There are two significant differences between inpatient and outpatient addiction treatment centers. What is important to know is that while one may be beneficial for one person, it may not be for someone else. There are many variables as to why this is a reality, but it doesn’t take away from the fact that an individual, given their circumstances, can find success in either setting. An inpatient or residential program will require a client to enter a specialized facility to stay only on site during their treatment.
During an intensive outpatient program, the individual will attend sessions, meetings, workshops and can go back home after a successful day. Outpatient programs range from intensive outpatient programs (IOPs) to less structured generalized outpatient models. IOP shares many similarities with a residential program in that it is more formal and intense, but the primary difference is that the client can return home each night. It also allows the person to practice their newly acquired tools in an environment outside of the safety net treatment offers.
An intensive outpatient program is sometimes the first line of treatment that is a step up from a less structured outpatient program when more support and therapeutic oversight is needed, or it’s a step down from a residential program if a certain amount of progress has been made that allows for greater chances of success in the continuum of care. If drugs and/or alcohol remain in the client’s system, it is recommended that they attend medical detoxification before entering anIOP to adequately remove the drugs or alcohol from their system.
The primary goal of intensive outpatient programs is to establish psychosocial supports and facilitate relapse management and coping strategies. These are ambulatory services for individuals who do not meet diagnostic criteria for residential or inpatient substance abuse treatment, or for those who are discharged from 24-hour care in an inpatient treatment facility and continue to need more support than weekly or bi-weekly sessions that are provided in traditional outpatient care.
IOP is designed to start as more intensive and continually become less intense over time as the client responds to treatment.
Below, we will examine the length of time one can expect to stay in an intensive outpatient program. While there is not a magic number that determines how long someone will remain in treatment, there is a generalized timeframe one can expect to stay in treatment.
IOP services offer a minimum of nine hours of service per week in three sessions lasting three hours, but some programs provide more sessions per week or more extended sessions per day.
As mentioned earlier, the program steadily decreases in intensity over time. However, because services are provided in outpatient settings, the duration could be longer than that required for inpatient services. IOPs allow clients to remain in their own homes and communities, which helps a great deal when adjusting to community life.
The National Institute on Drug Abuse (NIDA) notes that good outcomes are contingent upon adequate treatment length and that participation for fewer than 90 days limits effectiveness for treatment. Treatment dropout is a serious problem that is encountered by treatment programs, and those with more freedom sometimes may feel a stronger urge to use drugs.
If they decide to hang out with that old friend or get a phone call from their dealer, the urges may be so great that they feel they can’t resist. This is why more time spent in intensive treatment can be beneficial for the client long-term. Clinicians will measure progress and decrease the intensity as they see fit.
Intensive outpatient programs can last anywhere from between 12 to 16 weeks before the clients are ready to begin decreasing their level of care. A typical session lasts around 90 minutes, although longer and shorter time frames are available. One session can be dedicated to back-to-back group work when the clients who are members of the same recovery stage can share their thoughts or concerns.
In another course, a client will study psychoeducational topics that involve 30-minute lectures, and be offered an additional 15 minutes for questions. Another evening can consist of between 30 to 60 minutes of individual counseling, a 90-minute family therapy session, or 60 minutes of training to learn a new skill.
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A set of core services is vital to all intensive outpatient programs and must be a standard part of the treatment package. Therapists will participate in the creation of a daily schedule to offer direction to ensure that it features important aspects beneficial to recovery. Therapists can help clients identify things they do each day that will contribute to their well-being as well as sobriety. The schedule must be structured to avoid gaps because too much free time can contribute to thinking about substance use and serve as a trigger for relapse.
A typical portion of your time spent in IOP will be dedicated to therapy. You will receive services primarily through group therapy, but there are also individual therapists that you will meet with weekly. The groups are small and typically do not exceed 10 clients, which allow for a safer and more tranquil environment.
An example of a daily schedule in IOP looks like:
9:30 AM-10 AM: Group therapy
10 AM-11 AM: Educational group therapy
11 AM-Noon: Experimental group therapy
Noon-1 PM: Lunch
1 PM-2 PM: Triggers, cravings, and relapse preventions
2 PM-4 PM: Stress and emotional well-being
4 PM: Session concluded
Keep in mind that this is a sample schedule. It is subject to change based on the clinicians or staff or level of the clients care. This is meant more as a generalized view of what could be expected when entering into IOP.
As a client in a facility, there will be rules expected to follow. The standards were created to promote a safe and therapeutic environment for all of the clients. The client must treat the staff with dignity and respect.
The use of alcohol, drugs, or unauthorized medications is strictly prohibited. A physician must prescribe any medications that are brought into treatment and registered into the medical records. There is no alcoholic beverages or mind-altering substances allowed.
Sexual activity or any intimate physical contact is not allowed between clients or guests on the premises. Relationships with other clients are discouraged, and any social contact that occurs outside of the facility can be reported to your counselor which could result in discharge from the program.
Safety searches are performed on every client, and a staff member will inspect any items brought into the building. The client must leave any sharp or dangerous objects at home.
Clients are also expected to follow a dress code. They can dress casual and comfortable, but all clothes must fit properly. Shirts cannot be transparent or worn open. Short and tight-fitting clothing will not be allowed, and women must wear a bra at all times. Proper footwear is required, and overalls must be worn with an undershirt. Sunglasses or hats are not allowed inside the building, and clothes cannot contain pictures or words that reference drugs, alcohol, or sex.
National Institute on Drug Abuse. (n.d.). How long does drug addiction treatment usually last? 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