People who have completed a medically monitored detox and possibly spent time in a residential rehabilitation center may find that the intensive outpatient program (IOP) is the next step for them. IOPs also may appeal to people who need an aftercare program after completing an inpatient program. Intensive outpatient programs are viewed as just as effective as inpatient treatment for people who are working to overcome problems of substance use and abuse and alcohol and drug addiction.
Intensive outpatient programs for substance abuse are an attractive option for clients who need flexibility as they plan their substance abuse treatment plans. This means they can schedule treatment around their job and personal obligations by finding a treatment center that is near where they live.
IOP treatment is ideal for people who have maintained sound physical and mental health, are at low risk of having a relapse, and are comfortable participating in group sessions and in group settings. Before intensive outpatient treatment (IOT) is recommended for a client, a healthcare professional conducts a clinical or medical assessment to determine a person’s eligibility. If it is found that IOP care is appropriate, then a treatment program is tailored to fit the specific needs of the individual and treatment starts.
IOPs offer clients intensive therapies that promote sobriety and strategies to maintain it. Generally, required counseling or therapy sessions can be scheduled for three to five times a week for three hours per session. People in this program can meet with a therapist for individual, one-on-one sessions, to discuss maladaptive behaviors or behaviors that don’t allow a person to adjust well to certain situations. Or, they can participate in group therapy sessions where they cover issues with their peers who are going through similar experiences.
Groups may be kept small to maintain a safe and intimate environment. Groups can ideally have anywhere from six people or as many as 12 people. The group therapy setting offers participants the benefit of establishing ties with a supportive network of people who can encourage them on their path in a safe and nurturing environment. Once clients reach milestones they have set, the weekly session requirements may be reduced.
Several factors affect the IOP timeline, including how severe the substance abuse or addiction is. IOP treatment can last one month to about 90 days or three months. Clients meet anywhere from three times a week to up to six times a week. Sessions can last from a half hour (30 minutes) to an hour and a half (90 minutes).
During intense therapy sessions, clients spend a lot of time reflecting on the causes and reasons for their addiction(s) and what they need to do to stay on the path to meet their recovery goals. They also focus on healthy coping and life skills with psychotherapies, such as behavioral therapy, which addresses a range of conditions and disorders, and motivational therapy, which guides clients in recovery toward finding the motivation to make decisions that benefit their lives.
Intensive outpatient services, depending on the facility where they are offered, also may include:
Family counseling, marriage counseling:
Addiction is a family disease. Counseling services allow families to come together to address how substance addiction has affected them and figure out together how to move forward for a better life. Rebuilding relationships tested by the hardships of addiction is a key part of this process.
Relapse prevention planning
Relapse is a likely possibility in addiction treatment. It is not a personal failure or a moral weakness. It is an indication that treatment needs to be reinstated or adjusted or that another treatment is needed, according to the National Institute on Drug Abuse (NIDA). In relapse prevention planning, clients learn how to recognize the early warning signs that can lead to the return of substance use/abuse and what to do to stop a relapse or address it quickly if it occurs.
12-Step Facilitation Therapy
This structured therapy supports clients who wish to abstain from addictive substances with the help of a self-help group that is focused on sober living. Clients may take 12 to 15 sessions that are built on core principles of 12-step fellowships like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), among others. Twelve-step meetings allow participants to reflect on their past experiences openly and honestly with growth as a main focus and goal.
This ensures clients are taking medications that help facilitate their recovery as directed. These medicines may be issued to help manage physical symptoms of withdrawal or help clients abstain from substance use if they are needed. Generally, clients in intensive outpatient treatment have achieved medical stability to the point where they are able to take medications and monitor use on their own, but having additional support is a bonus.
If someone is unable to maintain their sobriety while in intensive outpatient treatment care, a medical professional may recommend that the level needs to be increased. This means they may need to head back to a medically monitored detox or return to residential treatment, which is a more restrictive environment, or partial hospitalization treatment.
IOP clients may have to take random drug tests to ensure they are on track and committed to achieving stability and sobriety. It is up to the individual program to decide if a person will be discharged from the program if they are unable to pass the drug test. If the client is allowed to remain, the person may be referred to a higher level of care that is suitable for their needs at that time.
Partial hospitalization programs (PHPs) and intensive outpatient programs are forms of care that do require an overnight stay or long-term stay in a residential rehabilitation center. In some cases, PHP can serve as a form of intensive outpatient care, but they generally differ in the time commitment involved. Some PHPs run for several hours for a good part of the day. Programs can start early in the morning and end sometime in the afternoon. Or they can last a typical work shift, such as 9 a.m. to 5 p.m. IOPs can be shorter than PHPs and may last a few hours during a couple of days a week.
Costs of intensive outpatient treatment depend on a few factors, and all should be considered before a decision is made. Among them are the client’s specific needs and what the person plans to accomplish while receiving recovery services. IOP treatment costs also depend on the facility where the person is receiving treatment and how much the facility bills for its services.
Health insurance providers also cover costs differently, which definitely affects what the final bill will be. Some will cover all or a portion of the costs while others will require that a deductible is paid before coverage starts. Some estimates put intensive patient program costs at $3,000 and $10,000 for 30 days, or one month, of treatment.
Each person’s recovery experience is unique and what works for one person might not work for someone else. That’s why it is important that a person’s needs are assessed and taken into account when it’s time to customize a personal treatment plan. As with anything, the results of intensive outpatient treatment are up to the person. According to the NIDA, good outcomes are contingent on adequate treatment length. While there is no predetermined length of treatment, NIDA recommends that a person complete at least 90 days of treatment; participation that is less than 90 days is of limited effectiveness.
Flow Psychology. (2017). Maladaptive Behavior Examples. from https://flowpsychology.com/maladaptive-behavior-examples
Drugs, Brains, and Behavior: The Science of Addiction. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research-Based Guide. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment