You might be familiar with the two main segments of rehab for mental health and substance abuse. One is inpatient treatment, the type of therapy that calls for you to live onsite at a recovery center for a time — a chance to commit to sobriety and healing.
Outpatient treatment occupies the other end of the spectrum; a recovery path that appeals to many people, allowing you to take full advantage of getting help without the need to be away from your daily obligations. In fact, studies show that outpatient treatment can prove more successful than a residential program, particularly in some instances of alcohol use disorder.
Yet there are times when neither one serves those needs. The former’s round-the-clock, 24/7 may be more than needed for less severe conditions, but the latter’s lack of structure and frequency may not be enough to manage symptoms, avoid relapse or simply stay engaged in therapy.
Another called an Intensive Outpatient Program (IOP) is one of two transitional types of treatments that seeks to find a middle ground between inpatient and outpatient. What goes into an IOP, and is it right for you or someone you care for?
What Is an Intensive Outpatient Program?
An IOP is a type of outpatient treatment that blends the rigorous, comprehensive parts of inpatient therapy with the flexibility of standard outpatient. Offered by rehab centers to help treat alcohol and drug addictions and mental health conditions, it’s a best-of-both-worlds type of recovery that, like a residential program, sees you attend therapy for several hours a day, most days of the week. But as an outpatient treatment, you have the chance to return home every night.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), IOPs serve several functions:
- As an entry point into substance abuse or mental healthcare
- As a primary treatment for substance use or mental health disorders; however, SAMHSA notes that an IOP is most effective as part of a comprehensive continuum of care.
- As a “step-down” plan after finishing a residential/inpatient program or a Partial Hospitalization Program, or PHP (another type of alternative outpatient treatment)
- As a more intensive “step-up” if outpatient treatment hasn’t been sufficient
What To Expect During IOP
In an IOP program, therapy sessions are largely held in the daytime hours, where you’ll leave at the end of the day, although some programs offer evening IOP sessions to accommodate busy schedules.
Here’s what a day in IOP might look like:
Mornings begin with arriving at the intensive outpatient rehab center. There, the day begins with a check-in among other peers joining you in recovery, where you can share challenges and successes with your therapist. This is a highly valuable part of the day, particularly on a Monday, since it’s a chance to talk about the past weekend’s experiences. How did you handle cravings? Was coping with anxiety triggers difficult?
Communal lunch bridges the morning into the early afternoon, where you might be in a mix of individual or group therapy according to your individualized treatment plan, exploring topics like managing cravings, navigating difficult emotions and rebuilding healthy relationships. Later in the day makes room for holistic or experiential therapy, skill-building workshops or psychoeducation.
By the late day, IOP participants conclude with a final meeting before departing for the day. It’s a chance to rejoin family and loved ones, reflect on the day and apply what you’ve learned.
IOP Addiction Treatment Services
Intensive outpatient care is designed to be as robust and all-encompassing as an inpatient program, only with the outpatient option of leaving at the day’s end. According to SAMHSA, most intensive outpatient addiction treatment includes several services, like:
- Case management from a dedicated case manager, your advocate from the start of intensive outpatient drug treatment to finish; they’ll keep you on track for the duration and connect you with resources once your IOP concludes
- Round-the-clock crisis services to address issues that might arise when you’re home, outside of IOP treatment hours, like psychological distress or suicidal thoughts
- Medication-assisted treatment (MAT), the prescribing of certain medications to ease substance withdrawal, minimize cravings and help with emotional symptoms
- Drug and alcohol monitoring/testing to keep you accountable for staying sober
- Psychoeducation sessions work in tandem with therapy to explore the science of addiction and mental illness, so you have better understanding and clarity when going into therapy
- Transportation and childcare services are also provided when needed
IOP Therapy Services
Across that continuum, from inpatient to outpatient and in between, intensive outpatient counseling is a valuable rehab gold standard that gives you the ability to make tangible changes in your life:
- Individual therapy comprises private, one-on-one sessions with a counselor, therapist or psychologist, in a safe, confidential space, to explore the root causes of an addiction or mental illness. By talking through your story and challenges, you can begin to understand the “why” behind your issues and work to resolve them.
- Group counseling sees you sit with other people in recovery, share your experiences, relate to each other, show support, engage in discussion and develop new perspectives.
- Family therapy is an opportunity for the entire family to come together and work to strengthen and heal relationships that have been affected by substance abuse or mental health issues · Research-based therapies like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) or eye movement desensitization and reprocessing therapy (EMDR) work to resolve and reconcile thoughts, emotions and behaviors — and reframe them more positively — while addressing issues like depression, anxiety, trauma or chronic substance abuse
- Holistic therapy like yoga, meditation, expressive arts and more work to heal your mind, body and spirit in unison
Dual Diagnosis Treatment In IOP
Addiction can often go hand-in-hand with a mental health condition — and vice versa — and exacerbate the symptoms of both. This is what’s known as a co-occurring disorder, which affects more than 21.5 million adults in the U.S. It’s not well known which might come first, but in many cases, a problem like depression can compel someone to binge drink, turning into an alcohol use disorder that also prompts the development of worsened depression or anxiety.
When the symptoms of a co-occurring disorder overlap, it requires a dual diagnosis, where both conditions are treated simultaneously rather than separately. One of the critical components in this process is psychiatric medication management. Your therapist and care team can determine if drugs are needed to help stabilize your mood and assuage symptoms to make the work you do in intensive outpatient rehab easier.
When Does Someone Need an Intensive Outpatient Program?
Two of the biggest barriers to healthcare, according to the Mayo Clinic, are not knowing how to navigate the system when searching for care as well as stigma surrounding mental health and substance abuse.
So how do you know if inpatient, outpatient or a step-up/step-down program is appropriate? IOP might be the right choice if:
- You’re independent enough to manage symptoms and cravings in evenings and on weekends and don’t need the 24/7 structure of a residential program
- Outpatient therapy might not be enough, especially if you have a more severe addiction or mental health condition that requires more rigorous, day-long support
- Intensive outpatient substance abuse treatment may also be ideal if you live in a safe, stable home environment that encourages and bolsters your recovery attempts when you return in the evening from treatment
Is IOP the Right Program for Me or My Loved One?
If the above bullet points resonate with you, dig a little deeper. An intensive outpatient drug treatment or intensive outpatient alcohol treatment program might be the right fit if you or your loved one can answer “yes” to these questions:
- Are you currently in treatment and segueing out of a residential or PHP program needing the same type of support but with some semblance of autonomy?
- Likewise, are you in outpatient but find that sessions aren’t frequent or structured enough, and you’re feeling tempted to relapse?
- Is your living situation substance-free, supportive, safe and free of toxicity?
- Are you motivated enough to attend therapy several days a week but also juggle work, school and home responsibilities? Do you want to stay involved in both and give them equal priority?
Speaking to a Loved One About Intensive Outpatient Treatment
It can be difficult to know exactly when to broach the subject of pursuing intensive outpatient substance abuse treatment with someone you care about. Many times, someone hiding an addiction might make themselves unapproachable. And that can leave just small windows of opportunity that can compel someone to ambush or confront them, pushing them away further.
The first thing to do is find a quiet, private moment when you can gain their undivided attention. Bring up the topic compassionately, not confrontationally. Bring focus to your concern for their well-being. Take accountability by using “I” statements.
For example, “I’ve been worried about you lately. Is everything OK?” Defensiveness or denial is a common reaction, whether it’s face-to-face or in the context of an intervention. Bring reassurance to the table. “It’s OK; I’m not angry at you. I want to help and support you. Would you consider trying rehab? I know of a good center that offers treatment — and I was hoping we might look into it together.”
Taking this gentler approach frames the conversation around loving kindness and support and empowers them to take an active role in their recovery.
What Happens After IOP?
After graduating to an intensive outpatient care after a residential stay, the most natural progression is to move onto other types of treatment that expand your freedom and independence in recovery:
Outpatient Treatment
The next logical step after intensive outpatient drug treatment or intensive outpatient substance abuse treatment is often standard outpatient rehab. This is what most people think of for the word outpatient, where you attend therapy during the day and go home at night. But how does outpatient differ from an IOP? Treatment is less frequent — no more than once or twice a week with your therapist — and there’s less supervised oversight in outpatient’s structure. It’s a phase
of treatment where you can be confident and trusting in yourself that you’re armed with the skills to cope with triggers or avoid relapsing as you live your life outside of therapy sessions.
Aftercare and Sober Living
There’s a misconception that you’re left to your own devices after treatment, from inpatient through to outpatient, ends. And that couldn’t be further from the truth. Aftercare is the process of continuing care, where your therapist to case manager and support staff remain onboard as resources once you become an Aliya alumnus. That means being connected with community support groups like 12-Step meetings and other organizations that lend to your recovery. And if you need added support before living independently again, your case manager can arrange contact with substance-free sober-living and transitional homes.
FAQ About Intensive Outpatient Treatment
The main differentiator of the two is the living arrangement. In a residential program, you promise to live at a rehab facility 24/7 for constant supervision. It’s a promise you must make to yourself as a pledge to get well before moving onto other types of treatment. By the time you move onto intensive outpatient care, treatment remains exactly as the inpatient therapy you’re familiar with, but you can live at home, where you’re in charge of coming and going from the rehab center.
Likewise, the differences between IOP and outpatient lie in the intensity of treatment. IOP treatment is built at the same level of focused, intensive therapy and programming as traditional residential rehab, but it’s similarity to outpatient is in the flexibility It affords — namely, that you don’t need to overlook or forfeit your family, personal or professional needs.
On its own or as part of a larger treatment plan, IOP treatment is invaluable because it offers the structure and format of inpatient rehab while encouraging you to practice the skills you’ve learned in therapy as soon as you go back to engage with your daily life at the end of each day.
“IOP programs provide opportunities to practice recovery skills in real time,” says SAMHSA. “Because treatment occurs locally, patients can apply newly acquired skills with family and friends, and in other circumstances while still engaged in treatment. By practicing these recovery strategies, patients can build self-confidence — a key attribute in making behavioral changes.”
An assessment starts the intensive outpatient addiction treatment process, whether you’ve entered it as a first-line treatment or stepping down from an inpatient program. It’s meant to gauge and meet you where you are, and how IOP treatment can meet your recovery goals. Once your treatment plan is mapped out, you’ll begin therapy as early as the next day without missing a beat.
The duration of an IOP can vary from person to person, since everyone’s needs and treatment trajectory can vary. On average, expect a 2-to-3-month period in intensive outpatient treatment for the full breadth and effectiveness of therapy.
During the approximately eight to 12 weeks of IOP treatment, expect to attend therapy about three to four days per week, three to four hours per day. In cases of more severe mental health or substance use disorders that need greater care and attention, therapy may extend to five days a week.
Intensive outpatient rehab doesn’t require you to live onsite, so room and board are not included. But during the hours you’re in treatment through the day, breakfast, snacks and lunch are served, and therapy is held in comfortable, private and safe surroundings.
Aftercare is provided in all levels of care through Aliya rehab facilities. If your treatment plan only calls for a period of IOP treatment, you’ll have access to aftercare benefits immediately afterwards. But the same aftercare — from 12-Step meetings, continuing individual/group counseling with your therapist or sober living opportunities — are available after completing any type of treatment.
To make the most of recovery from a substance use or mental health disorder and keep up your recovery momentum, you’ll ideally move on to a lower level of outpatient treatment after a period of intensive outpatient care. However, you have the chance to continue IOP treatment or resume inpatient care if you still need more intensive treatment.
Transitional housing and sober living are an option for anyone exiting our intensive outpatient addiction treatment and looking for a substance-free place to live before reclaiming their independence after a period in rehab. As you approach the end of your treatment, express interest in a sober living arrangement with your counselor and case manager, who can set the wheels in motion and work with you on finding the best place to set your recovery in motion.
What Are the Benefits of an Intensive Outpatient Program?
IOPs offer a balance not found in many other treatment plans — a combination of structure and freedom that, first and foremost, can serve you well in many ways:
- Flexibility: IOP treatment is comprehensive like a residential program, but once the day is over, it shifts gears into that of an outpatient program, where you can maintain commitments to work, school, family and the like.
- Immediate real-world practice: Since you leave treatment everyday back into your daily routine, you can apply the skills you learn in therapy to real-life situations.
- Cost-effectiveness: Intensive outpatient counseling is an investment in yourself and your well-being. And it’s a more affordable financial move than inpatient care because it doesn’t include 24/7 residential costs.
- Proven effective: SAMHSA cites studies noting that IOP programs are linked to improved long-term abstinence rates, fewer hospitalizations, reduced occurrences of symptoms and decreased usage of drugs, alcohol and illicit substances.
How Much Does Intensive Outpatient Treatment Cost?
SAMHSA also notes that proper intensive outpatient rehab not only produces treatment outcomes similar to residential therapy, but at nearly half the price. While the total cost of an intensive outpatient program can vary according to the rehab facility and your own individualizes treatment can vary, estimates show that the estimated cost (out of pocket, excluding insurance) can range from about $250 to $600 per day and from $2,000 up to $10,000 for an entire month.
Does Insurance Cover IOP? Yes, most private, state and federal insurance plans — including Medicare and Medicaid — as well as services for Native Americans and their families [including Indian Health Services (IHS)] provide coverage for intensive outpatient substance abuse treatment. Reaching out to our admissions team can help you quickly and easily verify your benefits to give you a clear understanding of your coverage.
Can I Go to IOP Without Insurance?
Yes, but cost should never be a barrier to getting treatment. If you choose to pay out of pocket or have a remaining obligation after an insurance claim, Aliya offers self-pay options. We can work with you to develop a payment plan that works within your budget and financial means.
Intensive Outpatient Program at Aliya Native Americans
In essence, Aliya’s intensive outpatient program used methods that are proven to work. We promise you that by entering treatment, you can put yourself on the path to recovery, where we’re here to see you follow through to a life you deserve free of substance abuse and with better physical, emotional and mental health.
We specifically designed our program to be a safe and supportive place for Native American families, where our staff is trained to understand and honor your individual needs with cultural respect and reverence.
Intensive Outpatient Treatment Near Me
If you or someone you care about is ready to take the next step in recovery, our team is here to help. We can answer your questions about treatment programs, verify your insurance and guide you through the admissions process. Contact us today to learn more about Aliya’s intensive outpatient program.