Substance Use Disorder Treatment
On this page:
- What are substance use disorders and what are the symptoms of substance use disorders?
- Why consider residential treatment at Riggs?
- What benefits does a therapeutic community provide in the treatment of substance use disorders?
- How does an integrated treatment team approach work in treating substance use disorders?
- How does psychiatric treatment in an open setting work?
- How does our comprehensive treatment prepare patients to return to a world beyond Riggs?
- How do I inquire about treatment at Riggs?
What are substance use disorders and what are the symptoms of substance use disorders?
Substance use disorders are diagnosed when the recurrent use of alcohol and/or other drugs causes clinically significant impairment or distress, placing a person at risk for serious problems with health, relationships, or role functioning, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
About half the patients at Riggs come to us having had, to one degree or another, difficulties related to the use of alcohol and/or other drugs. Since people who have these difficulties often find it difficult to refrain from using substances despite being aware of a variety of adverse consequences, we strongly recommend that people with substance use disorders use the resources available at Riggs, including certified substance use counselors and a substance use group.
Abuse of alcohol and/or other drugs can exacerbate the symptoms of depression, bipolar disorder, psychosis, and personality disorders, and can make treatment of those disorders much more difficult. Striving to be as comprehensive as possible, we include attention to substance use disorders in the treatment plan whenever it is a relevant issue.
Why consider residential treatment at Riggs?
Immersion in our treatment program helps patients who have complex psychiatric problems that often coexist with substance use disorders to
- develop strategies to achieve abstinence and recover from addiction both at Riggs and beyond;
- develop better emotional regulation and the ability to tolerate previously overwhelming feelings;
- come to grips with the emotional impact of having this kind of disorder, including the potential benefits—and risks—of a medication regimen;
- improve their ability to understand the meaning of their symptoms and behaviors;
- develop an awareness for the context of their troubles;
- face the reality that they may be coping with a chronic problem;
- learn to adapt to circumstances;
- understand that their behavior affects others;
- communicate in words instead of behavior;
- make life choices grounded in better understanding of themselves and their motivations; and
- discover a life worth living.
The “use and consequences” approach examines not only the individual consequences of substance use, but also the consequences to a patient’s family, friends, or community, whether here at Riggs or elsewhere.
All patients undergo a substance use assessment upon admission. Because of the difficulty of engaging in serious self-examination in the presence of active substance use, we ask that patients achieve abstinence prior to admission.
What benefits does a therapeutic community provide in the treatment of substance use disorders?
Exploring Different Roles with the Clinical Staff and the Therapeutic Community
At the Austen Riggs Center we have substantial clinical expertise and experience working with patients who may have a variety of diagnoses coexisting with substance use disorders. Our treatment program is intensive, including psychodynamic psychotherapy four times a week with a psychiatrist or clinical psychologist and embedded in a therapeutic community. Our certified substance use counselors recognize the specific treatment needs of patients with a substance use disorder.
Patients have rich opportunities to learn about themselves within the therapeutic community. They learn how others affect them, how they affect others, and they are often able to shed habitual unproductive roles. As a result of successful treatment at Riggs, patients develop greater confidence and more adaptive coping skills. The goal of this comprehensive approach is to help people develop ways of facing their future with greater competence.
How does an integrated treatment team approach work in treating substance use disorders?
Patients work with a multidisciplinary team that develops a treatment plan with them. Members of the team include clinical psychologists, at least one psychopharmacologist (who may also be the therapist to some patients), team nurses, and a substance use counselor. A therapeutic community staff member helps patients find their way into the formal groups and informal leisure activities within the Therapeutic Community Program. A clinical social worker, also part of the team, provides liaison contact with the patient’s family, convenes family meetings, and helps with practical concerns such as getting a driver’s license, applying to school, preparing for job interviews, and making plans to transition to life outside of Riggs. The same multidisciplinary team of clinicians generally works with a patient throughout their entire treatment at Riggs.
How does psychiatric treatment in an open setting work?
One of the distinguishing features of the Austen Riggs Center is the open setting. In this setting, patients have complete freedom, but in return take responsibility for their safety. There are no locked units or physical restraints and no privilege system. All admissions are voluntary; after a thorough admissions consultation, a person must decide whether to accept an offer of admission. Throughout one’s time at Riggs, there is ample opportunity for staff input and recommendations, but also an emphasis on developing a partnership between patients and staff that keeps in mind the each person’s developmental needs and goals.
How does our comprehensive treatment prepare patients to return to a world beyond Riggs?
As patients move through our treatment program, they may take on new responsibilities, learn new skills, and build confidence by accepting a position of leadership within the patient community. All of these efforts are designed to enable someone to develop greater skills in preparation for the transition to life after Riggs. As patients progress, they may step down to a lower level of care, increasing their involvement in the world beyond Riggs as they taper their participation in the therapeutic community.