Intensive outpatient programs (IOPs) are treatment programs used to address addictions, depression, eating disorders, or other dependencies that do not require detoxification or round-the-clock supervision. They enable patients to continue with their normal, day-to-day lives in a way that residential treatment programs do not. Whereas residential treatment requires that clients reside on site, clients in intensive outpatient programs live at home.
IOPs are sometimes used in conjunction with inpatient programs as a way of helping clients to more smoothly and seamlessly adapt back into their families and communities. They are designed to establish support mechanisms, help with relapse management, and provide coping strategies.
IOPs are an important aspect of care for people seeking help in overcoming addiction. For many people, inpatient care – whether in a hospital, clinic, rehab, or other facility – can be challenging. These live-in treatment options often provide the highest level of care, separating people with addictions from access to the drugs or alcohol they abuse and from other people who may encourage relapse or actively sabotage recovery efforts; however, they aren’t always feasible. People often have family or work commitments that prevent them from entering fulltime care. They simply can’t leave their lives behind for an extended period of time.
For these people, IOPs are often the best choice. They still get intensive treatment but they are able to reside at home.
Ideal candidates for intensive outpatient treatment have a safe home environment. This means encouraging family members and friends who are ready to support their loved one in their recovery efforts. If a person lives with other people who use drugs or drink, residential treatment is generally recommended to get the person away from these triggers for relapse.
IOPs are generally not recommended for those with severe cases of addiction or co-occurring disorders. Generally, these cases are referred to inpatient treatment since they require more immersive treatment and 24-hour supervision.
There are several stages of treatment for issues with addiction. The American Society of Addiction Medicine has defined five levels of treatment as part of a “continuum of care.”
IOP is considered Level 2 treatment.
The care received via an intensive outpatient program will vary from facility to facility and from provider to provider, but it generally consists of 10-12 hours of group and individual therapy each week, plus encouraged participation in a 12-step program. These sessions usually occur on site at a medical or therapeutic facility, but some options are being developed for individuals to participate in online programs. This can be especially useful for people who live in remote locations or in towns where adequate treatment services simply aren’t available.
Clients in IOPs usually visit a facility three to four times per week, often for three hours at a time. Again, the specifics will vary from program to program, but according to the Substance Abuse and Mental Health Services Administration (SAMHSA), most programs require 9 to 20 hours of participation per week. An IOP provides a higher level of care than standard outpatient programs, and this means more time spent in treatment each week.
Group therapy tends to serve as the core of most IOPs. Some studies show group participation is as effective as individual therapy in treating addiction.
Participation in a group offers support for clients in a variety of ways.
The group sessions in which clients participate are of varying types in order to address a range of treatments and skills required for successful recovery from addiction.
IOPs may include a variety of different groups.
Sometimes groups will be specialized, focused on a single type of client, such as men or women, LGBTQ individuals, veterans, or sexual abuse survivors. Groups generally contain between 8 and 15 members, per SAMHSA, though private IOPs often feature smaller groups, allowing a more individual focus.
Those seeking treatment from IOPs will also usually have access to individual therapy as well. While this is important, it is not usually the primary form of treatment, according to SAMHSA.
Individual therapy focuses on the pressing problems caused by clients’ substance abuse and their efforts to remain abstinent. In individual therapy sessions, clients often dig deeper into the work done in group therapy, allowing them to spend more time on individual issues. Some individuals don’t feel comfortable talking in a group setting so individual therapy gives them the space to talk about more personal matters.
Individual therapy sessions are part of most IOPs and will usually be scheduled on at least a weekly basis, if not more often, especially early in treatment. Each client is assigned a therapist who will endeavor to establish a close, honest relationship based on mutual trust and commitment to recovery.
Many IOPs offer alternative therapies to complement their traditional offerings. Treatments such as art therapy, music therapy, adventure therapy, or equine-assisted therapy may be offered. These treatments allow clients to tap into nonverbal ways of healing. Therapists that are trained in the particular treatment lead these sessions, and they often take place in a group setting.
Most IOPs recommend that clients participate in peer support groups like Alcoholics Anonymous or Narcotics Anonymous. In fact, many intensive outpatient programs host meetings on their premises, making it easy for clients to join when they are there for their treatment sessions.
These 12-step groups provide a structure for recovery that serves individuals well as they exit formal treatment. Meetings are held around the world at various times, allowing people to easily fit them into their schedule.
The National Institute on Drug Abuse outlines what individuals should look for in any treatment program. If you’re searching for an intensive outpatient program, take the time to ensure that the center you choose meets the following requirements: