The principles and benefits of Measurement-Based Care (MBC)

How MBC can be integrated into psychoanalytic-informed psychotherapy

The importance of patient involvement in treatment evaluation

Practical applications of MBC in clinical settings, including individual and system-based approaches

Insights from real-world case studies demonstrating the value of Measurement-Based Care on evaluating patient outcomes

I'm Steve Ackerman, a treatment team leader and psychoanalyst in the Austen Riggs Center 

. And I'm Seth Pitman, Associate Director of the 

 at Riggs. The two of us have developed Measurement-Based Care (MBC) programs in our respective areas at the Center that integrate measurement tools into psychoanalytic therapy, ensuring that patient voices remain central to the treatment process.

In this article we provide an overview of an online course we offered via the Erikson Institute of the Austen Riggs Center regarding how Measurement-Based Care can integrate systematic and routine assessments into treatment processes. While commonly utilized in cognitive-behavioral and medically driven therapeutic models, MBC has been underexplored in psychoanalytically informed care. In this piece, we explore how MBC can be effectively applied in psychoanalytic settings to understand treatment outcomes and therapeutic relationships, while shaping treatment interactions.

 in its entirety and receive free CE/CME from our online catalogue.

MBC involves the systematic collection of data to track patient progress and refine treatment plans accordingly. Traditionally, data collection in medical settings has been retrospective, meaning it informs future care rather than benefiting the current patient. MBC, however, is designed to adapt treatment in real-time, allowing therapists and patients to make informed decisions together.

Enhances the therapeutic alliance by joining patients and treaters in a shared task

Allows for early detection of alliance ruptures or negative therapeutic reactions

Increases patient engagement by giving them a voice in their own treatment

Helps therapists refine their approach through real-time feedback

Improves clinical outcomes by identifying barriers to treatment success

Why Measurement-Based Care Matters in Psychoanalysis

While MBC has often been associated with structured, symptom-focused treatments, its principles can be successfully adapted to psychoanalytic frameworks. Psychoanalytic therapy emphasizes understanding the patient's unconscious dynamics, subjective experiences, and emotional patterns. When combined with MBC, clinicians can create a more tailored and responsive treatment approach.

1. Tracking Progress Beyond Symptom Reduction:

 Many therapy outcome measures focus primarily on symptom improvement. Psychoanalytic-informed MBC assesses symptom improvement and goes deeper, examining underlying conflicts, relational patterns, and self-perception changes.

 Psychoanalytic therapy is relationship-driven, making it crucial to detect early signs of resistance or disengagement. MBC processes can reveal alliance shifts and highlight moments when a patient may struggle with deeper issues.

3. Encouraging Patient Reflection and Agency:

 Instead of merely collecting data, therapists can use the information to invite patients into discussions about their experiences, allowing them to take a more active role in their treatment.

 MBC data informs therapists about their strengths and areas for growth, fostering professional development over time.

, we present an in-depth case study to illustrate how a psychoanalytically informed approach to MBC can help clinicians highlight mismatches between patient’s self-reported symptoms and clinical presentation, uncover transference dynamics that might otherwise go unnoticed, and identify signs of deterioration that require a shift in therapeutic interventions.

For therapists in private practice, implementing MBC does not require large-scale system integration. It can be as simple as introducing a few key assessments to enhance reflection and therapeutic dialogue.

Steps for Private Practitioners to Implement MBC

 Start with simple, widely validated tools that capture common symptoms like depression (Patient Health Questionnaire-9; PHQ-9) and anxiety (Generalized Anxiety Disorder-7; GAD-7), the patients’ experience of the therapeutic alliance (Working Alliance Inventory; WAI), or even more nuanced measures like 

 to capture suicide risk from multiple angles.

 Have patients complete measures periodically and discuss results collaboratively.

 Consider tracking your own experience of the working alliance by filling out the therapist version of the WAI or using countertransference measures, such as the Therapist Response Questionnaire (TRQ), to gather additional diagnostic information about your patients.

4. Use Data to Enhance, Not Replace, Discussion:

 The key is to bring results into sessions as a conversational tool rather than letting them dictate treatment.

 Collect and review data over months or years to assess patterns in both patient outcomes and your own clinical development.

Measurement-Based Care in psychotherapy examines treatment outcomes by integrating systematic data tracking, improving patient engagement, and refining therapist interventions. At the heart of this approach is the commitment to centering the patient’s experience.

By combining structured assessments with deep, relationally driven inquiry, therapists can:

For therapists, MBC provides a structured approach to improving patient outcomes by incorporating common validated self-report measures along with tools that capture psychoanalytically relevant concepts such as psychic pain and countertransference. This evidence-based practice fosters better patient engagement, identifies hidden treatment barriers, and strengthens therapeutic alliances, ensuring that therapists remain responsive to both the evolving needs of their patients and their own professional growth – whether in large institutions or private practice.

MBC represents an invaluable tool for deepening psychotherapy’s impact.

We hope this article was both informative and helpful to you. 

The full online course is available for free

 online and you can earn continuing education credit after you view the presentation and successfully complete a short quiz derived from the content.

A woman talking to her therapist at the Austen Riggs Center.

Psychodynamic Psychotherapy at Austen Riggs

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In this piece, we explore how MBC can be effectively applied in psychoanalytic settings to understand treatment outcomes and therapeutic relationships, while shaping treatment interactions. 

How Measurement-Based Care Informs Psychoanalytic Psychotherapy

The Trevor Project For Young LGBTQ+ Lives Logo

Trevor Project’s 2024 National Survey on the Mental Health of LGBTQ+ Young People

 is an illuminating and essential resource for understanding the mental health needs of youth in America. At a time when national repositories of essential national health information are disappearing, the incredible efforts and dedication of the 

 to documenting and advocating for the needs of LGBTQ+ youth have never been more important or impactful.

these results highlight several positive findings

, including a strong sense of acceptance by community (90% of all respondents and 89% of youth identifying as trans or non-binary, specifically) and general accessibility of mental health services. Interestingly 70% of survey respondents who were engaged in mental health treatment indicated that they accessed care through virtual modalities, signaling the importance of telehealth options and services for addressing mental health needs within the LGBTQ+ youth population.

At the same time, significant obstacles and challenges remain, with respondents acknowledging high exposure to stressful or/or discriminatory experiences and general reluctance to talk about these experiences to mental health providers (nearly half of respondents for example cited fear of talking about their mental health concerns with a provider as a reason for not engaging with services).

Given the high rates of depression, anxiety, suicidality, and exposure to trauma and adversity in LGTBQ+ youth, public health officials and providers must redouble efforts to provide a safe and supportive environment for clients and to offer a range of modalities to address the unique needs of vulnerable youth.

 has led efforts across both of these fronts in increasing accessibility of care for students and young adults residing in MA, offering intensive psychodynamically-informed treatment that supports individuals while they navigate the challenges and benefits of living in their communities and work on developing a sense of safety and mastery in their daily lives and relationships.

The Trevor Project

The Trevor Project’s 2024 National Survey on the Mental Health of LGBTQ+ Young People is an illuminating and essential resource for understanding the mental health needs of youth in America.

The Trevor Project Releases National Survey on the Mental Health of LGBTQ+ Young People

Photo by Matt at Unsplash - Image of a white lily 

Riggs adjunct faculty member Lucy LaFarge, MD, died on Thursday, February 20 after a long struggle with a recurring illness. You can 

In speaking about Lucy’s work at Riggs teaching August Special Seminars and participating in continuous case seminars, staff psychologist Jennifer Stevens, PhD, ABPP, remarked, “Her clinical wisdom, theoretical brilliance and encyclopedic psychoanalytic mind were evident in abundance.” So many Riggs medical staff members benefited from her clinical expertise. She also presented several Friday Night Guest Lectures at Austen Riggs and was a notable speaker and teacher.

Outside of Riggs, Lucy was a training and supervising analyst and Theory II course chair at the 

Columbia Center for Psychoanalytic Training and Research

. She was the book review editor and then North American editor of the 

. In addition, from 2021 to 2024, she served as the first woman editor-in-chief of 

She received her MD from the Albert Einstein College of Medicine and completed her psychiatry residency at Albert Einstein/Bronx Municipal Hospital Center.

Contributions in Lucy's honor may be made to the 

 or by mail to Paul LaFarge Memorial Fellowship, MacDowell Colony, 100 High Street, Peterborough, NH 03458, Att: Robin Cheroff.

Iris

Riggs adjunct faculty member Lucy LaFarge, MD, died on Thursday, February 20 after a long struggle with a recurring illness.

Riggs Mourns Loss of Adjunct Faculty Member Lucy LaFarge

Behind the Inn of the Austen Riggs Center

Since the 1960s, Austen Riggs has been licensed as both a hospital and a Residential Treatment Center. Over time, credentialing agencies have increasingly defined “hospital” care as short-term crisis management focused on protection and safety. Given Riggs’ commitment to maximizing patients’ capacity to take authority over their lives, we gradually reduced the number of beds designated for “hospital care”—beds that provided more intensive nursing support during crises while preserving therapeutic relationships. However, these beds were rarely used. In the past five years, only four of our 71 beds have been hospital-licensed, averaging just 6.6 days of use per year. The last time they were used was December 2023.

These four beds, located in the Inn, formed our Voluntary Hospital Program (VHP), a short-term, fully open, and voluntary level of inpatient care. The VHP offered brief, intensive engagement with nurses and staff to help patients stabilize and assess whether they could safely continue treatment in our open setting or required transfer to a more restrictive facility.

Recently, in line with national trends, the Massachusetts Department of Mental Health (DMH) further tightened its interpretation of hospital regulations, requiring complete physical separation of “hospital” beds from our therapeutic community. This would have forced Riggs to wall off a section of the Inn, fundamentally altering our mission centered on patient authority and deep therapeutic relationships.

After careful consideration, Riggs has decided not to pursue re-licensure as a hospital. This decision does not affect our licensure as a Residential Treatment Center, nor does it alter our treatment model or non-profit status. During crises, we will continue to provide increased engagement and assessment for transfer when a higher level of care is needed.

“Our discussions with DMH over the past 10 months have been thoughtful and comprehensive,” said Medical Director/CEO Edward R. Shapiro, MD. “However, the increased restriction and isolation required for hospital beds would compromise the openness and therapeutic freedom fundamental to the Riggs model. Our decision reflects the broader shift in psychiatric care, where hospitals now primarily focus on protection and safety, while treatment increasingly takes place in Residential Treatment Centers. Riggs remains steadfast in its commitment to an open therapeutic environment, deep respect for individual autonomy, and a community that fosters meaningful engagement in treatment.”

Founded in 1919, Riggs provides intensive residential treatment for individuals with complex mental health challenges who are not in acute crisis but for whom outpatient care has been insufficient. Many Riggs patients have undergone multiple treatments—including medication, therapy, and inpatient care—without achieving lasting relief or the ability to take charge of their lives.

At Riggs, there are no locked doors, privilege systems, or physical restraints. Instead, patients balance freedom with responsibility. Our treatment pathway begins at the Inn Residence, where each patient has a private room and works with the same interdisciplinary team from admission to discharge. This care starts with 24-hour nursing support and transitions through step-down programs as patients take increasing authority over their lives and treatment costs decrease. Throughout their stay, patients engage in intensive four-times-per-week psychodynamic psychotherapy, active participation in our Therapeutic Community Program, medication management, family interventions, casework, and a diverse range of arts and education activities.

This decision reaffirms Riggs’ dedication to its core mission: providing deeply relational, psychodynamic treatment that helps patients understand and work through the meaning of their symptoms, fostering lasting change within a therapeutic community.

Austen Riggs Center Inn

After careful consideration, Riggs has decided not to pursue re-licensure as a hospital. This decision does not affect our licensure as a Residential Treatment Center, nor does it alter our treatment model or non-profit status. 

Riggs Clarifies Its License Status

Established in 1919 in Stockbridge, Massachusetts, the Austen Riggs Center is internationally recognized as a leading continuum of care that promotes personal resilience and self-direction in adults with complex psychiatric problems. Our treatment is built around an open setting and therapeutic community that emphasizes the importance of relationships, the voice and authority of patients, and intensive psychoanalytic psychotherapy. Over its 106-year history, Riggs has developed a psychoanalytic and systems psychodynamic approach for patients who have been unable to effectively use other treatments. The most recent addition to our services, the Online Intensive Outpatient Program (IOP), was created in response to the growing need for quality, affordable access to care which serves college students and emerging adults. We also have a deep history in clinical education, research and accessibility including Fellowships and high-quality training opportunities through our Erikson Institute.

The mission of the organization is to promote resilience and self-direction in those with complex psychiatric problems—to help people take charge of their lives. Our work is grounded in the conviction that an individual’s problems are inherently meaningful, that such problems are best understood in a social context, and that treatment leads to a more fulfilling life when the sources of suffering are addressed. 

The Austen Riggs Center seeks a Medical or Clinical Director/Chief Executive Officer (CEO) to lead the organization. 

This is a unique opportunity for a psychoanalytically oriented psychiatrist or psychologist, trained in the Riggs approach or its equivalent, to have a positive impact, not only on one of the nation’s oldest, most well-established, and well-respected treatment centers, but also on the entire field of psychology and psychiatry.

Reporting to the Board of Trustees, the Medical or Clinical Director/CEO will be responsible for the general management and oversight of both clinical and non-clinical affairs of the Center. The Medical or Clinical Director/CEO will guide a process (inclusive of Trustees, staff, and patients) that results in a comprehensive strategic plan for Riggs. This plan will address an increase in the visibility and impact of Riggs, communication of the efficacy of the Riggs approach, and the strengthening of strategic alliances with multiple constituencies. It will also address the need to strengthen the current infrastructure of the organization through cultural and technological advancement.

We seek strong leadership from an individual whose integrity, intelligence, and clear thinking will maintain the long tradition of clinical excellence at the Center while expanding its referral base, partnerships, national recognition, and educational and research contributions to the fields of psychology and psychiatry. The ideal candidate will be a good communicator, both internally and with the external world, whose decisive and confident leadership is balanced with the compassion and sense of humor necessary for open, collaborative engagement with the community at the Center.

The Executive Committee of the Board of Trustees named a national firm to assist in the recruitment of the Medical or Clinical Director/CEO. Applications, nominations, and inquiries should be directed in confidence to the firm as indicated at the end of this document.

The current climate of biological and evidence-based treatments for psychiatric disorders in a managed care system provides both challenges and opportunities for the Austen Riggs Center. While we continue to be well respected in the field and our Fellowship training program is almost universally viewed as second to none, we operate in a context of increased competition, biological reductionism, symptom and crisis management, and preference for “evidence-based” treatment. In many ways the Center is at a crossroads with how it engages with the world beyond its campus in Stockbridge. We have an important opportunity to be more vocal advocates for the efficacy of psychoanalytic treatment and systems psychodynamic understanding. The Medical or Clinical Director/CEO will be charged with developing strategies to achieve these goals while maintaining the Riggs tradition of clinical excellence.

The Medical or Clinical Director will be the CEO of the Corporation, the Austen Riggs Center, and Manager of the IOP. Subject to the direction and control of the Board of Trustees, the Medical or Clinical Director/CEO will have general management and oversight of all clinical and non-clinical affairs.

The senior leadership team reports to the Medical or Clinical Director/CEO. It is comprised of the Medical or Clinical Director/CEO plus 9 other members: Associate Medical Director/Director of Admissions, Director of Patient Care, Chief Nursing Officer, Chief Operating Officer/Chief Financial Officer, Director of the IOP, Director of the Therapeutic Community Program, Director of the Erikson Institute, Director of Human Resources, and Director of Communications.

The Austen Riggs Center seeks candidates for this position who are prepared to move to Stockbridge, Massachusetts upon assuming the position and live in a home provided by the Center near its campus; who will make a minimum five-year commitment to the leadership of the institution; and who bring the following skills and experience:

A doctoral-level degree e.g., MD, DO, PhD, PsyD, EdD

Have substantial experience and recognition as an effective psychoanalytic clinician treating patients with complex psychiatric difficulties, including supervisory expertise.

Have a minimum of 10 years progressive experience in organizational leadership and management and the capacity to inspire excellence in others.

Have experience in Tavistock-style group relations conferences.

Be able to help the Center take a leadership position in the mental health world at large regarding the psychodynamic treatment of complex patients.

Be able to think systemically about organizations as a whole, and about the Center and its relationship to the outer world.

Embrace research and have a record of scholarly contributions/publications.

Have demonstrated capacity to understand organizational finances.

Have Riggs training, either from having completed the Fellowship or served on the medical staff.

Bring an understanding of and experience with systems thinking.

Embrace the complexity of the Riggs treatment model while bringing fresh perspectives and innovative ideas.

Recognize and support the Center’s broad educational responsibility to the mental health field and larger society.

Have a deep understanding of the psychodynamics of family systems.

Understand the importance of fundraising; have experience with, or be capable of, participating in successful fundraising.

Have established networks with professional leaders, other institutions, and potential funders.

Have recognized stature in the mental health field.

All inquiries, nominations, and applications, including a resume and cover letter, should be submitted in confidence via 

Application for Medical or Clinical Director/CEO

Jaynanne Calaway-Habeck, President
Zack Funk, Senior Consultant
Calaway Habeck Talent Consulting

Review of candidates will begin immediately and will continue until the position is filled. To ensure full consideration, materials should be submitted by May 1, 2025. Ideally candidates should be prepared to assume the position between July 1, 2025, and January 1, 2026. Start date can be negotiated but will be no later than July 1, 2026.

For more information about the Austen Riggs Center,
please visit our website: 

The Austen Riggs Center is an equal opportunity employer.

Austen Riggs Center

The Austen Riggs Center seeks a Medical or Clinical Director/Chief Executive Officer (CEO) to lead the organization.  

 Austen Riggs Opens Search for Medical or Clinical Director/CEO

Austen Riggs Center Medical Office Building

"Identifying and nurturing the next generation of psychodynamic and biopsychosocial psychiatrists, educators, and leaders is essential to advancing the field of psychiatry," says 

, Director of Psychiatric Education at Austen Riggs Center. "That’s why we created the 

Austen Riggs Award for Excellence in Psychotherapy

Now in its 6th year, this prestigious annual award highlights and supports outstanding psychiatric residents who have demonstrated a strong interest and talent in psychodynamic psychotherapy or psychiatry. Additionally, it recognizes those showing promise as researchers in biopsychosocial approaches to psychiatric practice, including psychotherapy.

Winners of the 2024 Excellence in Psychotherapy Award given by the Erikson Institute of the Austen Riggs Center.

2024 Excellence in Psychotherapy Recients

Vanderbilt University Medical School Department of Psychiatry and Behavioral Sciences

Kaiser Permanente San Jose Medical Center Psychiatry Residency Program

Beth Israel Deaconess / Harvard Psychiatry Residency Training Program

University of Maryland Medical Center Psychiatry Residency

UT Southwestern Medical Center General Psychiatry Residency Program

Yale School of Medicine Psychiatry Residency Program

MGH McLean Adult Psychiatry Residency Program

UCLA Psychiatry Residency Training Program

nominated by: Farooq Mohyuddin, MD CGP, F-AGPA

Saint Elizabeths Hospital Adult Psychiatry Residency

We will be accepting nominations for the 2025 prize after July 1, 2025.

Now in its 6th year, this prestigious annual award highlights and supports outstanding psychiatric residents who have demonstrated a strong interest and talent in psychodynamic psychotherapy or psychiatry.

Riggs Announces 2024 Award for Excellence in Psychotherapy Recipients

 has a distinct focus: we aim to help individuals who struggle with the most difficult aspects of human experience and have been unable to use conventional treatments. Riggs has learned a lot about what gets in their way, and our organization is designed to address that. We prioritize 

 to discharge helps patients increasingly take charge of their lives. Our 

 reflects this commitment by maximizing our ability to meet basic dependency needs and minimizing how much we “take over” for our patients.

"We prioritize patient authority, ensuring that everything from admission to discharge helps patients increasingly take charge of their lives."

Edward R. Shapiro, MD, on the Austen Riggs' Mission

Bringing patients to an open setting–often when they are struggling with severe emotional distress, suicidal thinking, social isolation, or hopelessness–means we all share in the anxiety that comes with offering both freedom and responsibility. We collectively work to manage this anxiety with the patients and their families. We do our best to recognize that our patients are competent adults even if they’re entangled in destructive patterns. Our setting provides opportunities for them to take responsibility: at admission, in self-government in our community, in sponsoring other patients, in taking responsibility for their resources and their 

, we help patients learn how their minds work, why certain feelings overwhelm them, how behavior communicates unspoken issues, and how irrational roles can develop in families and relationships. Our operations staff assists with food, housing, medical needs, finances, and daily logistics–support that frees our clinical staff to focus on treatment. Of course, we sometimes get it wrong, either because we trigger old traumas for our patients, or because defending ourselves against the painfulness of our work makes it harder for us to listen objectively.

This mission places significant demands on all of us. We have agreed to serve this mission on behalf of our patients and on behalf of the broader field, which can sometimes reduce patients to their symptoms alone, leaving aside the importance of the whole person.

Many patients come to us with the label of “treatment-resistant.” At Riggs, we understand that label to mean that they have not yet found people who can listen and bear with them the painful experiences that they both carry and enact. We recognize our patients as capable adults and explore with them the barriers they face in stepping fully into their authority. In every area of the Center, we work to help them to acknowledge, bear, and put in perspective the painful life experiences that have limited their progress.

We recognize our patients as capable adults and explore with them the barriers they face in stepping fully into their authority.

Edward R. Shipiro, MD, on the Mission of Austen Riggs

One patient recently and memorably described Riggs as offering "too little care—on purpose." This mild sarcasm captures the careful negotiation we have with our patients to find the right level of care—too much can infantilize; too little can make patients feel unsafe and abandoned. Balancing the tension between empathy and accountability is core to our mission. In everything we do, we ask, 

“How is what I’m doing meeting appropriate and basic needs in a way that maximizes each patient’s opportunity to take charge of their own life?” 

Austen Riggs is a psychiatric residential treatment facility in Stockbridge, MA.

Psychiatric Residential Treatment

Riggs’ mission has a distinct focus: we aim to help individuals who struggle with the most difficult aspects of human experience and have been unable to use conventional treatments.

A Reflection on Riggs’ Mission 

 of the Austen Riggs Center has appointed 

, as Medical Director and Chief Executive Officer, effective January 1, 2025. Shapiro, who previously led the Center from 1991-2011, succeeds 

, who held the post from 2018 through 2024. Shapiro will serve as Medical Director/CEO while the Board of Trustees conducts a search for a new Medical Director/CEO.

"We selected Ed for this role based on his unique combination of expertise as a psychiatrist and psychoanalyst and his deep knowledge of Riggs, its staff, and the distinct treatment that the Center provides. Ed also has considerable experience advising CEOs, corporate directors, and other senior leaders," said Board Chair Lisa A. Raskin, PhD.

“As the pandemic recedes, we are seeing increasing numbers of people struggling with social isolation, psychological disturbance, and despair,” Shapiro said. "Riggs’ mission to help patients better understand themselves, deepen their relationships with others, and take up authority for their lives is a unique contribution to the world of psychiatric treatment. Our patients continually educate us about the internal and external pressures they are up against. My goal is to help us to deepen that mutual learning, further develop our treatment capacity, and advance Riggs’ mission,” he added.

Shapiro has dedicated his career to understanding and treating complex psychiatric conditions. A graduate of Yale College, Stanford University, and Harvard Medical School, he completed his psychiatry residency at the Massachusetts Mental Health Center and psychoanalytic training at the 

Boston Psychoanalytic Society and Institute

Prior to coming to Riggs, Shapiro was a Clinical Associate in the Adult Psychiatry Branch of the National Institute of Mental Health (NIMH) and directed adolescent and family treatment and psychosocial training at McLean Hospital in Boston. He is a recognized leader in the field of 

 and has been instrumental in bridging clinical practice with organizational and systemic thinking. Under his leadership at Riggs, he expanded the range of programs to meet the resource limitations and clinical needs of patients and families, founded the 

Erikson Institute for Education, Research, and Advocacy

, and expanded research efforts, solidifying the Center’s commitment to the integration of psychodynamic psychotherapy with psychosocial and medical care.

After stepping down from his leadership role, Shapiro continued to serve as a 

, author, and teacher, influencing the fields of psychiatry and psychoanalysis both nationally and internationally. His recent book, 

, outlines a developmental understanding of the individual’s capacity to assume authority and voice, from family role through organizations to society. His return marks a continuation of his lifelong dedication to patient-centered care and the advancement of a psychoanalytic systems approach to mental health treatment.

The Board is in the initial stages of launching the search for a new Medical Director/CEO and anticipates meeting with candidates over the first part of 2025.

 is an open psychiatric hospital, vital therapeutic community and institute for education, research, and advocacy in the field of mental health. Located in the Berkshire Hills of Western Massachusetts, Riggs has been serving adults since its founding in 1919. In addition to its residential program, Riggs also offers a fully online course of treatment for college students and other emerging adults in MA via its 

 (IOP). Riggs’ mission is to promote resilience and self-direction in those with complex psychiatric problems—to help people take charge of their lives when other treatments have not worked. In addition to the clinical mission, the 

 of the Austen Riggs Center studies individuals in their social contexts through research, training, education, and conducts outreach programs in the local community and beyond. For more information, visit 


John Zollinger 
Director of Communications 
Austen Riggs Center 
413.931.5816 


Edward R. Shapiro, MD

Shapiro will build on the experience of his previous 20 years as Riggs Medical Director/CEO to guide the Center into a second century of successfully treating patients with complex psychiatric problems. 

Edward R. Shapiro, MD, Named Medical Director/CEO of the Austen Riggs Center

Collage by Austin Hughes. Photographs courtesy Austen Riggs Center archive.

This article was originally published in 

Psychoanalysis studies psychological evolution through the analysis of the individual. At the same time it throws light on the fact that the history of humanity is a gigantic metabolism of individual life cycles.

Quote from Erik Erikson

For Erik H. Erikson there was more to psychoanalysis than individual psychology; he viewed humans as social animals existing in relationship to the people, culture, and society around them. This perspective grew out of his work in Vienna with Anna Freud, followed him to California where he taught at UC Berkeley, and stayed with him when Dr. Robert Knight recruited him to the medical staff of the Austen Riggs Center in 1951. He remained at the center for nearly a decade and provided clinical consultation to its staff into the 1980s.

Erikson’s sense that we both shape and are shaped by the world around us, and that who we are depends on our individual psychology, our experiences, and the social context in which we live, would become a critical organizing principle for Riggs; the mark he left was indelible.

In recognition of Erikson’s legacy, Riggs became home to the Erikson Institute for Education, Research, and Advocacy (EI) in 1994. The EI’s recent 30th anniversary provides an occasion for reflection on the power of a psychoanalytic approach that is grounded in the social world.

The work of the Erikson Institute enriches our understanding of society, culture, and history, and enhances our ability to understand patients based on the recognition that the consulting room does not exist in isolation but is inherently a part of the world.

Thomas A. Kohut, PhD, On the Erikson Institute of the Austen Riggs Center

The Erikson Institute’s goal is to learn from others’ perspectives and impart knowledge from the clinical learning that happens in Riggs’s residential program in a mutual effort to understand and respond to problems individuals, groups, and society face. Edward Shapiro, MD, who is Riggs Medical Director/CEO starting in January 2025, stated, “We named the institute after Erik Erikson because of his groundbreaking ability to bridge different disciplines and apply the ideas from Riggs’s clinical work to the social issues around us.”

The EI exists alongside the clinical system at Austen Riggs, which has a unique approach to treatment. The fact that the Austen Riggs Center has existed for more than a century, with a firm psychoanalytic foundation since the late 1940s, is a testament to the transformative power of psychoanalytic treatment, and related therapeutic treatments like psychodynamic psychotherapy work—there are decades of robust empirical evidence to support it.

Every aspect of the Austin Riggs Center is informed by three principal tenets:

symptoms have meaning that can be understood; and

patients have authority in their lives, including in their treatment.

These principles make Riggs an outlier in the world of mental health treatment. Our open campus resembles a small New England college where nearly 60 adult patients at any time have the freedom and the responsibility to come and go as they please. There are no locked doors or privilege systems; rather, it is the relationships between and among staff and patients that hold people in treatment and keep them safe.

At Austen Riggs, patients see a doctoral-level therapist four times a week for intensive psychoanalytic psychotherapy, benefit from the resources of an interdisciplinary treatment team that follows them from admission to discharge, are immersed in a dynamic therapeutic community program, work with psychiatrists trained in psychodynamic psychopharmacology, and have access to a full continuum of care. They are also agents in their treatment, with countless opportunities to engage in groups, paid work, activities, patient government, and more.

Led by the Evelyn Stefansson Nef Director, 

, the El seeks to study the problems that bring patients to treatment and to help better understand the world around us, offering new insights, understanding, and solutions, particularly in conversation with other disciplines. In the same way Erikson viewed the individual as innately part of culture and society, the Erikson Institute seeks to apply psychoanalytic ideas broadly to areas related to education, research, and advocacy.

The EI was to be a “portal,” says Yale sociologist Kai Erikson, “through which findings and inspirations and ideas that originated within Riggs can flow out to the larger world, and through which findings and inspirations and ideas originating out there in the larger world can find their way here.” One way that portal is manifest is in the EI’s Council of Scholars, an interdisciplinary group of experts with a focused interest in psychoanalysis that consults to the director of the EI or medical director/CEO with specific projects.

Quote From Anne Dailey, JD

Clinical Training, Research, and Advocacy

The psychoanalytic lens of all the EI’s educational offerings allows for a truly open, curious, and vibrant exchange of ideas. Riggs takes what it learns through the treatment of complex patients, many of whom have not found success in other treatment settings, and shares that knowledge as it relates to broader issues in behavioral healthcare and society. At the same time, the EI is the conduit for learning from other scholars, academics, artists, communities, and cultures to inform our understanding of human suffering and its alleviation, as well as the systems and structures that contribute to and get in the way of recovery.

 and Visiting Senior Clinician Program is a primary example of this conduit, allowing academicians, clinicians, and other professionals into the clinical and intellectual life of the center through participation in seminars, lectures, case discussions, and other learning activities. The EI’s other training offerings include

The EI’s recent 30th anniversary provides an occasion for reflection on the power of a psychoanalytic approach that is grounded in the social world.

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