This group of papers is from the Erikson Institute for Education and Research of the Austen Riggs Center. The clinical setting is a small, completely open spectrum of psychiatric treatment programs for treatment-resistant patients on Main Street in the small Berkshire town of Stockbridge, Massachusetts. Erik Erikson was attentive to context; he felt the individual could not be fully understood without attention to the ways in which he or she is embedded in the biopsychosocial, historical, and cultural surround. Treatment, too, is inevitably embedded in a larger setting and we cannot fully grasp its processes without attention to its context. Riggs has developed a treatment context to facilitate patients' capacities to bring themselves fully to their psychotherapy.

Riggs's patients are those with multiple DSM diagnoses whose treatment elsewhere has often become crisis management. They come to the center after being unable to benefit from short-term hospitalizations, medication trials, locked units with seclusion, and a panoply of treatments in other