People who need addiction treatment will find they have different options available to them. One of them is the outpatient program (OP). This type of program offers addiction treatment that doesn’t require an overnight stay at the center of a medical facility.
Recovering substance users who need addiction treatment but cannot commit to a longer stay in a residential facility may find a good fit in the outpatient program. A residential or inpatient arrangement typically requires clients to stay on site for at least a month or longer. The extended stay allows them to take more time to address the issues at the root of a person’s addictions and gain the skills and tools that allow them to face them in healthy ways.
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An outpatient program allows clients to live off-site while attending a rehab program. This way, they can still take care of their responsibilities, such as school and work, while going to a rehab facility, clinic, or hospital for treatment.
Who Are Outpatient Programs For?
An outpatient program, while adaptable to one’s needs, will not be for everyone. Some people will require a higher level of care that is the right one for their situation. For example, a person who is recovering from an addiction to opioid pain relievers such as oxycodone or Vicodin or an addiction to heroin, an illegal opiate drug, most likely would start care in a residential program where they live in a 24-hour monitored setting. This allows them to focus on learning how to overcome their addiction and receiving care from clinical and medical professionals along the way.
Outpatient programs generally are for people who:
- Have substance use disorders that are in the early stages
- Have had mild or less-severe addictions
- Do not need detoxification from drugs, alcohol, or other addictive substances
- Want to continue aftercare services and support upon exiting from residential/ inpatient treatment
- Cannot pay for inpatient treatment or residential treatment
- Can stay on a schedule and remain committed to sobriety while in recovery
- Benefit from a structured program and can access a network of supportive family and friends
Recovery from substance abuse and addiction does not end when one leaves treatment. In fact, it’s just beginning, and people who have decided to put addiction behind them must realistically face the probability that efforts to stay sober can last a person’s lifetime. People who have had extensive inpatient treatment can start an outpatient program to ensure their path to recovery is uninterrupted.
How Do Outpatient Programs Work?
Outpatient programs address the specific needs of the client, which vary by person. The length of the programs, as well as the level of the intensity of the therapies, offered all vary as they depend on the person.
This kind of program allows clients to schedule their treatment during the daytime or evening hours. The sessions take place in a therapeutic setting that allows them to focus on the therapies they need and receive the tools and strategies they need to address their addiction or substance use disorder.
Outpatient clients must still check into treatment at their scheduled time to receive counseling and any medications that have been prescribed to them.
Outpatient programs can include any of the following addiction therapies:
- Substance abuse education
- Cravings and triggers management
- Life skills
- Individual therapy
- Family therapy
- Group therapy
- Mental health treatment
- Cognitive Behavioral Therapy (CBT)
- 12-step programs
- Transitional living facility referrals (including sober living homes)
- Relapse prevention training
- Anger management
- Random drug testing
Outpatient programs can fall into three categories. They are:
Day Treatment Programs
Day treatment programs offered for people in recovery allow them to receive intensive rehabilitation treatment in a structured but non-clinical setting during the day before they return home in the evening. These sessions can run on a Monday through Friday schedule and be customized to meet the needs of the client.
Programs of this kind focus on helping clients achieve independence in completing everyday tasks and participating in activities of leisure. This will be particularly helpful when clients return to everyday life on their own.
Day treatment programs can include educational groups, counseling for individuals and families, recreational activities that promote team building, 12-step education, and relapse prevention planning.
Intensive Outpatient Programs
Clients who enter intensive outpatient programs (IOP) clients may attend five three-hour intensive therapy sessions a week. This can go on for anywhere from a month to three months. Once they reach preset milestones, the weekly session requirements may be reduced. Intensive outpatient programs are regarded as just as effective as inpatient treatment for people with substance use disorders.
IOPs are ideal for people in recovery who:
- Have finished higher levels of care (detoxification, residential treatment, partial hospitalization)
- Have recently relapsed and need more time to recover from the experience
- Seek help with transitioning to full-time sober living
- May have co-occurring disorders (dual diagnosis) along with substance abuse disorder
- Require continued support of therapists, mental health professionals, peers, supportive friends, and family while receiving IOP services.
Intensive outpatient treatment focuses on relapse prevention. It is recommended that clients receive counseling between three to five times per week, but sessions can be scheduled according to your needs. Clients can choose to go to counseling or therapy between eight hours a day and three to four hours a week. The time you spend in addiction treatment depends on the type of program you are in and how severe your addiction is.
Whether it is an outpatient program or an intensive outpatient program, these kinds of therapies work only if the person can remain abstinent and successfully navigate living on their own while doing so. If not, inpatient or residential rehab that starts with a drug or alcohol detox is likely a better arrangement.
Continuing care, also known as aftercare, is what happens after one leaves inpatient or residential treatment. This is the point in recovery where clients will have to seek resources that can help them stay focused on their recovery goals. There are different options that can be adjusted to their comfort level.
Some people join continuing care groups that follow the 12-step model of Alcoholics Anonymous, Narcotics Anonymous, or others. Some people may want a self-guided program such as SMART Recovery, which aims to help people recover from addictive behaviors involving drugs, alcohol, and addicting activities, such as gambling.
Is Outpatient Treatment the Right Level of Care?
When you first enter an addiction treatment program, you’ll go through an intake and assessment process to help determine the best level of care for you. Through this process, intake coordinators may use the ASAM criteria, a list of six factors that are used to determine the right level of care for someone seeking addiction treatment.
These six dimensions were outlined by the American Society of Addiction Medicine to help people find the best treatment for their needs. The criteria are designed to identify biological, psychological, and social needs that you might have as you enter treatment. The six dimensions of the ASAM criteria include:
If you enter treatment high or if you’ve just recently quit, you may go through withdrawal that requires medical treatment.
If you have medical needs because of a condition or a potential complication, medical treatment may be necessary, especially if you are also going through withdrawal.
If you have emotional, behavioral, or cognitive needs, they should be addressed in treatment.
Not everyone enters treatment ready to take on their substance use issues. Some people go on court orders or to satisfy loved ones. However, there are therapies specifically designed to prepare you to make a change in your life toward sobriety.
If you don’t have a firm relapse prevention strategy, or if you’re likely to relapse, you may need higher levels of care.
Where you are living during your recovery is a significant factor. If you have nowhere to live or if you live with people who still use, that may need to be addressed in treatment.
Someone ready for outpatient treatment will have relatively low-level needs when it comes to each of these factors. You would ideally have no high-level physical or psychological needs that require medical or clinical care for significant amounts of time each week. You will have a relapse prevention plan to help keep you from relapse. And you will be ready to live on your own in a safe recovery environment. In some cases, people in outpatient treatment will live in sober living houses, while others live completely independently.
When is Outpatient not Right for You?
Outpatient treatment is designed for people who have already gone through higher levels of care, or who otherwise have low-level needs. If you have recently stopped using a drug after developing a moderate to severe substance use disorder, outpatient treatment might be dangerous.
If you are going through withdrawal, it would be better if you had access to 24-hour medical monitoring, especially if you have just stopped using drugs with potentially life-threatening withdrawal symptoms like alcohol.
Likewise, if you have a medical or psychological need that would put you at risk of harm or relapse to live independently, something like residential or inpatient treatment might be better for you. If you are still addressing deep issues and working through relapse prevention strategies with your therapist, you may need more intensive care, even if you are ready to live on your own. In that case, you may go through intensive outpatient treatment.
Is an Outpatient Program for You?
Outpatient programs require a great deal of commitment and discipline from the client. Before considering this kind of treatment, take an honest assessment of your needs to see if an outpatient arrangement is something you should consider. Think about if you will be able to maintain your independence and attend sessions that can last anywhere from six to nine hours a week or 20-plus hours a week. Programs that are low-to-moderate in intensity may require treatment sessions that run once or twice a week.
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Outpatient treatment does not offer 24-hour care like inpatient and residential programs, so clients will have to manage their own distractions as they work toward healing from addiction.
Outpatient participants also are completely responsible for keeping their environment free of addictive substances, such as drugs, alcohol, and harming influences that can jeopardize their recovery plans. They also must remain aware of potential temptations and triggers that can bring relapse.
While outpatient treatment can take place at a center, hospital, or another kind of facility, it’s probably best to find one that is close to where you work and live. Living and/or working close by will make going to scheduled treatment sessions easier.
As you consider outpatient treatment, ask yourself these questions to get an idea of whether this is the right setting for you.
- Have I completed the detoxification process? Have I attained the stability to start my treatment?
- Am I able to manage everyday chores, take my prescribed medications on my own, and take care of responsibilities on my own?
If you answered “yes” to these questions, then outpatient rehab may be OK for you.
You can also ask:
- Did I previously enter outpatient treatment? Did I relapse after completing it? Did I feel like it was an effective setting for my situation?
- Do I need a restrictive setting with more structure, an intense focus on recovery, and few distractions?
If you answered “yes” to these questions, then an inpatient or residential rehab setting, such as the one offered at Arete Recovery, could be a better fit for your needs.
Addiction is a chronic brain disease that is treatable but not curable in many cases. The National Institute on Drug Abuse (NIDA) reports that at least 90 days, or three months of treatment, is ideal for people seeking recovery from substance abuse.
However, each person’s recovery rate depends on several individual factors. As NIDA explains, “Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length.”
American Society of Addiction Medicine. (n.d.). What is the ASAM Criteria? Retrieved from https://www.asam.org/resources/the-asam-criteria/about
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
National Institute on Drug Abuse. “How Long Does Drug Addiction Treatment Usually Last?” Retrieved April 11, 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
Polcin, D. L., & Henderson, D. M. (2008, June). A clean and sober place to live: Philosophy, structure, and purported therapeutic factors in sober living houses. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556949/
SMART Recovery (n.d). “Introduction to SMART Recovery.” Retrieved April 11, 2018 from https://www.smartrecovery.org/intro/
American Society of Addiction Medicine. (n.d.). What is the ASAM Criteria? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
SMART Recovery (n.d). “Introduction to SMART Recovery.” Retrieved April 11, 2018 from https://www.smartrecovery.org/intro/