The purpose of the Austen Riggs Center is to help patients strengthen their ability to take charge of their own lives. Treatment focuses on understanding what interferes with that capacity and helping patients develop the authority and perspective needed to manage their lives more effectively.

How difficulties begin — and why they persist

We all grow up in families where, inevitably, moments arise when a child's needs exceed a parent's capacity to meet them. In many cases, these mismatches remain minor and manageable. With time and communication, families adjust, and development continues.

But some mismatches disrupt development because they are emotionally overwhelming, unacknowledged, or simply too frequent. A child's innate neurological makeup may lead them to be chronically out of sync with their parents. Or a parent's previous trauma may limit their emotional availability. Or families may unconsciously carry the effects of trauma that were never recognized or understood in previous generations.

Children adapt to preserve the caregiving relationship, which they need to survive. If they decide a traumatic experience is their fault, they can still believe their parents are good. Over time, survival strategies like this continue to shape expectations, relationships, and identity long after the original context has changed.

Reenactment, not resistance

Although these adaptations once helped children cope, they often complicate adult relationships, including in treatment. Many of our patients find themselves unconsciously reenacting early family dynamics, experiencing their therapists or other staff members repeating the roles of misunderstanding or injurious caretakers. Even minor misattunements—an ambiguous tone, a missed cue—can trigger intense reactions: withdrawal, rage, or despair.

Clinicians in traditional settings may misinterpret these responses as resistance, defiance, or dysfunction, labeling patients as "noncompliant" or "untreatable." At Riggs, we see these reactions not as pathology, but as meaningful expressions of unmet developmental needs and unresolved trauma. When such patterns emerge in the therapeutic relationship, they offer an opportunity for understanding and change.

Why we don't lock the doors

We conduct treatment in a completely open setting—without locked units, seclusion, or restraints—because we trust our patients to share responsibility for their care.

In more restrictive environments, control measures like locked doors or restraints often unconsciously mirror the traumatic conditions many patients endured in childhood—conditions where autonomy was denied, emotions were punished, or the caregiver inspired both fear and dependence. These measures can retraumatize.

At Riggs, we respond to intense affect—rage, despair, suicidal feelings—not with coercion, but with shared emotional labor. Patients, families, and staff bear it together. This strengthens agency, mobilizes mature capacities, and deepens trust in the therapeutic process.

Creativity, responsibility, and strengths

Healing at Riggs extends beyond the therapy room. Our therapeutic community includes an activities program that fosters creative expression through art, music, writing, and performance. A work program gives patients the opportunity to contribute meaningfully in settings such as the nursery school, greenhouse, library, and kitchen—taking up roles that reinforce responsibility, competence, and connection. Through patient government, individuals help shape community life and exercise leadership.

These programs promote recovery by enhancing strengths, encouraging engagement, and restoring dignity through work, creativity, and shared governance. They support a shift from helplessness to agency.

The community as a living extension of the patient's world

Patients don't just repeat early dynamics with their therapists; they live them out across the community. They may idealize some staff and hate others, unconsciously recreating childhood divisions. At Riggs, we use a systems psychodynamic lens to understand these patterns. Rather than blaming individuals, we treat the staff system as a therapeutic instrument—reflecting, interpreting, and metabolizing the dynamics together.

In outpatient settings, patients often react strongly to people outside the therapist's reach. At Riggs, where patients and therapists are members of the same community, we can often observe these dynamics as they unfold, making them readily available for exploration and understanding.

When insight is not enough

Many patients arrive after years of thoughtful outpatient treatment. Insight may have grown, but life outside the therapy hour remains difficult. Feelings become overwhelming, and instead of being spoken about, they are often expressed through actions—conflict in relationships, withdrawal, substance use, anger, or other behaviors that later feel embarrassing or out of control.

Part of the work at Riggs is to bear that experience together and gradually translate it into a more complex understanding of what has happened in a person's life and relationships. At Riggs we try to understand actions and crises as communications. They are often attempts to express feelings that do not yet have words.

Why the community matters

Riggs is not only a place for psychotherapy sessions. It is also a therapeutic community. Patients live in an environment where interactions with other patients and staff provide opportunities to notice patterns in relationships. What happens in the community is often brought back into psychotherapy so that it can be understood together.

Rupture and repair

When emotions are intense, relationships often break down. At Riggs we pay close attention to these moments. Conflict, misunderstanding, and disappointment are not seen simply as failures. They are chances to repair relationships and build stronger ways of connecting with others. Learning that relationships can survive strain is an important part of restoring a person's capacity for attachment.

Life outside the patient role

To strengthen personal authority, patients are given meaningful freedom and responsibility. Patients participate in activities such as painting, woodworking, ceramics, theater, greenhouse work, and work roles in the nursery school. In those roles, staff do not know a patient's clinical history. They respond to them simply as adults working together on a task.

Patients also take up elected roles in the therapeutic community—holding meetings, managing budgets, creating activities. These are spaces to learn about taking up authority on behalf of others and to develop the experience of belonging.

We don't aim simply to relieve symptoms or change behavior. We join patients in exploring how they became who they are and how they might change. In a community that fosters emotional honesty, mutual responsibility, and genuine participation, patients can become active agents in their healing—moving from passive recipients of care to active authors of their lives.

Life outside the patient role

To strengthen personal authority, patients are given meaningful freedom and responsibility. Parts of life at Riggs involve roles where people are not understood as "patients."

They participate in activities such as painting, woodworking, ceramics, theater, greenhouse work, and work roles in the nursery school. In those roles, staff do not know a patient's clinical history and do not respond to them as patients. They respond to them simply as adults working together on a task.

Patients also take up elected roles in the therapeutic community—holding meetings, managing budgets, creating activities. These are spaces to learn about taking up authority on behalf of others and to develop the experience of belonging.

Difficulties that once felt shameful or disruptive are treated as meaningful communications. By understanding them together—in psychotherapy and in the life of the community—patients develop language for their experience, strengthen relationships, and gradually take greater authority over their lives.

People are typically referred to the Austen Riggs Center when well-conducted outpatient treatment has not led to sufficient change in how they live. Insight may be present, but it does not organize action, relationships, or self-management in a sustained way.

The six-week residential evaluation is the usual point of entry. From the first day, it is organized around the full treatment model: intensive individual psychotherapy, life in the therapeutic community, and participation in activities outside the patient role. The clinical question it holds throughout is whether this person, in this setting, at this point in their life, can make use of a treatment that asks them to take increasing responsibility for their own experience.

A structured process for understanding how a person functions

The evaluation is residential, intensive, and organized around the full treatment model from the first day. It provides enough time and structure to observe how a person engages in individual work, in the therapeutic community, and in activities outside the patient role — across settings and over time.

The focus is not only on symptoms or diagnosis, but on how the individual uses treatment itself—particularly under conditions of stress, conflict, and uncertainty.

You can read more about how treatment at Riggs works across these domains.

Enough time for patterns to emerge

Six weeks provides enough time to observe patterns as they unfold, rather than relying only on initial impressions. It allows for the development of relationships, the emergence of recurring difficulties, and the opportunity to begin working with them.

Shorter evaluations often capture only how a person presents at the outset. This structure allows for a more reliable understanding of how they function over time.

A well-informed clinical decision

At the end of the evaluation, a set of recommendations is made. For some individuals, this includes continued residential treatment at Riggs. For others, it may involve returning to outpatient care with a clearer understanding of what is needed, or consideration of alternative settings.

The goal is not to direct everyone into the same form of treatment, but to arrive at a well-informed clinical decision.

The evaluation may be helpful for individuals experiencing

• Depression or mood instability that has not responded to treatment
• Recurrent suicidality or self-destructive patterns
• Trauma-related difficulties that continue to disrupt daily life
• Persistent anxiety that limits functioning
• Dissociation or loss of continuity in experience
• Longstanding patterns in relationships that interfere with stability

Who it is not for

The evaluation is not appropriate for everyone. The program is an open therapeutic community, not a locked or primarily containment-based setting. It requires a capacity, even if initially limited, to participate in treatment and to engage in examining one's own experience. Determining whether these conditions are present is part of the evaluation itself.

What to expect

• Residential setting in Stockbridge, Massachusetts
• Daily schedule including individual sessions, groups, and activities
• Collaboration with referring clinicians when applicable
• Insurance and financial discussion through Admissions

Many people who come to the Austen Riggs Center carry a diagnosis of depression. They have often worked hard in treatment—psychotherapy, medication, sometimes hospitalization—and may have developed real insight into their history and emotional life.

Yet something essential has not shifted. Daily life remains constricted. Relationships are strained or withdrawn from. Periods of paralysis, despair, or self-criticism continue to interfere with the ability to work, to connect, or to sustain direction.

In these situations, the question is no longer only how to reduce symptoms. It is how a person is managing their life under the pressure of those symptoms.

Diagnosis describes. It does not explain.

A diagnosis of depression describes important aspects of experience—low mood, loss of energy, hopelessness, difficulty with motivation or concentration. But it does not fully explain how these experiences are organized in a person's life.

Two people with similar symptoms may function very differently. One may continue to work and maintain relationships; another may become immobilized. At a certain point, treatment requires a closer look at how a person uses their mind, their relationships, and the treatment itself.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

This means developing the ability to recognize and think about one's emotional experience, to use relationships without becoming overwhelmed or withdrawing, and to act with increasing deliberateness rather than reacting under pressure. These capacities are not assumed. They are built through the work.

Patterns that may remain contained in an outpatient office often emerge more clearly when a person is living in a community, participating in groups, or engaging in work and activities outside the patient role.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry

The usual point of entry is a six-week residential evaluation. From the first day it is organized around the full treatment model, and it provides the time and structure to understand how the patient functions across settings — in individual work, in the community, and in activities outside the patient role.

At the end of this period, recommendations are made. For some, this includes continued treatment at Riggs. For others, it clarifies how outpatient or other forms of care can be used more effectively.

Learn more about the six-week residential evaluation and what it involves.

Riggs is not appropriate for everyone. The work requires a willingness, even if initially limited, to examine one's own contribution to difficulties and to engage actively in treatment. For a fuller description, see how treatment at Riggs works.

Many people who come to the Austen Riggs Center carry a diagnosis of PTSD or have a history of significant trauma. They may have engaged in thoughtful treatment—psychotherapy, medication, specialized trauma therapies—and may understand the events that shaped their experience.

Yet the impact of trauma continues to organize daily life. Intrusive memories, emotional flooding, or periods of numbing and disconnection interfere with the ability to work, sustain relationships, or feel a sense of continuity in oneself.

In these situations, the question is not only how to reduce symptoms or process past events. It is how the person is living with the ongoing effects of trauma in the present.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with trauma, this often means increasing the ability to recognize shifts in emotional and physiological state, developing language for experiences that may feel overwhelming, understanding how expectations shaped by trauma influence current relationships, and expanding the capacity to remain engaged without becoming flooded or withdrawing.

The community provides repeated opportunities to recognize, misread, and repair interpersonal experience, which is central to modifying patterns shaped by trauma.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry

The usual point of entry is a six-week residential evaluation. It provides the time and structure to understand how the individual functions in the present — across settings and over time.

Learn more about the six-week residential evaluation and what it involves.

Many people who come to the Austen Riggs Center carry diagnoses of anxiety—generalized anxiety, panic disorder, social anxiety, obsessive patterns, or combinations of these. They have often engaged seriously in treatment, including psychotherapy, medication, and structured approaches such as CBT.

Yet anxiety continues to shape how they live. Efforts to manage anxiety—through control, reassurance-seeking, or rigid routines—can begin to narrow life rather than expand it. The question is not only how to reduce anxiety. It is how a person is organizing their life in response to it.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with anxiety, this often means recognizing how anxiety arises and escalates, understanding the strategies used to manage it, expanding the ability to remain engaged in situations that evoke anxiety, and developing greater flexibility in responding rather than narrowing one's life to reduce discomfort.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Many people who come to the Austen Riggs Center carry a diagnosis of borderline personality disorder. They have often been in substantial treatment—individual therapy, DBT, medication, sometimes repeated hospitalizations—and may understand a good deal about their patterns.

Yet life remains unstable. Relationships intensify quickly and then rupture. Emotions shift rapidly. Periods of self-destructive behavior, suicidality, or withdrawal recur. The question is not only how to reduce symptoms or prevent crisis. It is how a person is managing themselves and their relationships under emotional pressure.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with BPD, this often means recognizing emotional states before they escalate into action, developing the capacity to tolerate conflict, disappointment, and ambiguity without collapse or rupture, and taking increasing responsibility for one's own actions and their impact.

The community provides repeated opportunities for rupture and repair, which are central to developing more stable and reliable ways of relating.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Many people who come to the Austen Riggs Center carry a diagnosis of bipolar disorder. They are often in ongoing psychiatric care, including medication management, and may have had periods of relative stability. Yet sustaining that stability remains difficult.

The question is not only how to stabilize mood. It is how a person manages themselves, their decisions, and their relationships as mood states change.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with bipolar disorder, this often means increasing awareness of early shifts in mood and energy, developing the capacity to pause and seek input before acting, and strengthening the ability to maintain continuity of functioning across changing internal states. Medication management remains an important component, integrated with the broader treatment.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Many people who come to the Austen Riggs Center struggle with recurrent suicidal thoughts, suicide attempts, or patterns of behavior that put them at risk. They are often already in treatment and may have made serious efforts to stay safe. Yet the patterns continue.

The question is not only how to prevent immediate harm. It is how a person understands and manages the forces that lead toward self-destruction.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals struggling with suicidality, this often means recognizing early signs of escalating distress, developing the ability to pause and seek help before acting, increasing the capacity to tolerate intense emotional states, and taking responsibility for one's own safety within a structured setting.

You can read more about how treatment at Riggs works across these domains.

Riggs is not appropriate for everyone experiencing suicidality. The program is an open therapeutic community, not a locked or primarily containment-based setting. The work requires a capacity, even if initially limited, to participate in treatment and to engage in developing responsibility for one's own safety.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Many people who come to the Austen Riggs Center experience dissociation—periods in which their sense of self, memory, or connection to their surroundings becomes disrupted. They may describe feeling detached from themselves or the world, losing time, or having difficulty maintaining a continuous sense of who they are.

Developing capacity, not assuming it

Treatment at Riggs is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with dissociation, this often means increasing awareness of early signs of disconnection, developing the ability to name and communicate internal states, strengthening continuity of experience, and expanding the capacity to remain present and engaged.

Dissociative experiences that may be difficult to observe in outpatient settings can become more visible in a community—allowing the experience to be examined as it occurs, rather than only reconstructed afterward.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Some individuals who come to the Austen Riggs Center have a diagnosis of autism spectrum disorder, often identified in adolescence or adulthood. Many are highly verbal and intellectually capable. Yet their lives have become increasingly narrow, effortful, or isolating.

The question is not whether autism is present, but how the person is managing themselves and their relationships under the conditions that autism creates.

The central task remains the same

Riggs does not treat autism as a discrete condition to be corrected. The focus is on helping patients strengthen their capacity to understand and manage their own experience. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals with autism, the community setting is often particularly important. It makes visible the moment-to-moment challenges of communication, misunderstanding, overstimulation, and repair—experiences that can be examined in real time.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

Some people who come to the Austen Riggs Center have been given diagnoses of personality disorder. Others recognize that certain patterns in how they think, relate, and act have remained stable over time, even as they have worked to change them.

These patterns often appear across situations. They may be well understood. Yet under pressure, the same patterns recur, sometimes in ways that interfere with relationships, stability, or direction.

From classification to function

Treatment at the Austen Riggs Center is organized around a central task: helping patients develop the capacity to take charge of their own lives. The six-week residential evaluation is designed to assess whether this kind of work can be used.

For individuals struggling with longstanding patterns, this often means recognizing patterns as they emerge in real time, identifying the conditions under which reflection gives way to action, withdrawal, or repetition, developing the capacity to pause and respond differently, and taking increasing responsibility for one's own behavior and its impact.

You can read more about how treatment at Riggs works across these domains.

The usual point of entry is a six-week residential evaluation. Learn more about the six-week residential evaluation and what it involves.

At Riggs, families are included in the work, but in a different way than they may expect. The focus is not on assigning blame or finding immediate solutions. It is on understanding the patterns that have developed over time and how each person has been drawn into them.

Included, but differently than you expect

Families are not responsible for managing the patient's treatment, but they are not outside of it either. Family meetings provide a setting in which patterns of interaction can be observed and thought about together. These conversations are often difficult. Longstanding assumptions may be questioned. Family members may begin to see how they have been drawn into cycles of worry, accommodation, conflict, or over-responsibility.

The aim is not to judge these patterns, but to make them visible so that different choices become possible.

Three kinds of experience, working together

Treatment at Riggs is organized around three kinds of experience. The first is intensive individual psychotherapy—four sessions per week with the same clinician. The second is life in a therapeutic community where daily relationships become part of the clinical work. The third addresses a concern families often carry: that a person in long-term residential treatment will become more identified with being ill.

At Riggs, the opposite is a deliberate aim. Patients spend regular time in settings where they are not known as patients at all—as students of painting, pottery, or weaving; as horticulturalists; as teaching assistants; as actors. Staff in these programs do not know their histories or diagnoses.

You can read more about how treatment at Riggs works across these domains.

Your role may need to shift

A central part of the work is helping the patient take a more active role in their own life. In some cases, this means stepping back from roles taken on out of care that have unintentionally limited the patient's independence. These shifts are not imposed. They are developed through discussion and understanding.

Cost, length of stay, and logistics

Riggs is a private-pay institution. We do not participate in insurance networks, though many patients receive partial reimbursement through out-of-network benefits. We want the conversation about cost to happen early, not late.

There is no fixed length of stay. Patients remain as long as they are making genuine use of the treatment. The six-week evaluation period provides an early shared assessment of whether and how to continue.

Riggs is located in Stockbridge, Massachusetts. Patients come from across the country. The admissions team can help families think through logistics, including how visits work and what communication typically looks like during treatment.

Insight may be present, but does not organize action, relationships, or self-management in a sustained way, and patterns repeat despite serious treatment effort. The six-week residential evaluation is designed to clarify the clinical picture and to assess whether and how the patient can use a treatment that emphasizes increasing responsibility for their own experience.

The organizing task

Treatment is organized around a central task: helping patients develop the capacity to take charge of their own lives. This is understood as a developmental achievement that may be initially fragile or unavailable.

The program integrates three domains: individual clinical work, the therapeutic community, and opportunities to function outside the patient role. These domains are kept differentiated but in active relation. The patient's characteristic patterns emerge across settings and are used as the primary material for understanding, interpretation, and intervention.

Read more about how treatment at Riggs works.

Role differentiation as mechanism, not amenity

One of the underrecognized problems in long-term residential care is the regression produced by continuous immersion in the patient role. Riggs addresses this through a structured program of role differentiation. Patients participate regularly in settings where they are not known as patients. Staff in these settings do not know patients' histories, diagnoses, or treatment status.

Competence practiced outside the clinical frame generates material that the individual therapy then works with. A patient who functions capably in one of these roles encounters a version of themselves that chronic illness may have obscured—and that encounter becomes directly available to clinical work. This is the mechanism, not the amenity.

What is required — and what is not

Riggs does not require intact functioning at admission. Many patients arrive overwhelmed, disorganized, or discouraged by repeated treatment failures. The essential question is whether the patient can, over time and with support, engage in a process that requires increasing responsibility for their experience. This capacity is assessed during the evaluation rather than presumed at entry.

Patients who require a setting in which responsibility is fully assumed by the treatment team may not be well served by this model.

Preparing the patient for the frame

Referring clinicians are important participants in the process. A central task is preparing the patient for the nature of the treatment: Riggs will not take over their life, but will provide a setting in which they will be expected, with support, to begin to understand and manage it more effectively.

Riggs is not a setting for symptom management alone. It is a setting for patients who need to understand and change the patterns that organize their lives. The six-week evaluation is designed to assess that readiness—and, in many cases, to begin developing it.

Learn more about specific conditions

Advancing understanding — in the clinic and in the world

Established in 1994 and named for Erik H. Erikson—who was on the Riggs staff for ten years—the Institute is a leading national and international provider of psychoanalytic education and clinical training, as well as psychoanalytic research. It is directed by Jane G. Tillman, PhD, ABPP.

The Institute helps clinicians, educators, researchers, and scholars deepen their understanding of the complex psychological challenges facing individuals, groups, and society. Its work is embedded in the clinical life of the Center: the scholarship that emerges here is shaped by daily contact with patients, and the clinical work is continually informed by research and by conversation with scholars from other disciplines.

Partnerships that extend the work

Through the Erikson Institute, the Austen Riggs Center maintains important relationships with academic institutions, teaching hospitals, and psychoanalytically-oriented groups and organizations. These partnerships foster mutual learning, collaborative research, and new scholarly endeavors.

Yale Child Study Center

A long and rich partnership that began under former Medical Director Dr. Robert Knight. The Western New England Psychoanalytic Institute was first launched with faculty including Erik Erikson and other Riggs staff holding Yale appointments. Beginning in 2012, the Yale Child Study Center, the Department of Psychiatry at Yale University School of Medicine, and the Erikson Institute have hosted an annual conference. In 2025, the two institutions launched the Psychodynamic Research Mentorship Program (PRMP), an international multidisciplinary psychoanalytic research education program.

International Dialogue Initiative

Initiated by Senior Erikson Scholar Vamik Volkan based on his decades of international work, the IDI examines large group differences—and the emotionally charged perception of those differences—in an attempt to understand the effect of past trauma on present concerns and the contribution of large group identity anxieties to divisiveness and conflict. Riggs staff affiliated with the IDI include Donna Elmendorf, PhD; Edward Shapiro, MD; and Gerard Fromm, PhD, ABPP, who is the current president of the IDI.

Cambridge Health Alliance

An affiliation formed in 2007 with the CHA Psychology Department, providing increased training opportunities for pre-doctoral psychology interns. Interns visit Riggs twice yearly for immersive learning in complex severe psychopathology, psychodynamic psychotherapy, and attention to context and systemic issues.

Rapaport-Klein Study Group

A gathering of the students of David Rapaport and George Klein—both associated with Riggs in its early history—who meet annually at the Center to present psychoanalytically oriented research in progress. The group represents the leading edge of psychodynamic research.

Stuck in outpatient. Not ready for residential.

Some people are clearly stuck in weekly outpatient therapy — the sessions are thoughtful, the relationship is real, and nothing is substantially changing. But residential treatment feels like too large a step. Or the timing isn't right. Or it genuinely isn't needed.

The Austen Riggs Intensive Outpatient Program is designed for this moment. It offers a higher level of structure and relationship than weekly therapy — without requiring a patient to leave home, work, or school.

The IOP is delivered remotely and is organized around the same central question as residential treatment: not what is the diagnosis, but how is this person managing their life under the pressure of their difficulties?

Emerging adults, primarily

The IOP is designed primarily for emerging adults — roughly ages 18 to 30 — who are struggling with depression, anxiety, trauma, personality difficulties, or related concerns. Many have been in outpatient therapy without sufficient change. Some have had prior hospitalizations or higher levels of care. Some are transitioning out of residential treatment at Riggs and need continued support.

The IOP may also be a step toward residential treatment — a way to begin the work and assess whether a more intensive evaluation makes sense.

Start with a conversation

Admissions staff can help you determine whether the IOP or the six-week residential evaluation is the better starting point. The two programs serve different moments in the same journey. Sometimes one leads to the other.

A residential community organized around understanding

At the Austen Riggs Center, we offer something rare: an open, voluntary psychiatric treatment community where your voice matters. As one of the few longer-term mental health facilities in the country, Riggs focuses on lasting transformation. For over a century, the work has been organized around understanding the person — what has shaped their difficulties and what can change.

Patients are not confined to locked wards or managed with privilege systems. You are not a passive recipient of care, but an active participant in your own recovery, supported by a community of peers and professionals who believe change begins with understanding — not control.

Watch Our Video

Riggs Medical Director/CEO Ed Shapiro, MD, speaks about some of the distinguishing characteristics of Riggs treatment along with what kind of individuals might find a successful path to recovery here.

We treat the person, not just the diagnosis

The Austen Riggs Center exists to help people with complex psychiatric disorders take charge of their lives. Our work is grounded in the centrality of human relationships, understanding the meanings behind symptoms, and respecting the individual's authority and voice in their own treatment and their own life.

We are a residential mental health treatment center with a different approach. Our caring experts work with you to illuminate the stories behind your symptoms. Time, space, and support for reflection can lead you to better understand yourself and your relationships, enabling you to address a range of issues and build a more satisfying life.

Riggs at a glance

• We treat adults 18 and older with complex psychiatric conditions
• We average approximately 60 patients at any given time
• Completely open and voluntary — patient freedom and responsibility are expected and respected
• Each patient has individual psychotherapy four times per week with a doctoral-level clinician
• Multidisciplinary treatment teams: psychotherapist, psychopharmacologist, social worker, nursing staff, community staff, and substance use counselor
• Minimum length of stay is six weeks; median is five months; length of stay is open-ended
• Located in Stockbridge, Massachusetts — three hours from New York City, two hours from Boston, one hour from Albany
• Joint Commission Accredited; licensed by the Massachusetts Department of Mental Health

What treatment costs

Riggs offers a range of treatment programs, and the total length of stay can run from six weeks to a year or more. The median length of treatment is five months. The cost of the six-week evaluation and initial treatment phase ranges from $80,000 to $86,000 (as of July 1, 2025; subject to change), which includes an admission consultation fee of $2,000. A refundable payment of $50,000 is required on the day of admission, applied to the cost of treatment.

For patients who remain at Riggs for several months, the average cost is approximately $1,275 per day. Patients who step down to less intensive programs over time pay at lower rates.

All-inclusive fees cover: room and board, individual psychotherapy four times weekly, pharmacotherapy, clinical casework and family work when indicated, nursing care, fitness classes, access to the Therapeutic Community Program and Activities Program, and more.

Download the Program Rate Schedule (PDF) →

Out-of-network coverage

Riggs is a private-pay institution and does not participate in insurance networks. However, many patients have out-of-network benefits that provide partial reimbursement. Our admissions staff can help you understand what your plan may cover and how to submit for reimbursement.

Training in psychodynamic psychiatry where the work happens

The Austen Riggs Center Adult Psychoanalytic Training Program and Fellowship is available to post-residency psychiatrists and postdoctoral psychologists. It is fully accredited by the Accreditation Council for Psychoanalytic Education (ACPEinc) and is an approved institute of the American Psychoanalytic Association (APsA).

The program takes a systems perspective, emphasizing cultural and familial contexts as well as individual development across the lifespan. Fellows train alongside senior clinicians in an open residential treatment setting — working with complex, treatment-resistant patients while receiving intensive supervision in psychodynamic psychotherapy.

This is one of the few training programs in the country that places fellows directly within a functioning therapeutic community, making the dynamics of group and institutional life as available for study as individual clinical work.

Virtual Open House and application

The Erikson Institute holds regular virtual open houses for prospective fellows. These are an opportunity to learn about the program, meet current fellows and faculty, and ask questions.

For application information, upcoming open house dates, and program details, visit the Erikson Institute section of the Austen Riggs Center website or contact us directly.

The same team, throughout

Each patient at Riggs is cared for by an interdisciplinary treatment team that follows them from admission through discharge. The team includes a psychotherapist, psychopharmacologist, clinical social worker, nursing staff member, community staff member, and substance use counselor.

This continuity is intentional. The same clinicians who know a patient in individual therapy also observe them in the community, in family meetings, and across the activities program. Integration across these settings is part of what makes the work possible.

All individual therapists are doctoral-level — psychiatrists or clinical psychologists. Individual psychotherapy takes place four times per week.

Clinical scholarship rooted in practice

The research program at the Austen Riggs Center, housed within the Erikson Institute for Education, Research, and Advocacy, prioritizes empirical studies on psychodynamic psychotherapy's application to treatment-resistant disorders, suicidal behaviors, and personality psychopathology.

Central to these efforts is the Long-Term Data Repository — an evolution of the 1992–2001 Follow-Along Study — which tracks biopsychosocial factors influencing patient adaptation over decades, revealing patterns where relational dynamics predict sustained remission in chronic cases beyond initial symptom relief.

A pilot project employs smartphone-based ecological momentary assessment to capture daily social connectedness as a buffer against suicide risk, linking interpersonal ruptures to spikes in impulsivity and maladaptive coping.

Psychodynamic Research Mentorship Program

The Erikson Institute offers a Psychodynamic Research Mentorship Program for emerging researchers interested in developing empirical work within a psychodynamic framework. The program pairs mentees with senior Riggs faculty for guidance on research design, methodology, and publication.

Riggs also maintains an Institutional Review Board (IRB) that oversees all research activities in accordance with federal standards for the protection of human subjects.

Psychodynamic thinking across disciplines

Meaning Matters is an online community moderated by Austen Riggs Center staff, bringing together clinicians, researchers, educators, and other professionals who share an interest in psychodynamic thinking and its application to human experience — in individuals, families, institutions, and society.

The community holds regular online discussions, reading groups, and events that explore psychoanalytic theory and practice in contemporary contexts. It is open to professionals across disciplines who share an interest in depth psychology and the search for meaning in symptoms, relationships, and social life.

A calendar of educational offerings

The Austen Riggs Center hosts and co-presents a range of events for clinicians, researchers, and the public — including virtual conferences, continuing education courses, case conferences, and special lecture series. Events cover psychodynamic psychiatry, systems psychodynamics, personality disorders, trauma, identity, and related topics.

Recent events have included conferences on mentalization, racial trauma, technology and the psyche, psychosis care, and leadership. Free CE/CME courses are regularly offered through the Erikson Institute.

CME and CE courses

The Erikson Institute offers continuing medical education (CME) and continuing education (CE) courses accredited for psychiatrists, psychologists, and social workers. Many courses are free and available online. Topics range from clinical technique to organizational dynamics to social and cultural issues in mental health.

Recent news and publications

The Austen Riggs Center maintains an active news section covering clinical perspectives, staff publications, Center announcements, and contributions to the broader mental health field. Recent coverage has included commentary on the crisis of social connection, psychodynamic psychopharmacology, racial trauma, and the future of long-term psychiatric care.