One of Professor Ruffalo's main interests is the history of psychiatry, particularly mid-twentieth century American psychiatry and the paradigmatic shift that occurred in the field during this time. In the 1950s and 1960s, most psychiatrists were trained as psychoanalysts and saw patients in psychotherapy with limited and judicious use of psychotropic medications. By the late 1970s, psychiatry had adopted a firmly biological persuasion, psychiatric drugs became the mainstay of treatment, and the popularity of psychoanalysis had waned. Professor Ruffalo is interested in understanding the sociological, economic, and scientific forces that led to this conceptual shift and its impact on psychiatric practice. He lectures on the history of psychiatry to residents in the psychiatry residency program at Centerstone.

In addition to the history of psychiatry, Professor Ruffalo teaches courses on psychodynamic psychotherapy, human behavior, and psychopathology. He developed an original course on basic psychopharmacology for the graduate program at the University of South Florida School of Social Work. He has lectured previously as a guest lecturer at the University of Pittsburgh on the social context of psychiatry and the conceptualization of mental illness, topics which are of additional interest. Professor Ruffalo has also served as a psychotherapy supervisor for psychiatry residents in training at the University of South Florida. He encourages psychiatry trainees to take interest in psychotherapy as a core foundational skill in the practice of clinical psychiatry.