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Fellowship for Psychiatrists & Psychologists
Expand your expertise through the Adult Psychoanalytic Training Program and Fellowship for psychiatrists and psychologists.
We offer an Adult Psychoanalytic Training Program and Fellowship for both psychiatrists (post-residency) and psychologists (postdoctoral). Psychiatrists are also eligible to apply for a two-year Fellowship.
Our psychoanalytic training program is fully accredited by the Accreditation Council for Psychoanalytic Education (ACPEinc) and is an approved institute of the American Psychoanalytic Association (APsA). This program is part of the Erikson Institute for Education, Research, and Advocacy of the Austen Riggs Center. Our training includes a systems perspective, emphasizing individual development across the lifespan from within familial and cultural contexts. Fellows learn to work with disturbances in patients’ interpersonal and treatment contexts that reflect and illuminate patients’ intrapsychic struggles, fostering a more integrative approach while developing leadership skills and consulting skills.
The Fellowship Includes Training In:
- Adult psychoanalysis
- Psychoanalytic psychotherapy
- A systems perspective
- Family therapy work
- Psychological testing (for psychologists)
- Psychodynamic psychopharmacology (for psychiatrists)
- Work within a therapeutic community program, where learning is focused on the application of psychoanalytic understanding to group phenomena, and on the development of leadership skills and consulting skills
Fellows Benefit From:
- Clinical supervision
- Weekly didactic seminars by a distinguished faculty from Riggs, Yale, Harvard, Columbia, and other prestigious institutions
- Financial support for up to two years (300 hours) of personal analysis
- Opportunities to engage in clinical research related to complex mental illness
- Support for external education and conference attendance, and use of the superb Riggs on-site library and library services
- Opportunity to be candidate members of APsA and the IPA
- Recognition as a graduate psychoanalyst from an APsA-approved member institute following completion of the Fellowship
- Eligibility to be full clinical-psychoanalyst member of APsA and the IPA following graduation
- Eligibility to be board certified as psychoanalysts following graduation (either by the American Board and Academy of Psychoanalytic and Psychodynamic Psychology or the American Board of Psychoanalysis)
Our Program Prepares Fellows To:
- Work effectively with patients with complex psychiatric difficulties
- Understand a psychodynamic systems perspective in a therapeutic community program
- Teach and supervise others
- Contribute to the body of knowledge about disturbed development and its treatment
Satisfactory completion of the first two years of the Austen Riggs Adult Psychoanalytic Training Program and Fellowship meets postdoctoral supervised practice requirements for licensure in the Commonwealth of Massachusetts for Psychology Fellows.
Fellows are evaluated annually by supervisors (written and oral report) and throughout the academic year by individual instructors (written report).
Prerequisites
- Prerequisites for psychiatry applicants include completion of a psychiatric residency.
- Psychology applicants must have a doctoral degree in psychology from an APA-accredited program and a year of clinical internship at an APA-accredited or APPIC-listed site.
- In addition, three letters of recommendation and a personal statement are required.
Select applicants will be invited to Riggs for in-person interviews. The Austen Riggs Center provides an excellent and competitive salary and benefits package, including support for two years of personal psychoanalysis.
Our psychoanalytic training program is fully accredited by the Accreditation Council for Psychoanalytic Education (ACPEinc) and is an approved institute of the American Psychoanalytic Association (APsA).
Frequently Asked Questions
A series of videos with our training directors answering questions about the Fellowship.
What is the Austen Riggs Center Fellowship and who is it for?
Transcript:
Dan Knauss, PsyD, ABPP:
The Austen Riggs Center Fellowship is a postgraduate training program for post-residency psychiatrists and postdoctoral psychologists. It affords them the opportunity to train in adult psychoanalysis within our hospital setting, which is quite unique here at Riggs.
The Austen Riggs Center Fellowship is a postgraduate training program for post-residency psychiatrists and postdoctoral psychologists. It affords them the opportunity to train in adult psychoanalysis within our hospital setting, which is quite unique here at Riggs.
Psychiatry fellows also have the option of completing a two-year training program if they do not want to commit to the full four years of analytic training.
Our fellowship is accredited by the Accreditation Council for Psychoanalytic Education, Inc., and was recently accepted as an American Psychoanalytic Association member program. Our fellows graduate prepared to be analysts in the world, and also with a unique skill set related to group consultation and working in our hospital and residential community setting.
Currently, the fellowship only accepts applicants from U.S. programs. However, we sometimes have international students who graduate from U.S. programs and are interested in training here. Our Human Resources department works with those individuals on visa and work requirements to determine whether it would be feasible for them to participate in the fellowship.
David Mintz, MD:
Interestingly, in recent years, we have been getting more and more applicants who have already been in the workforce and have discovered—particularly in psychiatry—that the kind of work they are able to do without strong psychotherapy knowledge is not satisfying to them.
Interestingly, in recent years, we have been getting more and more applicants who have already been in the workforce and have discovered—particularly in psychiatry—that the kind of work they are able to do without strong psychotherapy knowledge is not satisfying to them.
We are certainly receiving more applicants who are mid-career or even late-career psychiatrists and want to develop their psychotherapy skills so they can have a kind of practice that is more interesting to them. We welcome those applicants.
Similarly, some psychologists who have already completed a postdoctoral fellowship or may already be licensed are interested in a different kind of training and work. We are open to accepting those applicants as well.
How is the Fellowship different from other analytic training programs?
Transcript:
David Mintz, MD:
In a traditional psychoanalytic training setting, a postgraduate candidate might take classes one day a week and work with a small number of analytic patients in any given week. That training can sometimes take seven or even 10 years as candidates work to acquire the number of patients they need to graduate.
In a traditional psychoanalytic training setting, a postgraduate candidate might take classes one day a week and work with a small number of analytic patients in any given week. That training can sometimes take seven or even 10 years as candidates work to acquire the number of patients they need to graduate.
The Austen Riggs Center Fellowship is different in several ways.
First, there is the nature of the patients. Our patients tend to have complex, co-occurring difficulties, so Fellows learn how to work with some of the most challenging patients.
The setting is also different because the work takes place within the context of a therapeutic community. You are doing your work in view of everyone. Your blind spots may be seen by others, which gives you an opportunity to learn about them.
At the same time, you are learning to apply psychoanalytic concepts to a wide variety of clinical skills beyond individual analysis. You learn about the psychodynamics of groups and group consultation, projective testing, and the application of psychodynamics to pharmacotherapy.
Another difference is that, because you are training in a hospital setting, there is a regular supply of patients. You are therefore able to complete your training within the four-year Fellowship, rather than taking the longer period of time that may be required in a traditional setting.
Finally, as far as I know, Riggs is the only psychoanalytic training program where you are paid to become an analyst rather than paying to become one.
What is the theoretical orientation of the Austen Riggs Center?
Transcript:
Dan Knauss, PsyD, ABPP:
One of the benefits of training here is that, theoretically, we are quite pluralistic and integrative as a staff.
One of the benefits of training here is that, theoretically, we are quite pluralistic and integrative as a staff.
At some institutes, you might expect to receive extensive training in one perspective—perhaps ego psychology or a modern Kleinian perspective. When you come to Riggs, however, you benefit from a diverse staff whose members have particular interests and expertise in different areas.
We are in constant conversation with one another as we think about where our understandings of our patients and our work intersect and where they diverge. Part of the richness of working in a therapeutic community with a cross-disciplinary staff is learning how to integrate ideas in meaningful ways while also recognizing the differences among them.
Most of the theoretical orientations you would expect within the broader psychoanalytic sphere are represented here. To name just a few, we have many people who are interested in the British Middle School, some who are more modern Kleinian, and people with interests in Lacan or Bion.
There is also a rich history of ego psychology represented in the tradition at Riggs and carried into our work today. There is a broad and rich representation of theoretical orientations at Riggs.
David Mintz, MD:
I would also add relational psychoanalysis.
I would also add relational psychoanalysis.
Dan Knauss, PsyD, ABPP:
Yes, of course.
Yes, of course.
What are Fellows' core responsibilities?
Transcript:
David Mintz, MD:
The core responsibilities of Fellows cover a range of different areas.
The core responsibilities of Fellows cover a range of different areas.
Of course, there is responsibility for the individual patient in analysis. Every Fellow is expected to work with three patients whom they see four times a week. But that is really just the beginning.
Because you are working in a therapeutic community, Fellows also learn how to consult with groups.
Responsibilities differ somewhat depending on whether you are a psychiatrist or a psychologist. Psychiatry Fellows provide pharmacotherapy for the patients on their teams. This might involve a caseload of eight to 12 patients in addition to their psychotherapy patients.
Psychology Fellows are expected to conduct psychological testing.
Because this is a hospital setting, our Fellows also function as doctors on call. They are periodically expected to be available when there are psychiatric emergencies or when the nursing staff needs a consultation.
Dan Knauss, PsyD, ABPP:
The core responsibility I hold in mind is that of being a learner.
The core responsibility I hold in mind is that of being a learner.
Everything Dr. Mintz outlined represents a learning experience. Fellows are also expected to be active participants in the daily and structured learning that occurs through our weekly seminars, continuous case conferences, and group supervision.
We expect Fellows to come here prepared to be active and engaged scholars and clinicians in training.
What are the primary training opportunities afforded to the Fellows?
Transcript:
Dan Knauss, PsyD, ABPP:
The primary training opportunities available to Fellows begin, in some ways, with the basic tripartite model you would expect at a psychoanalytic institute.
The primary training opportunities available to Fellows begin, in some ways, with the basic tripartite model you would expect at a psychoanalytic institute.
Our Fellows engage in a training analysis of their own, which we support and partially fund as one of the benefits of the Fellowship.
They are also engaged in their casework—what would be called control cases at a traditional institute. Fellows have a caseload of at least three patients whom they see four times a week throughout their four years here.
In addition, we offer a robust didactic program, including weekly Tuesday evening seminars during the academic year and additional offerings during the summer.
What makes Riggs particularly unique is the wealth of resources available through the Erikson Institute, which houses the Fellowship and provides many additional opportunities for learning. These include Friday evening guest lectures by esteemed analysts in the field and regular Grand Rounds presentations addressing the unique needs and concerns involved in working in a residential setting like ours.
We also have a library with extensive resources and staff members who are available to support ongoing learning. In addition, we have an excellent research psychologist who mentors Fellows interested in scholarly work, writing, and research and helps them learn more about that aspect of applied psychoanalytic work.
There are many opportunities. I am sure that, even as I speak, I am forgetting some. One of the wonderful things about being here is that it can feel like being a kid in a candy shop, given all that there is to learn.
David Mintz, MD:
There are several others. The one I think you left out is case conference.
There are several others. The one I think you left out is case conference.
We devote four hours each week to two two-hour case conferences. These provide an opportunity for the entire therapy or clinical staff to examine the intricacies of our patients’ cases.
Through that process, Fellows learn not only how to formulate and understand the struggles of our patients, but also how to think about adjusting treatment to meet each patient’s specific needs.
What does a typical week look like for a Fellow?
Transcript:
Dan Knauss, PsyD, ABPP:
There are some basic elements of a typical week for a Fellow that remain consistent, beginning with our three regular staff meetings.
There are some basic elements of a typical week for a Fellow that remain consistent, beginning with our three regular staff meetings.
On Mondays, Wednesdays, and Fridays, we have a one-hour multidisciplinary staff meeting attended by people from the different professional disciplines who work directly with patients.
The Monday and Friday meetings give us an opportunity to begin and end the week by hearing what is happening with our patients and in our work together. They help us hold in mind the people with whom we are engaged in the psychoanalytic process.
Wednesday’s meeting is more open and associative. We think dynamically about what is happening within the system, within the staff group, and within the patient group—and what we might learn by considering those groups in relation to one another.
Fellows also participate in two-hour case conferences on Tuesdays and Fridays. These provide an opportunity to closely examine the process of a particular case. The patient is usually in the initial six-week evaluation and treatment period, although we sometimes revisit cases that have been underway for a year or longer.
Fellows attend a weekly didactic seminar on Tuesday evenings. Depending on where they are in the Fellowship, they may also attend a weekly continuous case seminar that closely examines the process of one psychotherapy.
Psychology Fellows attend a two-hour psychological testing seminar each Thursday. They learn about projective testing and cognitive assessment, as well as how to write a distinctive type of report that responds to specific questions raised by the patient’s therapist.
Psychiatry Fellows meet weekly for a psychopharmacology group. This is an opportunity to integrate psychodynamic and psychopharmacological approaches and to think deeply about that work with patients.
In addition, there is the clinical casework. Fellows typically have approximately 15 hours of clinical work or related contact each week. Three patients seen four times a week account for 12 of those hours. Each case also includes one hour of individual supervision.
That structure remains consistent throughout all four years of the Fellowship. Fellows have the opportunity to choose supervisors based on relevant areas of expertise or interest, which gives them a meaningful way to shape their learning at Riggs.
Depending on where they are in the Fellowship, Fellows will also be involved in consulting to groups or participating in some aspect of the therapeutic community program. This usually includes a few hours of group consultation and an additional hour of supervision.
Although the number of patients a Fellow sees may seem relatively small, the schedule fills quickly because so many learning opportunities are embedded throughout each day.
Later in the Fellowship, Fellows have an opportunity to set aside time to specialize in an area of interest. This might include research and writing, teaching and supervision, additional group consultation, or human development. When Fellows develop a particular area of interest, we encourage them to work with us to create a way to support their continued learning.
General work hours are typically 8:30 a.m. to 5:00 p.m. Fellows also periodically have on-call responsibilities. Although these are less frequent than in many hospital settings, they are an important part of learning how to respond to emergencies or crises after hours.
David Mintz, MD:
The only other regular part of the weekly structure I would add is that Fellows participate in two one-hour team meetings each week.
The only other regular part of the weekly structure I would add is that Fellows participate in two one-hour team meetings each week.
Those meetings provide an opportunity to think closely about a smaller group of patients. As an entire community, we are holding in mind a patient population of approximately 50 to 60 people. A treatment team, by comparison, may focus on 12 to 15 patients.
This gives Fellows a much better opportunity to examine those individual treatments in depth. The focus is not only on psychotherapy, but also on how the different treatment modalities are integrated.
Fellows learn to pay attention to issues such as systems enactments that may emerge in a patient’s treatment. They develop the ability to move back and forth between thinking about a patient as an individual and thinking about that patient within the broader treatment context.
How long does it take to complete the Fellowship?
Transcript:
David Mintz, MD:
The Fellowship is fundamentally a four-year program, which is the length of training required to graduate as a psychoanalyst.
The Fellowship is fundamentally a four-year program, which is the length of training required to graduate as a psychoanalyst.
Because psychiatrists may face more significant opportunity costs, we also offer a two-year Fellowship option. In our experience, most psychiatrists initially enter the two-year Fellowship. Over the past eight to 10 years, however, nearly all of them have decided to remain for the full four-year Fellowship.
In general, Fellows begin during the summer. Psychiatrists typically start in July or August, while psychologists begin in September.
There are situations in which someone cannot join at that time. When significant conflicts arise, we have been able to offer some flexibility regarding a Fellow’s start date.
What does the trajectory of the four years look like for Fellows?
Transcript:
Dan Knauss, PsyD, ABPP:
During the first year of the Fellowship, the primary focus is on settling into what it is like to work in an open setting and a therapeutic community where the learning and clinical work are so public.
During the first year of the Fellowship, the primary focus is on settling into what it is like to work in an open setting and a therapeutic community where the learning and clinical work are so public.
For people accustomed to working at a quick pace—whether as a psychologist in an internship or a psychiatrist in residency—there is often an adjustment to the spaciousness of time. Fellows have time to think deeply about the work, but they must also learn how to navigate the Fellowship’s unique setting and learning environment.
The first year is therefore largely about becoming acclimated and finding your way. Part of that process involves an introduction to the group work we do. Most Fellows begin as silent observers so they can see what happens in groups and within the community and immerse themselves in the experience.
As Fellows settle into the Fellowship, Psychology Fellows begin conducting some psychological testing themselves. Psychiatry Fellows become increasingly involved in the psychopharmacology group, although they prescribe medication from the beginning.
The first year is really a process of asking: Where am I? What am I learning? How do I begin to engage in this learning process?
During the second and third years, Fellows take on more responsibility and gain greater autonomy. They consult directly to groups and may begin giving external presentations, working on publications, or receiving mentorship from other staff members.
As Fellows become more established, they can begin identifying their interests and the areas in which they want to grow.
The Fellowship is a very public learning process because we are constantly presenting our work. The second and third years provide time to reflect on strengths and areas for continued growth and to consider what learning remains necessary to become a competent analyst by the end of the four years.
Throughout that process, Fellows are actively engaged by their peers and supervisors as they develop their skills and grow into the identity of a psychoanalyst.
During the fourth year, advanced Fellows have unique opportunities. They may provide external supervision to clinicians or organizations seeking a basic psychodynamic understanding, allowing them to develop their supervisory skills.
They may also teach within the institution, perhaps co-teaching a Tuesday evening seminar with a faculty member, or teach externally. Our Fellows often teach at places such as the Yale Child Study Center or Massachusetts General Hospital, where we have partnerships that traditionally provide opportunities for people who want to learn how to teach.
Fellows may also pursue particular areas of interest, such as independent psychological testing, training as an admissions officer, or undertaking additional group consultation.
Fourth-year Fellows are encouraged to take greater authority over their learning and work with Dr. Mintz and me to identify a particular track in which they might specialize. These opportunities are optional, of course. The four-year analytic training program is already quite robust.
The fourth year is ultimately a time to consolidate all the learning that has occurred.
David Mintz, MD:
The only other element I would add to that developmental trajectory is the progression from the continuous case seminar to training in supervision.
The only other element I would add to that developmental trajectory is the progression from the continuous case seminar to training in supervision.
During the first two years of the Fellowship, Fellows attend a continuous case seminar. In that seminar, they either present their own process notes or listen to other Fellows or faculty members present theirs.
They learn to think with the group about the intricacies of the clinical work, including formulation and technique. Fellows may continue participating in that seminar after the first two years if they choose.
Beginning in the third year, Fellows are also able to join a seminar on supervision. Many of our Fellows will enter the field with the skills needed to become effective supervisors, so we encourage them to begin developing those abilities during the Fellowship.
The supervision seminar combines didactic material, reading, and discussion. Beginning in their third year, Fellows may also supervise psychiatry residents or psychology interns outside of the Austen Riggs setting and bring those supervisory experiences back to the seminar for group consultation.
How are Fellows evaluated?
Transcript:
Dan Knauss, PsyD, ABPP:
Fellows are evaluated both formally and informally throughout their time here.
Fellows are evaluated both formally and informally throughout their time here.
During the first year of the Fellowship, Fellows are formally evaluated twice by their supervisors and by the people involved in their learning through the Erikson Institute and the Fellowship.
They receive feedback about the gradual development of their competencies and their work. This helps them understand where they are when they enter the system and what they still need to learn.
There is a wide range of skills that people either bring with them or need to develop after they arrive, given the diversity of applicants and Fellows in the program.
After the first year, a group of supervisors and staff conducts a formal evaluation once annually. This process provides feedback to Fellows and marks their progression from the second year into the third year and from the third year into the fourth year.
When I say that we formally mark their progression, I mean that we assess a basic set of competencies we would expect a psychoanalyst in training to demonstrate after one, two, or three years.
There are core competencies that Fellows must meet by the end of the Fellowship to graduate as competent psychoanalysts. At the same time, we recognize that this is a developmental process. What those competencies look like during the first year will differ from what they look like during the second, third, or fourth year.
That is the formal aspect of the evaluation process.
Informally, we are constantly presenting our work in different settings. This happens during case conferences, weekly team meetings, and staff meetings, where a therapist may be asked to explain why a patient is struggling and how they understand that struggle from a dynamic perspective.
It also happens during the continuous case seminar. Every day, there is some opportunity—and some need—for someone to account for their work, thinking, and learning.
These moments are not tallied or formally tabulated because there would be an endless number of them. However, we are always engaged in a mutual learning process here, and Fellows are informally evaluated through that process.
How does the Fellowship differ for psychiatrists and psychologists?
Transcript:
David Mintz, MD:
The Fellowship is largely the same for psychologists and psychiatrists. It is an interesting system in which the traditional hierarchy is, in many ways, diminished. Psychologists and psychiatrists work together within the fellows group and share almost all the same responsibilities.
The Fellowship is largely the same for psychologists and psychiatrists. It is an interesting system in which the traditional hierarchy is, in many ways, diminished. Psychologists and psychiatrists work together within the fellows group and share almost all the same responsibilities.
The main difference is that psychologists conduct psychological testing. Approximately once a month, or sometimes more frequently, they write a psychological testing report. They also regularly administer components of psychological assessments, which are then brought together by one of the other fellows.
Psychiatrists prescribe medication for the patients on their teams. This involves conducting a comprehensive evaluation and then meeting with each patient anywhere from weekly to monthly, depending on the patient’s pharmacological needs.
Beyond those responsibilities, there are no significant distinctions between what the psychologists and psychiatrists do within the Fellowship.
What are some of the key benefits Fellows enjoy?
Transcript:
Dan Knauss, PsyD, ABPP:
There are some significant benefits of employment and of the Fellowship here at the Austen Riggs Center, including several that may not always be recognized.
There are some significant benefits of employment and of the Fellowship here at the Austen Riggs Center, including several that may not always be recognized.
One is the stipend we provide toward each Fellow’s psychoanalysis. The cost of a training analysis can be one of the most significant barriers to entering psychoanalytic training. For us, providing financial support is a matter of equity. It allows people who would be outstanding candidates as analysts, but who might otherwise be unable to afford the training, to participate.
As a nonprofit organization, Austen Riggs also qualifies for student loan repayment programs for physicians. More recently, some loan repayment benefits have become available to psychologists in Massachusetts as well. These programs may help Fellows who have accrued significant student debt.
The Erikson Institute and the Fellowship also provide financial support for ongoing learning. Our Fellows regularly attend national conferences through organizations such as the American Psychoanalytic Association, Division 39 of the American Psychological Association, the American Psychiatric Association, and other professional groups.
Fellows attend these conferences not only to learn, but also to present their work and participate as discussants. Part of our tradition is encouraging Fellows to become not only strong analytic clinicians, but also scholars who are actively involved in the broader field and who represent what they have learned through the Fellowship.
The Erikson Institute provides Fellows with $3,000 annually for continuing education and training, which can be applied toward conferences and other events. An additional $1,000 is available through the training director’s budget for learning opportunities.
For people who are just beginning their careers and may not be earning much money, traveling to and presenting at conferences can be a significant burden. Yet it is an important part of professional development and of participating in the professional community beyond Austen Riggs. We support that financially, as well as relationally through encouragement, mentorship, and opportunities for growth.
The Fellowship also offers a great deal of autonomy. Although Fellows are engaged in rigorous learning and have daily clinical responsibilities and meetings, they have considerable freedom to shape their schedules in collaboration with their patients.
That can feel surprising to people who come from highly structured systems in which they are constantly directed to be in a particular place doing a particular task. Here, there is a certain freedom to learn and to be.
Because Fellows are employees of Austen Riggs, they also receive health insurance and other employee benefits. In my experience, the health insurance is comprehensive and particularly helpful for people who relocate to the Berkshires with their families.
Another benefit, at least to me, is living in the Berkshires. Although it is a rural area, it is culturally rich and conveniently located within reach of both New York City and Boston. It is possible to enjoy life here while still having access to larger cities.
I am sure I am forgetting some of the other benefits you may have in mind.
David Mintz, MD:
Perhaps one of the most significant benefits is that you are paid to become a psychoanalyst, which is very unusual.
Perhaps one of the most significant benefits is that you are paid to become a psychoanalyst, which is very unusual.
The Fellowship also provides five weeks of paid vacation and generous benefits such as parental leave. In those respects, the organization is very supportive.
There is also recognition that four years of training represents a potential opportunity cost for someone who could otherwise establish a private practice.
One way Austen Riggs addresses that is by making office space available to licensed Fellows for a very modest fee. This makes it easier for them to begin developing a private practice and to earn additional income while completing the Fellowship.
Even compared with other fellowships, the Austen Riggs Center Fellowship is generally well compensated.
What scholarly work do Fellows engage in?
Transcript:
David Mintz, MD:
Fellows generally come here for psychoanalytic training, but I think Austen Riggs is unique in another way. We are a small institution with a significant academic footprint in the fields of psychiatry and psychoanalysis.
Fellows generally come here for psychoanalytic training, but I think Austen Riggs is unique in another way. We are a small institution with a significant academic footprint in the fields of psychiatry and psychoanalysis.
One way we maintain that presence is through a strong emphasis on scholarship.
Every Fellow is afforded many opportunities to learn both inside and outside the institution. By the time Fellows graduate, they are also expected to have invested themselves in some form of academic project.
That project might involve teaching within Austen Riggs or at another institution, writing papers, or conducting research. There is an expectation that each Fellow will have done something to contribute to the learning of the field and of their colleagues.
What does the Fellowship prepare Fellows for in their professional lives post-graduation?
Transcript:
Dan Knauss, PsyD, ABPP:
One of the things that is unique about the Fellowship is what it prepares graduates to do after they leave Riggs.
One of the things that is unique about the Fellowship is what it prepares graduates to do after they leave Riggs.
Traditional psychoanalytic institutes are often focused specifically on psychoanalytic work, usually in private practice and sometimes in a community-based setting. The training at Riggs also involves extensive work with groups and within a therapeutic community.
As a result, Fellows learn a great deal about consulting to groups and working within systems from a psychodynamic or psychoanalytic perspective. This prepares them particularly well for leadership roles after they leave Riggs.
Many of our graduates go on to become leaders in hospital or community-based settings. Even when their primary interest is private practice, they often form consultation groups for clinicians in their area and take leadership roles in helping professionals hold patients in mind collectively, work collaboratively, and communicate across disciplines.
This ability to communicate across disciplines is another benefit of the Fellowship. Riggs prepares Fellows to work effectively with professionals outside their own discipline and to translate psychoanalytic knowledge and clinical experience into accessible, experience-near language.
That language can provide understanding and containment for other people working with a patient, whether they are nurses, members of a therapeutic community staff, or clinicians on a hospital unit. Graduates are able to offer an analytic perspective that might not otherwise be available in those settings.
Fellows who do not remain in the Berkshires or at Riggs often become important contributors to psychoanalytic institutes in their new communities. They may teach, become training analysts, or participate actively at the national level in organizations that support psychodynamic principles and approaches to clinical work.
In summary, our Fellows are prepared to become excellent and competent psychoanalysts. They are equipped to work with highly complex patients like those we treat at Riggs, as well as with people experiencing less complex difficulties and more typical clinical presentations.
They are also well prepared to become leaders in the organizations where they work because they know how to work effectively in groups and on teams.
David Mintz, MD:
To put an exclamation point on what you were saying, some years ago we held a reunion of former Fellows to learn more about what they were doing professionally.
To put an exclamation point on what you were saying, some years ago we held a reunion of former Fellows to learn more about what they were doing professionally.
There was a wide range of work represented. Most were providing individual psychotherapy or psychoanalysis, but there were also many academics and consultants. Some psychiatrists were working primarily in pharmacotherapy.
We discovered, however, that they all had one thing in common: they had become the go-to people in their local communities for complex patients and complex clinical situations.
I think that emphasizes the skill set people develop here. Fellows learn to think deeply about individuals and about the ways those individuals engage the larger treatment system.
What types of patients would the Fellows see?
Transcript:
David Mintz, MD:
The patients we treat generally arrive at Riggs because they have proved resistant to more mainstream treatments. Often, they have had multiple therapies, multiple analyses, and multiple medication trials.
The patients we treat generally arrive at Riggs because they have proved resistant to more mainstream treatments. Often, they have had multiple therapies, multiple analyses, and multiple medication trials.
One reason those treatments may not have worked is that these patients are often very complex and have multiple co-occurring conditions. By research criteria, our average patient has approximately six and a half diagnoses, usually including significant character pathology.
A common combination might include a Cluster B personality disorder with major depression, substance use, anxiety, PTSD, or another condition.
More than half of our patients have made at least one medically serious suicide attempt. In a sense, they are alive by accident, and they come here to be treated in a completely open setting.
Some patients do not fit that description. They may come here simply because they have heard about the reputation of Austen Riggs and are seeking the best treatment they can find. There is therefore a range of patients.
At times, people outside the organization have asked whether our Fellows are adequately prepared to treat higher-functioning patients. We were curious about that question, so within the past year or two, we reached out to former Fellows representing approximately five decades of the Fellowship.
We asked whether they felt the Fellowship had prepared them to treat higher-functioning neurotic patients. Our former Fellows were very clear that the preparation they received for working with more complex patients also prepared them well to work with patients who are somewhat less complex or higher functioning.
What is the treatment environment like at Riggs for Fellows?
Transcript:
Dan Knauss, PsyD, ABPP:
The setting in which Fellowship training occurs is quite unique and worth describing briefly.
The setting in which Fellowship training occurs is quite unique and worth describing briefly.
When people picture a residential level of care, they often imagine a setting with many constraints—locked doors, privileges, and other restrictions. Coming to Riggs can be a jarring experience because it is an entirely open and voluntary setting.
Our way of holding treatment, particularly complex treatment, is through relationships and an agreement about the shared task of treatment. For many of our patients, the question of whether they want to remain alive is very much on the table.
When patients are admitted and agree to engage in this work, they are agreeing to bring forward the things that are painful and perhaps feel impossible to discuss. In other settings, those experiences might be discouraged, pushed aside, or addressed primarily through safety planning and restrictions.
Here, the emphasis is on saying difficult things and putting experience into words. That work happens both in analytic therapy and within the community.
We have a therapeutic community program in which patients are actively engaged. It includes group offerings and opportunities for patients to exercise agency and authority, including through patient government.
Staff and patients are all part of that community and engaged in mutual, collaborative work.
People may arrive imagining a residential setting with locked doors, clear distinctions between patients and staff, and a strong hierarchy of authority. It can therefore feel unusual to enter a building where we do not wear name tags or use other markers that distinguish us from one another. Instead, we are all participating in a mutual effort.
It is also worth noting that the residential setting includes a continuum of care.
The main building houses approximately half of our patients, including those who may have more acute needs. There are also step-down programs with different areas of focus. One emphasizes the development of more independent living skills, while another focuses on group living and includes more frequent daily meetings.
There is also a day treatment program. Patients can move into the local community while continuing to return to Riggs for treatment services.
Our aftercare program is closer to an outpatient practice. Patients no longer participate in the therapeutic community but continue their clinical work.
Fellows therefore gain a wide range of experience. At one end, they work intensively with patients who are being held within a residential setting. That environment can allow clinicians to work at greater depth and take thoughtful clinical risks because patients are held within a broader network of relationships and observation.
The community may notice aspects of a patient’s experience that the patient is struggling to recognize independently.
At the other end of the continuum, Fellows also work with patients in a setting that more closely resembles private practice. The Fellowship therefore provides experience across a broad range of treatment environments.
What is life like in the Berkshires for Fellows?
Transcript:
Dan Knauss, PsyD, ABPP:
Life in the Berkshires is, by my estimation, pretty wonderful and unique.
Life in the Berkshires is, by my estimation, pretty wonderful and unique.
For those who have not been here, it is a rural setting. Stockbridge may bring to mind Norman Rockwell’s America. For people who move here—especially those who enjoy the arts or the outdoors—it is a wonderful place to find yourself at any time of year.
During the summer, we have Tanglewood, the summer home of the Boston Symphony Orchestra, which offers events throughout the season. We also have a number of museums nearby that are rich in resources and enjoyable to visit.
There is also a great deal to do outdoors. During the summer, there are many trails and places to hike, swim, kayak, enjoy water sports, and fish.
In the fall, the changing foliage is beautiful, and there are many festivals and traditional seasonal activities throughout the area.
During the winter, when we have good snow—which we often do—there are wonderful opportunities for cross-country and downhill skiing. Within 30 to 45 minutes of Riggs, there are at least six ski areas to enjoy.
Year-round, it is a wonderful place to be outdoors and participate in the local community.
It is also a wonderful place for families, including Fellows who relocate here with children. The educational systems are excellent, and there are many opportunities for community engagement.
There are also opportunities connected more directly to the Fellowship and training. Fellows can participate in outreach and give back to what is often a lower-resourced community around us. This might involve working with local hospitals, community centers, or school districts that are eager to engage with us around mental health issues and childhood development.
Riggs has a long history and an established place within the broader community, which creates opportunities for engagement and collaboration.
It is a small community, however. Training and living here means you are likely to encounter many of your colleagues—and probably some of your patients—outside of Riggs. That presents its own challenges, but also provides valuable learning opportunities.
I have found it to be a lovely place. I could not imagine living somewhere else.
David Mintz, MD:
I would add that, when I arrived here, it took almost no time for me to realize that I never wanted to live anywhere else.
I would add that, when I arrived here, it took almost no time for me to realize that I never wanted to live anywhere else.
As Dan said, it was a wonderful place for my children to grow up. Children raised in rural settings are not always enthusiastic about that experience, but the Berkshires offer a remarkable combination of nature and culture.
You can attend a performance by the Boston Symphony Orchestra at its summer home here and, an hour later, be in the woods catching salamanders.
Because the Berkshires are also a cultural vacation destination, particularly for people coming from New York and Boston during the summer, the area offers amenities you might not expect in a small community.
I live in a town of approximately 2,000 people, but at one point I counted 63 restaurants within a 20-minute radius of my house.
It really is a wonderful combination of nature and culture.
Are there things trainees can do to become more competitive for the Fellowship?
Transcript:
David Mintz, MD:
When we look at applicants, we are looking for people who are psychologically minded. We are looking for people who we think have the potential to take on leadership positions in the field. We are also looking for people who have the fortitude to work with complex and challenging patients.
When we look at applicants, we are looking for people who are psychologically minded. We are looking for people who we think have the potential to take on leadership positions in the field. We are also looking for people who have the fortitude to work with complex and challenging patients.
There are several things applicants can do to position themselves optimally.
First and foremost is developing one’s own capacity for psychological-mindedness, whether through reading or one’s own treatment, so that you are able to think not only about your patients, but also about yourself.
I also think it is beneficial to work with complex patients so that you can learn whether this is a population you enjoy working with and whether you have the fortitude to do so. To the extent that you can, I would encourage you to take on patients who are somewhat more challenging.
Anything that demonstrates a capacity for intellectual leadership is also a plus. This might include engaging in psychoanalytic research and writing, teaching, taking classes at psychoanalytic institutes, or pursuing other activities that demonstrate your interest in and commitment to psychoanalysis. Anything that shows you are contributing to the field’s body of knowledge in some way is beneficial.
Although we do not assess or judge applicants based on whether they have undergone psychoanalysis, I think that experience can put someone in the frame of mind to think in the ways we hope our trainees will think.
Dan Knauss, PsyD, ABPP:
I would also add that, for psychologists in particular, having some experience working in a residential or hospital-based setting is useful.
I would also add that, for psychologists in particular, having some experience working in a residential or hospital-based setting is useful.
Psychiatrists tend to have that experience deeply ingrained by the time they complete their residency and come here. There is something unique about the intensity of working in a setting like this, which is different from working in an outpatient community clinic.
Psychology applicants hoping to become Fellows usually benefit from having had some form of hospital or residential experience.
What is the application and interview process for prospective Fellows?
Transcript:
Dan Knauss, PsyD, ABPP:
The application process for the Fellowship can be accessed online. It is a fairly typical process involving letters of recommendation, submission of a CV, and information about an applicant’s learning experiences.
The application process for the Fellowship can be accessed online. It is a fairly typical process involving letters of recommendation, submission of a CV, and information about an applicant’s learning experiences.
Applicants with specific questions are always encouraged to reach out to Dr. Mintz or me. Our Human Resources department can also help guide people through the process.
In terms of the selection cycle, we usually begin reviewing applications in late fall, around November and early December. At that point, we determine which applicants we would like to invite for interviews.
The number of Fellows we hire varies from year to year based on the needs of the hospital and residential system, but it is usually between two and four. That group may include both psychiatry and psychology Fellows. The selection processes occur concurrently rather than separately.
We often think carefully about which combination of applicants might work well together, how they might fit with the current Fellows, and how they would function within the hospital and residential setting.
Once we identify the people we would like to interview, we invite them to visit for an in-person interview. We understand that travel is not always possible, so we can also accommodate virtual interviews.
We prefer in-person interviews when possible because they provide a richer and more informative experience for everyone. Applicants have the opportunity to attend a case conference, meet with current Fellows, and hear informally about their experiences.
Applicants also meet with several members of the educational and organizational leadership. This typically includes Dr. Mintz and me, the director of the Erikson Institute, the medical director, and the director of patient care.
This allows applicants to gain a sense of who we are. The selection process is mutual: we are evaluating applicants, but we are also being evaluated. We want people to understand what they would be entering and whether coming here feels like a good fit for them.
We usually make Fellowship offers around February for positions beginning in the late summer or early fall. Start dates typically fall between July and September, depending on when applicants complete their current training or professional commitments.
People who are interested in learning more about the Austen Riggs Center and the Fellowship before applying or being invited to interview are welcome to contact Dr. Mintz or me.
We frequently host prospective applicants as visitors. They may attend a case conference and gain a sense of what the work is like outside the formal interview schedule. We can discuss with them whether such a visit would be feasible.
There are also opportunities to engage with other parts of the Austen Riggs system. We offer a wide range of educational programs that can provide a sense of who we are, including Friday evening guest lectures and Grand Rounds. These are free and available through the Erikson Institute section of the Austen Riggs Center website.
Finally, we usually hold a virtual open house for prospective applicants at least once, and sometimes twice, each year.
For people who cannot travel to Riggs, the open house provides an opportunity to meet some of us on Zoom and watch a mock case conference. This offers a glimpse of the learning experience that takes place twice each week, when we carefully examine one patient’s treatment and experience within the system and discuss the case as a group.
At the end of the open house, those of us in formal educational leadership roles step away so prospective applicants can speak directly with current Fellows and hear about what it is like to train here.
Application Process
Applications are accepted year-round for psychiatrists and are due by December 1 for psychologists.
Apply Now
Fellowship Curriculum
In addition to carrying out intensive individual psychotherapy, group consultation, family treatment, and therapeutic community work, the Fellows participate in case conferences and didactic seminars addressing psychopathology, clinical theory and technique, developmental theory and research, psychopathology, history of psychoanalysis, and group and family processes.
Individual Psychoanalytic Psychotherapy and Clinical Assessment
Fellows engage in intensive and often long-term, four-times-weekly psychotherapy with patients who have been labeled treatment-resistant. Fellows are assigned three psychotherapy patients, with an option for a fourth, and receive weekly clinical supervision with an experienced psychotherapist per case.
Team Meetings
As members of multidisciplinary teams, Fellows learn to integrate their work with the perspectives of other disciplines as they help organize their patients’ treatment.
Case Conference
Clinical case conferences are a central aspect of the psychoanalytic training experience at Riggs and take place twice a week. These two-hour meetings offer space for the clinical staff to integrate assessments and develop a psychodynamic understanding of unconscious processes, transference, countertransference paradigms, conflicts, and defenses. Further integration occurs in team and clinical staff meetings.
Group and Family Consultation
Family therapy work and group consultation are important elements of treatment at Riggs. Learning to consult to families, small groups, large groups, and organizations are skills acquired by Fellows, who work as co-therapists with the patient’s social worker and become consultants to one or more groups in the therapeutic community.
Additional Curriculum Elements
Fellows also meet regularly as a group with the Medical Director to discuss clinical and systems issues. Lectures by internationally respected clinicians and theoreticians are held regularly. Fellows may also choose elective training in psychodynamic research and organizational consultation.
Faculty
Our faculty is a robust group that includes experts and thought leaders in psychoanalytic theory and practice.
Medical Staff
Steven Ackerman, PhD
Michael Blake, PsyD
Marilyn Charles, PhD
Heather Churchill, PsyD
Sandra Delgado, PsyD
Donna Elmendorf, PhD
Heather Forouhar Graff, MD
Kathryn Gallagher, PhD
Samar Habl, MD
Daniel Knauss, PsyD
Megan Kolano, PsyD
Katie Lewis, PhD
David Mintz, MD
Cathleen Morey, PhD, LICSW
Margaret Parish, PhD
Molly Reider, LCSW
Jeremy Ridenour, PsyD
David Rosenthal, LICSW
Jennifer L. Stevens, PhD
Jane G. Tillman, PhD
S. Daltrey Turner, LICSW
Beth Turner, LICSW
Michael Blake, PsyD
Marilyn Charles, PhD
Heather Churchill, PsyD
Sandra Delgado, PsyD
Donna Elmendorf, PhD
Heather Forouhar Graff, MD
Kathryn Gallagher, PhD
Samar Habl, MD
Daniel Knauss, PsyD
Megan Kolano, PsyD
Katie Lewis, PhD
David Mintz, MD
Cathleen Morey, PhD, LICSW
Margaret Parish, PhD
Molly Reider, LCSW
Jeremy Ridenour, PsyD
David Rosenthal, LICSW
Jennifer L. Stevens, PhD
Jane G. Tillman, PhD
S. Daltrey Turner, LICSW
Beth Turner, LICSW
Adjunct Faculty
Barri Belnap, MD
A. Jill Clemence, PhD
Steven Cooper, PhD
Darlene Bregman Ehrenberg, PhD
Melinda Gellman, PhD
Claudia M. Gold, MD
Jesse A. Goodman, MD
Jay Greenberg, PhD
Nicholas A. Holliday, MD
Frank Lachmann, PhD
Nancy McWilliams, PhD
Jack A. Miller, MD
David Olds, MD
Jonathan Palmer, MD
Craig Piers, PhD
Ellen Rees, MD
Anne Rocheleau, PhD
Marie G. Rudden, MD
Amy Taylor, PhD, ABPP
Elizabeth Tillinghast, MD, JD
Hannah Wallerstein, PhD
Elizabeth F. Weinberg, MD
Lyn Yonack, LICSW
Joanne Yurman, PhD
A. Jill Clemence, PhD
Steven Cooper, PhD
Darlene Bregman Ehrenberg, PhD
Melinda Gellman, PhD
Claudia M. Gold, MD
Jesse A. Goodman, MD
Jay Greenberg, PhD
Nicholas A. Holliday, MD
Frank Lachmann, PhD
Nancy McWilliams, PhD
Jack A. Miller, MD
David Olds, MD
Jonathan Palmer, MD
Craig Piers, PhD
Ellen Rees, MD
Anne Rocheleau, PhD
Marie G. Rudden, MD
Amy Taylor, PhD, ABPP
Elizabeth Tillinghast, MD, JD
Hannah Wallerstein, PhD
Elizabeth F. Weinberg, MD
Lyn Yonack, LICSW
Joanne Yurman, PhD
Additional Information
We have established the following contact protocols regarding Due Process and Complaints pertaining to the Adult Psychoanalytic Training Program and Fellowship.
Due Process
A Due Process procedure is available to all Fellows from the director of training. For additional information on the policy or the Fellowship, contact director of training Daniel Knauss, PsyD, ABPP, at daniel.knauss@austenriggs.net or 413.931.5304.
Complaints
Formal complaints about the professional conduct of Fellows or Full Faculty of the Erikson Institute may be made by writing or calling: Jane G. Tillman, PhD, ABPP, Evelyn Stefansson Nef Director of the Erikson Institute for Education, Research, and Advocacy of the Austen Riggs Center, 25 Main Street Stockbridge, MA 01262 or 413.931.5213.
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