue in addition to everything else they have that they might have let's say gotten some help with. They have gone to a substance abuse program. They're not using, they're not drinking, but they have ongoing difficulties. Sometimes patients come to us before they go through all of this. They come to us early because an outpatient therapist might have figured out this person needs more before they waste a lot of time in treatment that's likely not to help them. Let me send them to a residential place. But there's another way to think about it. A lot of our patients struggle in ways that individual encounters with a psychiatrist or the therapist will not illuminate enough of what their troubles are. That doesn't say at all that their individual psychotherapy isn't a good treatment, that they're not doing good work in their individual psychotherapy. They have a lot more trouble that has to do with complicated ways that they are caught up in difficult roles in their family of origin that they repeat in their current relationships. People do that in marriages. Sometimes they repeat aspects of that in their parenting, and they begin to struggle where they have a hard time taking up actually, their roles, their productive social, socially productive roles in the world. They start struggling in really serious ways, and so the individual psychotherapy doesn't cut it. So they go to treatment, they do the best they can, but then they go out and they can't function in between to assume the roles. That's a way to gauge that somebody might need more.