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The Therapeutic Community Program: Learning, Leadership, and Change in an Open Setting
Part Three in a Series on the Open Setting at Austen Riggs Center
In earlier pieces in this series, we explored how the open setting at Austen Riggs Center supports responsibility, freedom, and examined living as central components of treatment. This third installment looks more closely at how those principles take shape in daily life through the Therapeutic Community Program (TCP)—the living, relational heart of the Riggs model.
What Is the Therapeutic Community Program (TCP)?
The philosophy of the open setting is made concrete in the Therapeutic Community Program. Within this structure, patients actively engage in a dynamic, closely connected community where they can:
- Recreate and examine the interpersonal patterns that contributed to their struggles
- Receive feedback from peers and staff in real time
- Discover and develop their strengths as contributing members of a community
Rather than being passive recipients of care, patients in the TCP are participants in a shared therapeutic environment—one that emphasizes agency, accountability, and connection.
A Range of Therapeutic Groups Supporting Growth
The TCP includes a wide range of group experiences, with a staff consultant/facilitator, designed to support different aspects of growth:
- Interpersonal learning groups: In the Inn Residential Program–Group (IRP-G), patients attend two daily groups focused on connection, feedback, and mutual support
- Process Groups focus on central aspects of human experience relevant to relationships and treatment: 1) the study of authority and 2) the study of belonging. These groups offer the opportunity to learn from the "here and now" experience, including group dynamics.
- Issue-focused groups: These address specific challenges such as substance use or disordered eating
- Psychoeducational and somatic (related to the body) groups: These promote overall mental and physical wellness
Together, these groups can foster leadership, responsibility, and real-world relational skills and create a layered therapeutic experience that mirrors the complexity of life outside treatment—while offering structure, safety, and support.
Patient Government: Responsibility in Action
A distinctive feature of the TCP is patient government, where patients take active roles in shaping community life.
Key components include:
- Community Meeting (CM): Held every weekday and chaired by an elected patient, this is the central forum where patients and staff come together to address community concerns and shared experiences
- Task Group: A patient-led group where individuals receive feedback about interpersonal challenges and work toward understanding and repair
- Community Events Board (CEB): Organizes on- and off-campus activities, managing a budget and fostering community engagement
These structures are not symbolic—they are central to treatment. They provide patients with meaningful opportunities to practice leadership, communication, and accountability in real time.
A Clinical Example: From Conflict to Leadership
The learning opportunities within the TCP are perhaps best illustrated through lived experience.
Mark* was admitted to the IRP-G level of care. Early on, he struggled in groups—monopolizing conversations and reacting angrily when others offered feedback. At times, he would leave abruptly, slamming the door behind him.
His behavior quickly became a topic of concern within the community. Some patients questioned why staff allowed him to continue attending groups, feeling his presence disrupted others’ treatment.
Rather than intervening in a top-down way, staff encouraged the community to engage Mark directly. The conflict itself was framed as an opportunity for learning.
Eventually, a peer referred Mark to the Task group, hoping to better understand what was driving his behavior.
At first, Mark refused. He feared being “ganged up on.” But after a one-on-one conversation with the Task chair—who emphasized the group’s goal of support through feedback—he agreed to attend.
What unfolded was a shift.
As Task members expressed genuine curiosity about his experience, Mark began to share feelings of not being welcomed and of being judged—experiences that echoed painful dynamics from his family life. In turn, other patients acknowledged that the community, overwhelmed by a wave of new admissions, may not have been as welcoming as they had hoped.
This moment marked a turning point.
Mark began to recognize a longstanding pattern: reacting with anger when hurt, pushing others away when he most needed connection. At the same time, the community began reflecting on its own challenges—grief over recent discharges and the difficulty of integrating new members.
Three months later, Mark ran for and was elected Community Meeting chair.
In this leadership role, he focused on improving how new patients were welcomed and integrated. Drawing from his own experience, he connected with others around fears of rejection and helped foster a more inclusive environment.
*Mark is a fictionalized patient, used for illustrative purposes.
Why the Therapeutic Community Model Matters
This example highlights a core principle of the Riggs model: healing happens in relationship.
The therapeutic community provides a space where:
- Patterns can be lived out—not just discussed
- Feedback is immediate, relational, and meaningful
- Patients can experiment with new ways of relating
- Growth emerges through participation, not instruction
For many, this is the first time they can clearly see—and begin to change—the interpersonal dynamics that have shaped their lives.
Reflections from the Associate Director of the TCP
In my role as Associate Director of the Therapeutic Community Program, I continue to be struck by the depth of learning that occurs in this environment.
For all of us, our first experience of group life is within our family. Throughout life, we often recreate those early dynamics—sometimes in ways that limit connection and belonging.
The therapeutic community offers something different: a chance to experience those patterns in real time, with the support needed to understand and change them.
With feedback, reflection, and engagement, patients begin to:
- Recognize recurring relational patterns
- Articulate their experiences more clearly
- Develop new ways of connecting with others
Over time, this work supports a deeper sense of belonging—both within the community and beyond it.
Continuing the Series on the Open Setting
This article is part of a three-part series exploring the open therapeutic setting at Austen Riggs Center:
- Part One: Examined Living, Reflection, Responsibility, and Learning in an Open Therapeutic Community
- Part Two: An Open Setting—Empowering Patients Through Responsibility and Freedom
- Part Three: The Therapeutic Community Program (this article)
Together, these pieces offer a closer look at how the Riggs model supports meaningful, lasting psychological change.
Related Resources
News
The Open Setting: Empowering Patients Through Responsibility and Freedom at the Austen Riggs Center
November 12, 2025
Discover how the open setting at the Austen Riggs Center—a unique, unlocked therapeutic community—empowers patients to take responsibility for their treatment, fostering resilience, self-direction, and lasting recovery through psychoanalytic psychotherapy and collaboration.
News
Examined Living: Reflection, Responsibility, and Learning in an Open Therapeutic Community
January 21, 2026
Examined living is an ongoing, community-wide process of public reflection on the meaning of behaviors, choices, and interactions—among both patients and staff.
News