April 14, 2020 PCI Centers
Many of you have probably encountered the acronym IOP when searching for treatment or checking treatment centers in your area.
We want to use this blog post to explain what IOP is. It’s an important treatment option, and how it is supposed to serve people struggling with mental illness and addiction disorders.
So what exactly is an IOP. In the simplest terms, IOP stands for Intensive Outpatient Program. When it comes to the treatment of addiction disorders, the official source of evidence-based practice is ASAM, so we work within their guidelines when it comes to addiction treatment. Intensive outpatient programs (IOPs) are specialized treatment programs for individuals seeking rehabilitation for substance use, mental health, or both (referred to as “dual diagnosis”). These programs are designed to be more intensive than traditional outpatient rehabilitation programs. However, the individual is not required to live at the treatment facility for the duration of their treatment course.
Since these programs are much more intensive, the patient receives a higher level of care from providers than they usually get in other programs. These programs also do not use detoxification as a form of treatment. IOPs are not recommended for those who have more severe levels of addictions or co-occurring disorders. Those programs are referred to as inpatient treatment, as those programs are more immersive and have 24/7 supervision.
What ASAM, or the American Society of Addiction Medicine, defined as IOP (Level 2.1) is:
“Intensive Outpatient Services for adolescents and adults. This care level typically consists of 9 or more hours of service a week for adults to treat multidimensional instability. Level 2 encompasses services capable of meeting people’s complex needs with addiction and co-occurring conditions. It is an organized outpatient service that delivers treatment services during the day, before or after work or school, in the evening, and/or on weekends.”
Generally, according to the Centers for Substance Abuse Treatment (CSAT), the goals of an IOP are as follows:
- Helping clients maintain abstinence or engage harm reduction services as needed.
- Encouraging behavioral changes as part of a new lifestyle supporting wellness.
- Encouraging participation in community-based support groups (e.g., 12-Step fellowship)
- Helping clients manage or improve psychosocial problems, such as unemployment, financial issues, lack of adaptive friendships, or family distress.
- Enhancing clients’ coping skills and ensuring consistency of skills application across a wide array of settings.
Why is IOP Important?
In our view, there are two primary reasons why IOP is an important treatment option for people struggling with both mental health concerns and/or addiction disorders.
First, many people attend more intensive (i.e., a higher level of care) facilities. They then need to “step down,” which means get a less intensive support system in place to keep their treatment momentum going effectively. Imagine, with no prior experience or knowledge, going away for 30 days to train in martial arts in artificial scenarios, only learning to fight with other novices. You’re just shoved out into the “real world” with no one further coaching you on how to fight in different real-world scenarios, with more expert opponents. Well, for many people struggling with mental illness or addiction disorders, it’s a fight, a fight for their lives, their careers, and families. Thus IOP can help people function more independently while also providing structure to learn or reinforce needed mental health skills/ideas.
Second, there are a variety of circumstances that make more intensive treatment impossible. Many people cannot afford very costly “rehabs” or residential facilities. Others cannot quit their jobs and can only afford to attend a few days per week of treatment. In those and many other, circumstances people might be best served by the IOP level of care. Many IOPs offer multiple tracks at different times of day, with experts from various disciplines.
The goal of an IOP program is to assist the individual in areas including, but not limited to:
- Mental health support—Includes therapists, as well as people certified in overall wellness (i.e., yoga instructors, nutritionists, meditation instructors)
- Improve distress tolerance and problem-solving skills
- Establish a stable support network—Includes friends, family members, and therapists
- Address psychosocial concerns, such as vocational skills or requirements related to legal matters
- Behavioral changes aligned with their goals
- For those navigating substance use disorders:
- Encourage active participation in support groups and connect with additional resources for support (i.e., 12-step groups)
- Maintaining sobriety and abstinence from all problematic substances (i.e., relapse prevention skills)
How Our IOP Might Help You
Okay, now that we know what IOP is, you’re likely at least curious about what we do. Per ASAM and CSAT, we adhere to the highest standards of care. We help people learn and practice mental health and relapse prevention skills in the real world. Family therapy to help you and your loved ones work through the recovery journey together and resolve the conflict before treatment (which there are usually many). Our career counseling specialist, whose sole focus is to help people get back to work, back into school, or develop strategies for managing current employment issues. In addition to all that, we practice evidence-based care in our psychotherapy sessions and medical consultation sessions. Check our staff page to see who our professionals are. Please let us know how we can help you, even if it’s just a phone call to discuss options.
Typical Program Format
The typical intensive outpatient program format consists of a series of meetings held during the week, either in the morning or in the evening. These programs often consist of group therapy modalities; however, individual psychotherapy and/or specialized services may also be available. In most cases, IOPs comprise 9 hours of treatment per week, usually over 3 days per week; such programs may extend for approximately 90 days and may include drug testing for individuals attending the substance use tracks.
While other services may be offered within any given treatment facility, group therapy is a focal point of IOPs. Group therapy interventions can build on and improve communication and socialization skills and relapse management simultaneously with substance abstinence and relapse management. Group formats also provide support, structure, routine, and exposure to other perspectives and experiences that are essential and effective for early recovery.
Common Treatment Interventions Used In IOPs
Many IOP treatment facilities incorporate various evidence-based treatment interventions, meaning that the treatments have been widely researched to prove their effectiveness. Expressly, interventions such as motivational interviewing (MI), cognitive-behavioral therapy (CBT), and dialectical behavioral therapy (DBT) are often incorporated as part of the treatment programming. These modalities are targeted at addressing disordered thinking patterns, bolstering one’s insight into the connection between thoughts, feelings, and behaviors, and building distress tolerance and emotional regulation skills to improve one’s psychological and interpersonal functioning.
A Typical Day
Many treatment centers will first meet with the individual to obtain comprehensive background information and inquire about medical, mental health, and substance use history. This is often referred to as a biopsychosocial intake and is intended to ensure that the providers have all the necessary information to most effectively meet the individual’s treatment needs and goals. At treatment facilities such as PCI, a typical week for an individual receiving IOP services may look like the following:
9:00 am – Attend group therapy session (e.g., meditation)
10:00 am- Attend individual psychotherapy session
11:00 am- Attend group therapy session (e.g., Cognitive Behavioral Therapy for identifying triggers)
9:00am- Attend group therapy session 1 (e.g., mindfulness techniques)
10:00am- Attend individual vocational therapy session
11:00am- Attend group therapy session 2 (e.g., Relapse prevention skills training)
5:00 pm- Attend group therapy session (e.g., Behavioral techniques)
6:00 pm- Attend group therapy session (e.g., Cognitive-behavioral interventions for mood)
7:00 pm- Family therapy session (e.g., Family members come in to join the therapy sessions)
Intensive outpatient programs (IOPs), relative to standard outpatient programs, are intended to provide treatment and rehabilitation services for individuals with more severe addictions and/or mental health issues and/or limited or insufficient support.
Determining If A Person The Right Fit For An IOP
Generally, an IOP is typically best suited for individuals who may (a) be transitioning into their everyday routines after completing an inpatient or other higher-level care program (i.e., residential treatment program), or (b) require more intensive rehabilitation if the standard outpatient treatment provisions are not sufficient enough to meet treatment needs.
For individuals who present with substance use disorders or mental health and substance use concerns, an IOP is typically ideal for an individual who is a) transitioning from a detoxification program or inpatient treatment program or b) may require more intensive rehabilitation to maintain their sobriety.
Generally, an ideal candidate for intensive outpatient rehabilitation is an individual who presents with problematic use of substances but does not require inpatient care and 24/7 supervision or medical detoxification at the time of their admission. The program is part-time, which includes partial hospitalization. This incorporates a recovery process from the days the individual is in the program, allowing them to collect their thoughts and emotions before moving forward.
What if the person has a job, family or goes to school?
IOPs can help offer support and continuity of care while actively engaged in their daily routine/life. IOPs are designed to accommodate those who hold jobs and/or go to school. It is also not uncommon for those who are unemployed to attend an intensive outpatient program, as the more intensive program structure may be needed to support optimal recovery.
The ideal candidate for IOP who is likely to achieve success in an IOP tends to have the following qualities:
- Highly committed to improving their comprehensive well-being and highly committed to sobriety (for those who are receiving treatment for substance use)
- Motivated to change and improve their health and wellness
- Amendable to alternate perspectives to support behavioral change
- Willingness to learn
- Actively engaged in all aspects of treatment program
- Willing and able to attend all sessions within the treatment course
What IOPs Are Not
IOPs are not like residential treatment programs. Those involved in an IOP will not live at the facility they are receiving care at. Therefore, no meals, housing, recreational activities, or medical care are provided. Additionally, individuals who opt to engage in care at the IOP level will not receive 24/7 monitoring or psychiatric holds. The treatments involved in IOPs are considered part-time, unlike partial hospitalization, which entails treatment for several hours a day, at times greater than 5 and 5 days per week). Since it is not an inpatient program—it is an intensive outpatient program—the individual will live at home.
For these reasons, IOPs are not recommended for individuals with more severe addictions and co-occurring disorders. For individuals with more severe addictions and co-occurring disorders, inpatient treatment should be sought.
Pros Of IOPs
One of the many reasons IOPs are ideal is that they allow the individual to live at home while engaged in treatment. Since it is not a 24/7 treatment process, the individual does not reside at a treatment center, allowing them to carry on with their regular lives while still undergoing treatment throughout the week. Additionally, an IOP program offers flexibility to accommodate the individuals’ daily routine to allow the individual to still attend to their responsibilities and activities of daily living and simultaneously receive mental health care and/or substance use rehabilitation.
Generally, IOPs are a middle ground for inpatient or residential treatment, offering the individual high-level care without the monitored supervision so that they may continue their day-to-day routines while in treatment. Along with the group therapy treatments, each person also gets individual therapy sessions. The individual also can apply their learned skills in real-world situations as they encounter triggers and other aspects of their respective unique realities. The treatment options for IOP treatment are personalized for each individual that seeks this type of treatment.
Specific to those presenting with substance use concerns, research suggests that IOPs are just as effective as inpatient treatment for individuals seeking care for alcohol and drug use disorders. Collectively, IOPs are formulated to provide the individual with the resources to foster psychosocial support, relapse management, and coping skills as they navigate their sobriety.
Regarding individuals who seek treatment for mental health symptoms, research suggests that those who engage in IOPs tend to be more likely to continue connecting with care providers to establish ongoing mental health support. In other words, IOPs have been identified as a protective factor for individuals who suffer from mental health concerns. Engagement in an IOP provides the individual with the tools, resources, and support to protect themselves from future episodes of psychiatric destabilization.
Collectively, regardless of the individuals presenting concerns, intensive outpatient levels of care have been proven to lower rates of readmission to this level of care; individuals who receive intensive outpatient care for substance use and/or mental health treatment are less likely to require readmission to intensive care treatment programs. This means that IOPs are highly effective in providing the support and resources to reduce symptoms associated with presenting concerns.
From The Perspective Of A Treatment Facility
At PCI, we provide psychological services for the treatment of mental health and addiction. We put our patients first and work collaboratively with them to tackle their toughest challenges. Our goal is to help outpatients reduce their symptoms associated with their presenting concerns and support them in acquiring the resources to establish a level of wellness aligned with their goals.
Using treatment models and interventions rooted in scientific research, PCI’s team of highly compassionate and dedicated providers goes above and beyond to address the factors that help individuals build their capacities for reflection, healthy relationships, and adaptive thinking patterns. PCI offers a variety of treatment services that are uniquely tailored for each individual to meet their treatment needs while also considering their unique identity factors that we believe are important for long-term stability and well-being.
Amid the provision of intensive outpatient care, PCI takes a wellness-oriented and interpersonal approach, which allows us to move at our patients’ pace, giving them agency and empowerment within their treatment journey. We care about who our patients are as individuals, and we do not believe that mental health or substance use disorders define a person. We are committed to ensuring that our patients feel comfortable, safe, and empowered as we work beside them to navigate their presenting concerns.
PCI offers varieties of groups that focus on specific elements of overall well-being, both within the context of mental health and/or substance use rehabilitation. PCI also offers specialized services, ranging from vocational therapy, family therapy, and individual therapy to psychological and cognitive assessments to help our patients learn more about their brain health and help our providers understand our patients’ cognitive functioning to provide the most optimally effective treatment plan.
PCI houses treatment providers who are highly skilled and specialize in areas such as trauma, LGBTQ, and ethnic minority populations, just to name a few. Our treatment team regularly collaborates to adapt our programming to meet the patients’ needs to ensure that our patients receive optimal care.
We offer a range of groups with topics such as relapse prevention, meditation, mindfulness, spirituality, wellness workshops, healthy relationships, cognitive-behavioral interventions, and many more. Overall, PCI is wholly dedicated to establishing authentic and compassionate connections with those we serve. We do whatever it takes to ensure that our facility is our patients’ last stop in their treatment journey.
Contact us today to learn more about intensive outpatient treatment or check out our website to learn about substance use, mental health, wellness, and videos and links to our blog on topics related to substance use, mental health, and resources for support.
Costa, M., Plant, R.W., Feyerharm, R., Ringer, L., Florence, C.A., & Davidson. L. (2020). Intensive outpatient treatment (IOP) of behavioral health (BH) problems: Engagement factors predicting subsequent service utilization. Psychiatric Quarterly, 91, 533–545.
Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 3. Intensive Outpatient Treatment and the Continuum of Care. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64088/