Recovery in an Intensive Outpatient Program 

Everyone experiences addiction differently. Even once the initial detoxification period from substances is over, a tailored treatment plan is necessary to manage any lingering symptoms in addition to the many facets contributing to the addiction.

Intensive Outpatient Programs provide a specialized type of addiction recovery program with the benefit of more structure and a more intense level of care than traditional outpatient programs. Though they may be more involved, IOPs still allow people to carry on with their normal work and family lives. IOPs can follow after medically-assisted detox, serve as an after plan following an inpatient program, or be a primary form of care. In this article, you’ll learn:

• What is an IOP program?
• How Does IOP treatment work?
• Who may benefit from IOP?
• What can I expect from an IOP?

What Is Intensive Outpatient Program?

IOPs are an attractive option for many people experiencing a substance use disorder because it allows them the ability to attend school, work, or familial obligations while still receiving evidence-based treatment. Some people use IOP as a first-line form of care, while others transition into therapy following detoxification or discharge from an inpatient treatment center. The goal of IOP is to build or expand upon coping mechanisms in an effect to reduce risk of relapse.

How Does IOP Differ From Other Programs?

IOP is a unique form of treatment ideal for individuals that require a high level of care and structure, while still having the flexibility to attend other obligations. The biggest difference between and inpatient treatment setting and IOP is that a person receiving IOP has the option of leaving the treatment facility once each session is over.

Inpatient programs typically last 30,60, or 90 days. As such, they can represent a significant commitment, which may serve as a barrier to treatment for people that have other responsibilities. On the other hand, Intensive Outpatient Programs allow each participant to schedule therapy when it is most convenient for them. While individual schedules vary, IOP programs typically involve three days a week of treatment, with sessions lasting 2-4 hours each day.

Intensive Outpatient Programs provide very similar services as those available in an inpatient setting, such as individual, family, and group sessions. Research shows that they are also similarly effective. IOP should be considered as an alternative to inpatient or residential treatment when leaving family or work obligations is not an option.

What Does an Intensive Outpatient Program Look Like?

Intensive Outpatient Treatment Programs offer many of the same services as other treatment programs. They are, however, typically more structured and involved than other outpatient programs. Often, programs involve a combination of group and individual therapy in order for participants to understand the many factors contributing to their substance use disorder, while developing a support network and coping skills that help identify triggers and prevent relapse.

When you begin an IOP treatment program, you will first meet your treatment team. Using a series of evaluations, your health history, and other metrics, they will work with you and decide on a treatment plan that works with your schedule and needs. IOP services use a combination of services focused on coping, enhancing life quality, and relapse prevention.

Types of IOP Treatment 

The following are some of the most common types of therapy you’ll find in an Intensive Outpatient Programs:

Group Counseling

Group therapy settings are an essential aspect of any IOP program. They work to develop communication skills, offer social support, create and enforce a sense of structure, and reinforce sober behaviors. Group therapy can vary in its approach, but generally tackles some of the most important parts of the recovery process, such as stress management, development of healthy coping mechanisms, enhancing life skills, addiction education, and more.

Individual Therapy

Though individual therapy is not the main focus of an IOP, each program typically involves some one-on-one type with an addiction therapist. In these sessions, therapists can help identify maladaptive behaviors and work with the participant to find healthier alternatives in order to support a long term recovery.

Family Therapy

As an aspect of IOP, family therapy sessions help each family unit understand how a substance use disorder affects dynamics and helps heal relationships between the person experiencing substance abuse and their immediate family members.

Detoxification

In some cases, IOPs can include detoxification for those who need assistance weaning off a substance in the initial stages. Keep in mind, however, that this only applies to those who are not vulnerable to dangerous or life-threatening withdrawal symptoms. Some IOPs may refer to medically-assisted detox programs before enrolling you in their program.

Medication Management

Some intensive outpatient treatment programs offer medication assisted treatment as part of a holistic addiction treatment program. MAT is an evidence-based method for reducing cravings, blocking the desirable effects of substances, and supporting a long term recovery.

IOPs also manage medications for co-occurring mental health disorders. Substance Use Disorders often accompany other diagnoses such as anxiety, depression, and PTSD. Effective treatment of co-occurring mental health disorders can help address all factors contributing to a disorder.

Finally, medication management may also include alternative pain treatment plans for those experiencing an Opioid Use Disorder (OUD). Often, OUD begins with a valid prescription for pain medication, due to a medical condition causing discomfort. When a person stops using opioids, it is essential to treat their pain effectively in order to prevent relapse.

Evidence-Based Interventions

No matter what kind of substance use disorder you or a loved one has, all intensive outpatient programs involve evidence-based interventions. A SUD involving a stimulant, for example, may rely on the Matrix Model, in which a therapist acts as a coach and teacher, creating an environment that creates a sense of self-efficacy and high regard. Other programs you may encounter include Cognitive Behavioral Therapy (CBT), trauma-informed care, and the chronic care model.

Frequently Asked Questions About IOPs

It’s natural to feel hesitant about entering treatment. The more information each individual has about the treatment options available, the better suited they are to make the choice to seek help. Here are some things that potential participants and their families should know about intensive outpatient programs.

What Activities Can I Expect in an Intensive Outpatient Program?

The basic tenets of an IOP include group therapy, medication management, individual therapy, family therapy, detox, and interventions rooted in evidence-based methods. It can be helpful to know what to expect from an IOP on a daily basis. Some of the activities you or a loved one might encounter when participating in an IOP include:

• Treatment for Post-Acute Withdrawal Syndrome, or PAWS. This syndrome involves the psychological and emotional cravings associated with an addiction, which persist long after the physical dependence. In an IOP, you’ll learn to identify the symptoms of PAWS and develop healthy coping mechanisms for cravings.
• Relapse Prevention Skills shops. As you progress through treatment, you will be able to consistently identify triggers for relapse, which may include work stress, social networks, and more. You’ll learn what to do when a craving occurs and what steps you can take to reduce triggers in your life.
• Addiction Education. Substance Use Disorder affect brain chemistry, laying the groundwork for an addiction. It is helpful to understand the physiological, emotional, and psychological aspects that make up an addiction. Participants will learn that addiction is NOT a moral failing, but a combination of biological and environmental factors.
• Enrollment in supportive services such as employment counseling. A substance use disorder can affect several aspects of an individual’s life, and it may be difficult for you or a loved one to get back on their feet. IOPs can include life skills training that allow participants to reenter the workforce or independent living situations.

Who Benefits From Intensive Outpatient Programs?

IOPs are specifically designed for people that experience a high level of disruption to their daily lives associated with substance abuse and/or co-occurring mental health disorders. It is also ideal for someone who may benefit from an inpatient or residential treatment setting, but does not want to experience that disruption to their daily lives. Often, IOPs are presented as an option when an individual perceives inpatient therapy as a barrier to getting help.

An individual may request eligibility for an IOP during the intake process. Each person who elects to receive Substance Use Disorder/addiction treatment completes mandatory medical and clinical assessments as a part of admissions. From there, clinicians and therapists can determine if an individual is a good fit for an IOP or would benefit from some other form of treatment.

How Long Do IOPs Last?

The length of an IOP depends on the facility and individual patient needs. Typically, you can expect and IOP to last around 8 weeks, but more treatment may be required depending on the needs of the individual.

What Does Family Therapy Look Like?

Research shows that when a family is involved in treatment, they are more likely to experience a long-term recovery and are less likely to experience relapse. As such, many IOPs work to involve families in the process. Family education programs help explore relationship dynamics, but also to provide education pertaining to the physiology and psychology of addiction.

Myths About IOP

Several misconceptions about recovery, and IOP and particular, still persist and may keep people from treatment:

• Treatment is too much of a time commitment. IOPs are outpatient and allow you to fulfill your work and familial obligations.
• I cannot afford treatment. Many recovery centers accept insurance and some work on sliding scale structures. Still others accept benefits such as Medicare and Medicaid.
• Group therapy doesn’t provide me with the help I need. Research shows that group therapy can help improve self-efficacy and is effective in preventing relapse.

Intensive outpatient programs are a good “middle ground” option for those who do not want to go into residential treatment, but need more structure than other outpatient programs. With a robust body of evidence supporting their success, it can be a good option for supporting a long term recovery.