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 infrequent and limited 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 and psychotherapy had waned. Professor Ruffalo is interested in understanding the sociological, economic, and scientific forces that led to this conceptual shift and its major impact on psychiatric practice. He lectures on the history of psychiatry to residents at the University of South Florida and Centerstone Hospital.

In addition to the history of psychiatry, Professor Ruffalo teaches courses on psychodynamic psychotherapy, human behavior in the social environment, and psychopathology. He developed and implemented a new 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 psychiatric medicalization and the social construction of mental illness, topics which are of additional primary interest. Professor Ruffalo also serves 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.