Substance Use Disorders

The Austen Riggs Center is a top psychiatric treatment center in an open therapeutic community. Although we do not admit or offer treatment to those whose substance use disorder (SUD) is primary, many of those struggling with mental disorders have co-occurring SUDs. We provide support to these individuals to help them maintain abstinence while in treatment at Riggs.

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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 with difficulties related to the use of alcohol and/or other drugs. We will consider such individuals for admission to Riggs only if their SUD is a co-occurring rather than primary disorder, and only if they have achieved substance abstinence. In addition, 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, as supports to help them maintain abstinence.  

Use 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. If an individual relapses into active substance use and cannot quickly return to abstinence, we will recommend discharge and a period of substance use disorder treatment before resuming treatment at Riggs.

Why consider residential treatment at Riggs? 

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 drugsImmersion in our treatment program helps patients who have complex psychiatric problems that often coexist with substance use disorders to

  • develop strategies to maintain abstinence while 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 how 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. 

Learn more about the substance abuse services offered at the Austen Riggs Center.

What benefits does a therapeutic community provide for those with co-occurring 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 mental disorders that co-occur 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 work to support sustained abstinence in patients with co-occurring substance use disorders. 

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 with those with co-occurring 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.

Patient Outcomes

How do I inquire about treatment at Riggs?

For more information about our admissions process and treatment program, please visit our Admissions page, call 1-800-517-4447 or visit our Contact page.