When caught in the cycle of substance abuse, an intensive outpatient program can provide help to those who do not have the means for a residential program, but require more structure than a typical outpatient program.
What is an Intensive Outpatient Program (IOP)?
An intensive outpatient program, or IOP, is a treatment program that is used for substance abuse and addiction problems. It is an immersive program wherein the patient lives at home, but is required to visit a facility to attend various services, such as:
- Case management
- Individual and group counseling
- Specialized addiction therapies
- Classes and workshops
- Job training
The intensity of the treatment program is designed to work alongside the early stages of sobriety, which is considered the most crucial period of recovery. An IOP program can be the first step after physical detoxification of drugs or alcohol is complete and may be the next step down from a residential facility for those who are at a high risk of relapse. High risk patients are those who have experienced addiction to heavy drugs (heroin or oxycontin), those with long-term addiction issues, or those who lack a support network to help them through recovery.
The length of time one spends at an intensive outpatient program varies and depends upon the individual's needs. The American Society of Addiction Medicine has set the minimum requirement of nine hours of therapy each week to qualify as an IOP. Because of this, many facilities use a standard three days per week, consisting of three hours each time, in which the patient must attend some type of therapeutic counseling. The National Institute on Drug Abuse recommends a minimum of 90 days for this type of program to be effective for long-term recovery.
Many people utilize IOP for financial reasons or have a lifestyle that may require a flexible schedule. These programs allow a patient to schedule therapy, classes or workshops around work, school or other personal commitments, and the cost is less than a residential facility.
Intensive outpatient programs are also beneficial for people with a co-occurring disorder, which is when the addiction is accompanied by other mental health issues such as bipolar disorder or depression. In an IOP setting, the longer time spent gives therapists a better chance to uncover other mental health issues and can help them find therapies or counseling for that as well as addiction services.
How Does IOP Help with Addiction?
Before beginning an IOP for addiction, a patient is assessed so that an addiction specialist or a case manager can organize an individual program unique to them. Mental and physical health are evaluated to determine any underlying health problems or co-occurring issues. This helps the patient and their family have confidence that their program will be the right one for them.
Patients are then scheduled in a structured program of therapy and counseling sessions. The time involved is more than a typical Outpatient Program, which helps the addict stay focused on their recovery. They spend more time being proactive in their healing, which instills confidence that they can carry into the world..
These programs typically provide the patient with behavioral, psychological and social support. With the help of individual therapy, patients can uncover reasons why they may have an addiction disorder, and then learn new behaviors to resist or avoid relapse.
Other therapies may be utilized during an IOP. Through group therapy, the patient receives social support of others who are also experiencing addiction. Classes may be held to teach how their Substance Use Disorder (SUD) may be damaging to the body and brain chemistry, or one may attend workshops for job training. Immersion in these types of sessions keeps the patient moving forward in their healing, leading to a better chance for long-term success.
Different Types of Therapies Involved with an IOP
- Individual Counseling is often the focus of most substance abuse programs. This is private, individual counseling with a licensed therapist that will help uncover challenges the patient is experiencing. The style used in this treatment is talk therapy (also called psychotherapy) and is crucial to uncover co-occurring issues, as well as treating addiction issues. The therapist can help the patient understand their actions and behaviors and guide them throughout their recovery.
- Case Management may be a regular part of an IOP. In this case, the patient may have an opportunity to work with a central case manager who can adjust the program as their needs evolve. This can help the patient stick to goals.
- Group Therapy may be utilized and will vary according to the individual. Within group therapy exists numerous specialized therapies that may address different stages of recovery, such as self-help during the recovery process or relapse prevention. Group therapy is an important stage of healing that allows the individual to realize they are not alone in experiencing addiction.
- 12-Step Programs are a type of group therapy, but are often run without a licensed counselor or therapist. It is centered around the attendees and allows them to share successes and challenges. During these programs, people can share stories of how they stay on their path of recovery and avoid relapse.
- Cognitive Behavioral Therapy is a traditional and proven method of therapy used in addiction treatment and recovery. Through these sessions a patient can identify negative or false thoughts that lead to self-destructive behavior, like substance abuse. Once identified, the patient learns how to adjust their thinking to help create more positive behaviors and outcomes.
- Dialectical Behavioral Therapy is also an evidence-based therapy that is often used in addiction treatment. The term, “dialectic” refers to two opposite ideas and thus promotes two goals for patients, change and acceptance. This therapy helps the patient identify specific goals to help create a healthier and happier life.
- Family Therapy may be used in an IOP for substance abuse. According to the National Council on Alcoholism and Drug Dependence, addiction is a family disease, causing stress for every family member. But family therapy can help identify harmful patterns that may inhibit recovery, while at the same time help the family understand the process of healing. Studies show that when families get involved, the patient has a better chance at long lasting recovery.
FAQ about Intensive Outpatient Programs
Who is Eligible?
While each Intensive Outpatient Program is individualized according to a patient's needs, an assessment is often required by most facilities to qualify for enrollment. These types of programs are designed for people with substance abuse issues and co-occurring disorders that may accompany addiction.
Does IOP include physical detox?
Intensive outpatient programs for substance abuse often do not include detox. Physical detoxification is the first step to recovery from substance or alcohol abuse, and may be risky. Some of the side effects of withdrawal during the detox process may include seizures or coma. Because of the risk, is it often recommended that patients stay at a hospital or clinic during this stage of recovery. Individual requirements for physical detoxification can be determined by an addiction professional who can recommend the right course of action for treatment. Once successful detoxification has taken place, the IOP can begin.
What Do I Do in IOP?
After an individual has made a commitment to an intensive outpatient program, they will be given a schedule of sessions or appointments they must agree to adhere to. A professional addiction therapist or case manager might recommend the patient attend sessions three or more days a week, and may include a mixture of services tailored to the needs of the patient. Some of these may include:
- Individual Counseling
- Group Therapy
- 12-Step Programs
- Meditation Classes
- Stress Management Classes or Workshops
- Anger Management Classes
- Relapse Prevention
- Family Education or Therapy
Is a 12-Step Program Required?
This depends on the services offered by the IOP and the individual’s needs. A case manager can help make this determination, as not everyone may be suited for a group session like a 12-Step. In some cases, a patient may not start out using a 12-Step, but then decide to go as their recovery evolves.
How Long does an IOP Last?
While 90 days is the recommended amount of time to complete an intensive outpatient program, the true length will depend on the individual. Some may feel more comfortable with a longer time period, while reducing their time in a “step down” pattern until they feel confident to live without the services of the program. Long-term addictions may require six months or more for complete and confident recovery.
Getting Help for Addiction
Realizing one needs help for an addiction, and then actually asking for it, is a difficult thing for many people to do. Addiction is often accompanied by shame or denial, as many have become “accidentally” addicted, but never realized it until it was too late. Once a decision for recovery is made, people can check their health insurance for what type of treatment is covered, or ask their physician for a referral to an addiction specialist.
Once a treatment plan is decided on, physical detoxification should take place. If the addiction is mild, the patient may detox at home. If it is more severe, such as long term or heavy use, then the patient should stay in a residential type of program to safely detox under medical supervision. After detox, long-term healing can begin.
At this point, a patient will know if they will require inpatient treatment, an outpatient program or an IOP. An addiction specialist can help find the appropriate therapies and guide the patient through their recovery. If the patient has a support network that includes family, they may be encouraged to recruit family members for help or support.
Substance abuse can ruin lives. Seeking help is difficult, but necessary, and recovery is always possible. An intensive outpatient program for substance abuse can help fill the gap between residential treatment and a traditional outpatient program. It is structured and aggressive, but comes with more freedom and accountability, which can greatly increase the chance of long-term, successful recovery.