In its upending of everyday life, the COVID epidemic has also given the therapy community at the Stockbridge, Mass.-based Austin Riggs Center an unlikely catalyst to create an innovative Intensive outpatient program (IOP).
Launched last November, the program is aimed at college students already experiencing troubles brought on by the pressures of entry into the adult world.
The advent of COVID called for the creation of online and hybrid treatment systems at Austen Riggs to continue to deliver therapeutic help while protecting the health of staff and patients. To date, the Center’s IOP has treated about 30 students.
The center adapted to COVID-induced limits on in-person work by shifting to HIPAA-compliant Zoom. With this adaptation, it identified a wider group of those in need of remote access. Included in this group are college students who experienced a significant growth in need of treatment. In light of the demands of a college schedule, remote access to treatment was deemed to be beneficial.
Even before COVID, feelings of uncertainty, anxiety, isolation, and identity issues have been a part of college life. However, particular crises became more exposed during the pandemic.
The remote program is initially available to students who reside in Massachusetts, to comply with licensing requirements. The center plans to add services in New York state in 2023.
It currently provides an integrated systems approach to treatment that includes individual and group psychodynamic therapy, as well as family work and the prescription of what Austen Riggs describes as “psychodynamic psychopharmacology” which addresses the biochemical effects of medications.
The program offers nine to 12 hours per week of individual therapy, delivered via Zoom, all integrated by a treatment team with the invited participation of college counselors.
“Developmentally, college students are working to establish themselves as adults in the world,” said Spencer Biel, Psy.D, director of the Remote Access IOP. “This task has become more challenging through the pandemic as the world they are trying to join feels increasingly unpredictable and unstable.”
Eric Plakun, M.D, DLFAPA, FACPsych, medical director/CEO of the Austen Riggs Center, said that once in college, the priority question shifts to, “What will it take to let you learn what you need to in college to help you live the life you want to live?”
The IOPs offered by many campus counseling centers focus more on crisis management than recovery, said Plakun and Biel.
To date, Austen Riggs has partnered with the counseling centers of several public and private colleges and universities, among them UMass-Amherst, Williams College, and Tufts University.
The schools provide referrals of students who do not benefit from the counseling center or outpatient therapy alone. Their issues range from difficulty modulating their feelings, intense social anxiety, shame, early adversity, and trauma.
Students enrolled in school but on medical leave may still participate in the Austen Riggs IOP program if they physically reside in Massachusetts.
The program is not deemed appropriate for people experiencing active addiction problems or at risk of suicidal action.
While Austen Riggs is an out-of-network provider, it currently works with private insurance to secure coverage under their specific plans and does not balance-bill. While the full daily IOP fee is $800, the Center only accepts reimbursement provided under individuals’ insurance plans. Needs-based financial assistance is available.
The length of treatment is determined by patient objectives and clinical assessments, with the current average at three months. Family involvement only occurs with patient authorization.
Austen Riggs is collecting data through self-administered assessments that track symptoms like anxiety and depression as well as patients’ sense of belonging in groups, perception of rapport in psychotherapy, and experience of being in treatment remotely, said Plakun and Biel.
The Center will share results once it has treated a larger number of patients. It is now conducting exit interviews with patients.