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Intensive Outpatient Care 101

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Medically Reviewed By: Diana Vo, LMFT

November 28, 2023

Table of Contents

If you’ve successfully completed residential treatment for addiction to drink or drugs, this is not the end of your journey, but rather the beginning of a lifelong process. The process of recovery starts with residential treatment and ends with intensive outpatient care. Addiction is a disease, and it’s a chronic and relapsing disease. While there is no cure for addiction, it can be successfully treated.  An  IOP (intensive outpatient program) to help transition back into day-to-day life. With residential or inpatient rehab, you’ll follow a program for 30 to 45 days in a designated rehab facility. Following medically-supervised detox and withdrawal from drink or drugs, you’ll then take full advantage of both individual therapy and group therapy alongside a variety of appropriate support meetings. Addiction can be treated, but there is unfortunately a similar rate of relapse to that of many other chronic diseases. To address this issue of relapse head-on, an IOP can be rolled out as part of the continuum of care.

Intensive Outpatient Care Programs: What Are They and Who Are They Aimed At?

Healthcare providers typically recommend IOPs for one of two purposes: For patients with a mild addiction not calling for medically-supervised detox For patients who need the support of ongoing recovery services once discharged from residential rehab Intensive outpatient program centers are effective for addiction to drink and drugs. Among those dependent on alcohol or addicted to drugs in America, SAMHSA (Substance Abuse and Mental Health Services Administration) estimates that 8 million have a co-occurring disorder. This means they have an underlying mental health condition presenting simultaneously to substance use disorder or alcohol use disorder. With an IOP, you’ll be able to get help addressing both of these issues. This will maximize your chance of a successful recovery. Although intensive outpatient programs are not residential, decent programs will offer some form of crisis service out-of-hours. You’ll often find 24/7 hotlines available in these centers. Family members are encouraged to get involved when their loved one is undergoing an IOP. With a healthy and supportive atmosphere in place at home, some patients find intensive outpatient programs provide the support they need without prohibitive restrictions like remaining at the facility for up to a month. Understandably, not everyone is able to take a month out. So, now you have an understanding of what an IOP is, what are the main goals of intensive outpatient programs after residential rehab?

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Intensive Outpatient Care Programs: Main Goals

Residential rehab is essential for some patients with severe addictions or unstable home environments. Inpatient treatment can also be extremely effective. Leaving a treatment center and its sheltered, caring environment can be risky if you don’t have the right follow-up care in place. Outpatient programs allow the recovering alcoholic or addict to build a strong foundation for sustained recovery while in a familiar environment with the requisite support on hand. Some of the goals of IOP include:

  • Abstaining from drink or drugs
  • Making behavioral changes
  • Improving your problem-solving skills
  • Addressing issues with employment, housing, or probation
  • Assembling an appropriate, reliable support network
  • Attending 12-step programs or SMART Recovery groups

Now, we’ll look at how these goals are typically achieved during IOP, but first, how long do these programs last? 

How Long Do Intensive Outpatient Programs Usually Last?

The National Institute on Drug Abuse (NIDA) recommends that an outpatient program should last for at least 90 days. If you’re seeking treatment for heroin addiction and you need methadone maintenance treatment, programs of up to 12 months are considered the minimum. What can you expect to unfold if you commit to an intensive outpatient program, then?

IOP: Schedule

You can expect a detailed assessment before any treatment begins. This allows treatment to be personalized. While the individualized nature of an IOP means there is no one-size-fits-all schedule, it will be expected that you conform to the schedule that’s arranged. Treatment normally takes place for 6 to 30 hours a week. Many variables impact the number of hours you’ll need to commit to, in particular the type and severity of addiction. The hours and the timing of these sessions will also vary due to the intrinsic flexibility of these programs. Treatment is typically delivered in blocks of 3 to 4 hours on weekdays. Each session is around 90 minutes long. Often, sessions are held back-to-back. Since the nature of an IOP is to allow flexibility for the recovering addict to start normalizing their situation, the hours and timing of sessions vary. Generally, group work consists of patients at approximately the same stage of recovery.

IOP: Core Components

Now, IOP can sometimes be offered as a first line form of treating addiction. Intensive outpatient drug rehabilitation services can also be used to step down from residential rehab, or as a step up from a less rigidly-structured outpatient program.   Wherever you enter an IOP on the continuum of care, you can expect the following services according to the SAMHSA Treatment Improvement Protocols:  

  • Behavioral therapy
  • Case management
  • Close monitoring of use of alcohols or drugs
  • Exposure to educational opportunities
  • Group counseling
  • Individual counseling
  • Medical treatment
  • Mental health treatment
  • Pharmacological tools
  • Support group meetings
  • Training in core life skills
  • 24-hour crisis management

  Beyond this, you can also expect to find a number of other elements from nutritional and fitness programs through to family and childcare programs. Addiction tends to shatter lives. An effective intensive outpatient program can help you to rebuild that life systematically while normalizing some of the chaos that comes hand-in-glove with addiction to drink or drugs. After undergoing therapy and counseling sessions, you’ll learn new skills, and you’ll practice implementing them. You should also brush up on your communication skills which will improve your relationships. In group sessions, you can gain strength and support from others going through the same experience. Since you return home after a day at an IOP, this makes it easier for you to implement what you have learned. When action follows theory, there’s more chances of the learned behaviors sticking and becoming habitual, slowly helping you to replace poor habits with healthier ones. So, these are the areas common to all IOPs. What specific therapies can you expect beyond general individual and group counseling, then? 

Therapies Used in IOPs

Research indicates that no one type of therapy is more suited than others to intensive outpatient programs.  Instead, treatment centers employ many different theoretical approaches to IOP. Here are some of the most common modalities on offer: 

  • Cognitive Behavioral Therapy: CBT is grounded on the concept that all behaviors and thoughts are learned. This includes self-destructive behaviors like drinking or abusing drugs. Patients use CBT to identify triggers for such negative behaviors. They will also develop superior coping skills to help minimize the chance of relapse.
  • Motivational Interviewing: Motivational interviewing can be effective if patients have been previously unwilling to engage in addiction treatment. A therapist can sometimes help dismantle this resistance. The patient will take full responsibility for their actions. They will make an inventory of the harmful consequences of drinking or using drugs. This type of therapy can help pave the way toward more productive and healthy behaviors.
  • 12-Step Programs: Many intensive outpatient programs teach the fundamental principles of 12-step programs. Often, patients are encouraged to attend local 12-step meetings outside the treatment center. Sometimes, groups like NA and AA will hold meetings on-site at treatment centers to improve access and attendance.
  • Therapeutic Community: This type of therapy points to the whole community as a therapeutic agent. Mindfulness and absolute honesty are encouraged and the road to recovery is viewed as developmental. The only certainty is change, according to this model.
  • Matrix Model: The matrix model combines elements of different therapies. This approach works best for addiction to stimulants like cocaine. The core focus is on relapse prevention, time management, and community support groups.

There are many other forms of therapy, and you’ll also find a combination of styles. All that counts is finding the right treatment for you. 

Do You Undergo Drug Tests in an IOP

Now, if you’re planning on undergoing an intensive outpatient program, you’ll need to be prepared for random drug tests. The goal of these tests is not to catch patients out. Instead, the object is to guarantee a drug-free environment where you can safely focus on your recovery while simultaneously learning to follow rules. Renaissance Recovery is one of the most effective outpatient programs in Orange County making it one of the best choices for drug rehab treatment. In the event of a positive drug test, the client is typically stepped up the continuum of care.

IOP vs Residential Rehab

The primary difference between residential rehab and an IOP is the fact you live at the treatment facility with residential programs, and return home at night when following an IOP. Many IOPs don’t offer any services like medical care or recreation. A residential treatment program is much more expensive than an IOP. You also need to devote much more time to residential rehab, and you’ll need to be away from your family. This can, of course, be beneficial if your family environment is not conducive to recovery. Both programs are broadly similar in terms of overall structure. Once you have completed a residential rehab program, it’s commonplace to step down to an IOP to continue with your fledgling recovery. To recap, then, the core benefit of residential treatment is the highly structure environment and distance from the normal triggers to relapse. The main advantage of an intensive outpatient program is the more flexible and streamlined reintegration into the home and community it allows for.

The Role of Family in IOPs

Family plays a central role in an intensive outpatient program. IOPs work most effectively when there is a solid and stable support system in place. The atmosphere should be encouraging of recovery and not enabling of destructive behaviors. There are many family education programs to help family members access the information they need and to develop the skills required to help their loved one negotiate the early steps on the road to recovery without succumbing to relapse. Family members can also benefit from support if they are finding the process hard themselves.

Are Intensive Outpatient Programs Effective?

In 2014, the American Psychological Association published a meta-analysis of many studies assessing the effectiveness of IOPs. According to most of these studies, anywhere from 50% to 70% of clients remained abstinent at the point of initial follow-up after successful completion of the program. This rate is roughly similar to that experienced after residential treatment. The increased duration of IOPs and the way you can more easily get back into the swing of family life are the other primary benefits. Establishing precise success rates is problematic, but it’s clear that intensive outpatient programs can be highly effective, particularly when used to follow up residential treatment. IOPs can be successfully used to treat all types of addiction.

What Comes Next After An IOP?

What happens when you get to the end of an intensive outpatient program, though? Well, upon completion of the program, you’ll meet with your therapist. You first need to determine whether you have achieved all the goals of the IOP. If so, your therapist will usually recommend that you step down to a less intensive level of care. This could be a continuation of the IOP but with less frequent sessions, or you may be able to engage in virtual sessions. You might step down from the IOP and continue attending local 12-step meetings. Sometimes, your therapist might use a combination of the above approaches. When personalized, an IOP has more chance of yielding a successful and ongoing recovery. When you leave the structure of an IOP, it’s time to take full advantage of community resources like family therapy, training, and ongoing medical care. Ultimately, the most crucial component of an IOP is the understanding that recovery needs ongoing work. You are not cured of addiction, but you have moved one step further along the journey to ongoing recovery. Keep up those 12-step meetings, draw on the support of your family, and if you need any assistance at all, call the friendly Renaissance Recovery team today at 888.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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