How Do Intensive Outpatient Programs Work?
In general, there are two main types of addiction treatment: inpatient and outpatient.
With an inpatient or residential program, clients enter into a specialized facility and stay on site for the duration of the treatment. In an outpatient program, the person attends sessions, meetings, workshops, and meetings, and then goes home each night. Outpatient programs range from intensive outpatient programs (IOPs) to less structured general outpatient models. An IOP is often very similar to a residential program in its structure and intensity, with the main difference being that the individual returns home to sleep each night.
Components of Intensive Outpatient Programs
An intensive outpatient program can be the first line of treatment, a step up from a less structured outpatient program when needed, or a step down from a residential program after a certain amount of progress is made. This helps to form a seamless continuum of care. Individuals may attend a detox program before entering into an IOP when drugs or alcohol are still in the body and need to be safely processed out.
While IOPs can vary as to what is included, in general, there are several core services typically offered, according to the Substance Abuse and Mental Health Services Treatment Improvement Protocols (SAMHSA TIP). These include:
- Group and individual counseling sessions
- Behavioral therapy sessions (both individual and in a group setting)
- Monitoring of alcohol and drug use
- Case management
- Medical and mental health treatment
- Pharmacological tools
- Life skills trainings
- Educational opportunities
- Support group meetings
- Access to 24-hour crisis management
Nutritional services, fitness programs, childcare services, vocational trainings, anger management classes, family programs, and other services may also be offered as part of an IOP. Goals of an IOP include achieving and maintaining sobriety, and often, drug tests are performed to ensure compliance. Therapy and counseling sessions are used to teach new and effective ways to communicate, manage stress, improve problem-solving and coping skills, and modify negative thoughts and behaviors into more positive ones. Group sessions can provide clients with insight from others who are also struggling with addiction.
One of the benefits of an outpatient program is that individuals can try out new methods in the “real world” almost immediately as they return home each night.
Life skills are enhanced through training and educational sessions.
Treatment providers may use medications for various physical and emotional concerns, and they will help individuals manage these during the program. Support groups and 12-Step programs are often important aspects of an IOP, as they work to facilitate healthy social networks and peer connections with others with similar experiences and long-term goals.
Typical Intensive Outpatient Program
An intensive outpatient program generally works the same way that residential programs do. Clients usually go through an assessment prior to admission to give treatment providers the information needed to design a personalized treatment plan. Medical, physical, and mental health are evaluated, and co-occurring disorders can be treated in many IOPs. Treatment providers work closely with the individual and their loved ones to plan and implement a viable care plan.
With an IOP, classes, sessions, meetings, and workshops are scheduled throughout the day, and individuals are expected to adhere to the strict structure of the program. Per SAMHSA’s TIP, intensive outpatient programs generally facilitate 6-30 hours a week of programming for addiction treatment. The exact number of hours and types of sessions will vary from person to person. On average, individuals will likely attend sessions in 3-hour or 4-hour blocks 4-5 days per week. Sessions may be day sessions or night sessions, depending on what works best for the person’s schedule and what the facility can provide. The National Institute on Drug Abuse (NIDA) recommends that addiction treatment programs should last at least 90 days and stresses that remaining in treatment for a suitable amount of time greatly enhances recovery.For group therapy, individuals in an IOP program may be placed into a group “class” with others who are in a similar place in their treatment and recovery. IOP sessions typically begin with a general check-in around the group to see how everyone is doing and if anyone has anything to report. Personal stories are encouraged to be shared, and concerns are addressed. Trained professionals lead these group sessions, and after the initial discussion, they usually dive into a specific topic chosen for that particular group on that day. Topics may include methods of handling stress, coping with potential triggers, conflict management and resolution, what to expect emotionally and physically during recovery, and more. The group setting provides a supportive and encouraging environment.
An IOP will also provide individual services, and trained professionals are able to provide referrals for additional care if needed. SAMHSA reports that around 8 million people in the United States battled both addiction and a mental illness in 2014; therefore, specialized and integrated care for co-occurring disorders is needed. IOP treatment plans are often able to cater to co-occurring disorders, providing simultaneous care for both mental health concerns and addiction.Individuals in an IOP are also encouraged to attend 12-Step meetings or other community-based peer support groups in tandem with the group sessions. These meetings may be held in churches or community centers at various times of day and night to accommodate schedules, and clients are encouraged to be involved in these programs on the weekends or days off from IOP sessions. This can help to keep recovery on track as the people in these groups work to provide an empathic ear, tips for minimizing relapse, and hope.
Crisis services are available for individuals attending an IOP and often include a 24-hour hotline that individuals can call whenever the need arises. An IOP often includes family involvement in a treatment program. Education and counseling for family members are provided in order to foster a fully supportive home environment.
Benefits of an IOP
An outpatient program may be more cost-effective than a residential one, offering families a more budget-friendly option for care. Insurance may also cover outpatient services or require individuals to try outpatient care before providing coverage for a residential program.
IOPs are generally best suited to individuals who have a strong support system at home. Families and loved ones should be on board with the treatment plan, and willing and able to foster an encouraging environment that is conducive for recovery. Highly trained professionals work closely with families and individuals to make sure that the care plan continues to be beneficial throughout the entirety of an IOP, making changes to services and programming when needed.
In 2014, approximately 21.5 million Americans struggled with addiction, as published by the National Survey on Drug Use and Health (NSDUH). That’s over 8 percent of the entire population over the age of 12 in the United States, making addiction a far-reaching and relatively common disease. It is also complex and highly personal in nature, and no two treatment plans will look exactly the same. Each individual will need to seek out care that is optimal for their individual case.