Outpatient Treatment

Drug abuse is a complex issue. It often requires specific types of treatment. One of the most well-known treatments for addiction is outpatient treatment.

Within outpatient treatment there are two subcategories. One is Intensive Outpatient Treatment, or IOP. The other is Partial Hospitalization Program or PHP. IOP recovery options are best for those who require treatment but are unable to enroll in a facility full-time because of employment, education or familial commitments. Those enrolling in IOP receive treatment 3 hours a day, three days a week on average.

PHP is more intensive than IOP. Those taking part in partial hospitalization programs are usually receiving treatment 6 hours a day, 5 days a week.

According to the National Center for Biotechnology Information, intensive outpatient services or IOP services should be flexible for each specific client group.

Outpatient Treatment, a Viable Solution in Desperate Times

According to the Substance Abuse and Mental Health Services Administration, more people become addicted to substances than actually get clean from substances every year. While an ideal scenario for some would be enrolling in an inpatient facility that is not an option for everyone.  Certain factors can prevent a lot of people (the majority actually) from being able to avail themselves of inpatient treatment.  Perhaps they cannot afford the cost of residential care.  They might not be able to take the time off of work and they may have families to support.  Their health insurance might not cover a stay at a residential facility.  Whatever the reason, residential treatment is not always feasible, necessitating a backup plan through outpatient rehab.

Outpatient treatment is very specific in the services it offers, though even the best authorities on the subject agree that outpatient treatment should never be used as a substitute for inpatient treatment unless absolutely necessary.  In fact, though the National Institute on Drug Abuse applauds outpatient recovery centers for their positive impact to society, they also say that outpatient rehab programs should be a necessity-only alternative to inpatient treatment.  According to the National Institute on Drug Abuse:

“Outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education.”

Outpatient treatment centers offer a variety of services to their clients.  The mainstay of their programs is usually group counseling, but these programs very often offer one-on-one therapy services in tandem with group sessions.  Many outpatient facilities will carry further licensing to allow them to treat medical or psychological traumas and difficulties in addition to drug abuse and alcoholism.

Outpatient treatment centers usually offer their services on an open schedule, allowing for clients to hold jobs, manage families, attend school, etc. while also attending treatment.  Most outpatient centers require twenty to thirty visits over the course of one to three months to qualify for completion of the program.  Each visit lasts for one to three hours and visits are done usually one to four times a week, depending on the program.  There is a lot of variety in outpatient recovery routes, which allows prospective clients to pick the program that will serve their needs best.

Intensive Outpatient, A Gradient Above

People who struggle with addiction sometimes attempt an outpatient program but cannot stay away from their substance while in treatment.  This offers little in the form of safety or security for their clients, as the clients are still free to roam the town and score substances during the times when they are not attending treatment at the outpatient facility.  This of course is the main stumbling block of outpatient centers.  They simply cannot provide the safety, security, and forced abstinence from substances that an inpatient center can.  This leads directly to lower success rates than inpatient centers offer.

To try to find a comfortable middle ground, Intensive Outpatient Programs (IOP) were created in the early part of the 21st century to attempt to combine the positive traits of both outpatient and inpatient treatments.  An Intensive Outpatient Program (also IOT) offers a treatment approach with group sessions as its backbone.  The group sessions are well varied, very unique, multifaceted, and truly original, but the structure is essentially the same for each modality.  The National Center for Biotechnology Information, U.S. National Library of Medicine did their own research on addiction treatment as pertains to IOP and IOT programs, and they arrived at the conclusion that:

"Groups form the crux of most IOT programs. Several recent studies confirm that, for delivering relapse prevention training, a group approach is at least as effective as a one-on-one format (McKay et al. 1997; Schmitz et al. 1997). Group counseling allows programs to balance the cost of more expensive individual counseling services."

Intensive outpatient rehabs, while still not as fully safe and secure as inpatient rehab centers are, offer a form of help and tools for recovery that some struggling addicts can use to vanquish addiction.

Partial Hospitalization Programs, Addressing Medical and Spiritual Addiction in Tandem

Partial hospitalization programs are a form of addiction treatment that was designed for struggling addicts who could not go to residential rehab but who still needed medical care.  This is an approach for recovering addicts who require a much higher level of care than the usual outpatient program or even an intensive outpatient program can provide them with.  The schedule at a partial hospitalization program, or PHP program, would include the client spending long hours at the treatment center during the day while receiving medical monitoring and treatment care, but not staying overnight at the center.

A PHP is more intensive and time-focused than outpatient or IOP treatments are.  These treatment programs will require their clients to meet every other day or five days a week Monday through Friday, for about four to eight hours a day, depending on the center.  The purpose of the more intensive approach is to provide medical monitoring and examination of each patient, closely analyzing them during each session to ensure a safe and stable recovery.

The steps to a PHP are very similar to those of fully residential center.  Intake staff conduct a thorough evaluation of the prospective patient.  A full physical and psychological analysis is done to ascertain what types of services will be needed.  Depending on each individual’s condition upon arrival, this will determine the amount, time frame, and types of services the client will receive while in the program.  Some recovering individuals come to partial hospitalization programs as follow up care after having completed inpatient treatment, and others are fresh off the street.  This variety of the patient-base requires PHPs to be able to offer unique services and customization in their programs.

The National Institute on Drug Abuse particularly recommends PHP for adolescents who cannot go to a residential program due to an age restriction, school restrictions, or financial restraints.  NIDA states that:

Adolescents with more severe substance use disorders but who can still be safely managed in their home living environment may be referred to a higher level of care called partial hospitalization or day treatment. Patients can attend a few hours each day.

While PHP may not be as intensive or structured as inpatient rehabilitation is, it does offer an admirable alternative, especially when medical assistance is required.

Day Treatment, A Cost Effective Rehabilitation Approach

Yet another outpatient approach to addiction treatment is that of day treatment.  Day Treatment is very similar to the Partial Hospitalization Program, the primary difference being that day treatment centers do not offer the same degree of medical services that PHPs do.

Another primary difference between Day Treatment and other approaches is the time spent in treatment.  While Day Treatment does not offer a wide range of medical services like PHP does, Day Treatment is the next best thing to residential care in terms of amount of time spent in treatment.  Clients who participate in a Day Treatment program typically spend their entire day in the program, at least five days a week, and only spend their overnights at home.  Day Treatment is the closest one can get to going to a residential treatment center without actually checking into an extensive overnight stay at a rehab facility.

Day Treatment is a good choice for a small percentage of the population of addicts.  It is a good choice for a small population because the people who do well in Day Treatment programs are people who have a lot of different factors and key issues to work on but conversely can be counted on to not abuse substances outside of the Day Treatment facility, in between sessions.  Day Treatment is an approach to addiction recovery that is useful yes, but not as widely used because so few addicts can abstain from substances and still work on their issues without being in a residential organization.

Sober Living, a Look at Post-Recovery Support

Though sober living centers do offer inpatient services more often than not, sober living institutes fall under the same category of outpatient programs because they are, “Ancillary, continuing care facilities. Sober living programs are only entered into after an individual has overcome addiction through inpatient or outpatient means.  The purpose of sober living is to provide a safe and supportive community for recovering individuals to transition into after completing treatment at a qualified rehab.

The reason why sober living facilities are in such abundance is because life after rehab is perhaps the hardest experience a recovering individual will experience.  In fact, some believe that life after rehab is even tougher than life before rehab, just in a different way.

When a person gets out of rehab, they are immediately thrown back into the real world, and all the demands and constraints of day to day living that they had left behind while in rehab come back in full force.  Stress comes back.  Obligations and responsibilities come back.  Old environments may loom back up once again, and negative, toxic people may come to call shortly after.  Old stresses and trigger mechanisms may emerge, and day to day life often feels like a battle to just stay sober.  Tools and therapy techniques plus knowledge gained from rehab will help, but it is often not enough and people frequently relapse.

According to the National Institute on Drug Abuse in a joined survey study with the Substance Abuse and Mental Health Services Administration, roughly half of all recovering individuals who seek some form of addiction recovery will relapse at some point in their lives, most of whom will relapse within one year of completing treatment.  Engaging in sober living is a decisive effort towards preventing that from occurring.

The National Center for Biotechnology Information, U.S. National Library of Medicine performed an extensive study and research project on the purported value of sober living.  They came out with conclusions that this approach far exceeded previously-thought levels of value.  Their summary was:

"Lack of a stable, alcohol and drug free living environment can be a serious obstacle to sustained abstinence. Destructive living environments can derail recovery for even highly motivated individuals. Sober living houses (SLHs) are alcohol and drug free living environments for individuals attempting to abstain from alcohol and drugs."

While not a substitute for actual treatment, sober living centers offer an exemplary service to individuals fresh out of rehab who need support and further assistance in their monumental transition back into day to day living.

The Value of Outpatient Treatment

The value of outpatient addiction treatment is very clear to see.  Outpatient treatment provides an avenue for recovery that hundreds of thousands of struggling addicts avail themselves of every year.  Outpatient care creates safety and peace of mind for recovering individuals, giving them support and a place to learn the tools and gain the knowledge they need to walk away from drugs and alcohol for life.  To service a wider population of struggling addicts, outpatient therapies also come in different styles and approaches, designed to provide the exact care that individuals need.

  • Straight outpatient counseling and group support gives clients a way to find themselves and to find their mission in life, a recovery that is stable and unshakable.
  • Intensive outpatient delivers similar services as outpatient programs, only more extensive and involved.  More time is spent, more subjects are covered, and more avenues are taken to provide the kind of care needed to give recovering addicts control over their lives once again.
  • Partial hospitalization presents an invaluable service to clients who need medical and physical assistance but who are not able to enter into and through a residential recovery program or detox.  Partial hospitalization helps clients immensely to find their own path in life and to expand on that path to the best of their abilities after healing them physically
  • Day treatment provides clients with a recovery process that is as close to an inpatient stay at a residential center without actually involving overnight stays.  Day treatment centers are an excellent recourse for mothers of young children who have to be home at night, for individuals who have a physical disability that prevents them from staying at a residential center, or for individuals who simply cannot fund a stay at a residential program.
  • Sober living.  So important that it could be considered mandatory, sober living should follow any recovery program to ensure that recovered clients can stay clean for life.  Sober living centers give recovering individuals the tools they need to stay clean for life, no matter what kind of hardships they may end up facing.  Sober living centers create a very helpful environment that is based off of support and the shared goal of attaining a lifetime of sobriety.

Residential Care vs Outpatient Rehab

Residential addiction treatment is often the recommended solution for many reasons. But, it can be impossible for some to attend this type of treatment, making outpatient a viable option. Outpatient programs help thousands of addicts’ triumph over addiction every year.  For more information call our help line today.