Intensive outpatient programs (IOPs) are one of the many options available for individuals who are seeking treatment for a substance use disorder. An intensive outpatient program allows participants to live at home and visit a facility several days each week for treatment.
This article will discuss the goals of IOP, the treatment breakdown and benefits from engaging in IOP. You will also learn about the differences between outpatient therapy, inpatient rehab and IOP.
Key Facts
This article offers key takeaways regarding IOP treatment:
- The breakdown of IOP and what happens during treatment
- Benefits of IOP
- Higher vs. lower levels of care – Comparing IOP to inpatient rehab treatment
- Finding a group that best fits your need and your background
- Payment options – Insurance coverage and options for those who are under-insured or have no insurance
- How to seek services with links to a directory to find an IOP program near you
What Is Intensive Outpatient Drug Rehab Program?
Intensive outpatient programs (IOPs) are one of the many options available for individuals who are seeking treatment for a substance use disorder. An IOP allows participants to live at home and visit a rehab facility several days each week for treatment.
This type of treatment is designed for people who do not need detox or 24/7 supervision. They may be struggling with mild to moderate addiction or are transitioning from a residential treatment program to the next step in recovery.
What Are the Goals of an Intensive Outpatient Program?
IOPs provide support, relapse prevention and coping strategies to help people step back into their lives and families while maintaining healthy sober habits.
Common goals of an intensive outpatient program include:
- Maintaining abstinence
- Learning early-stage relapse management
- Achieving behavioral change
- Developing coping strategies
- Participating in support programs and therapies
- Establishing or re-establishing support systems
- Addressing psychosocial issues such as housing, employment and meeting probation requirements.
- Emphasizes real world skill practice between sessions to speed community reintegration.
Placement on the ASAM Continuum of Care
The ASAM Continuum of Care is the most widely used and comprehensive set of standards for placement, continued service, and transfer of patients with addiction and co-occurring conditions.
There are four levels of care that range from the least intensive/lowest (Level 1), which includes standard outpatient therapy or counseling sessions, to the most intensive/highest (Level 4), which is medically managed inpatient rehab. IOP falls into Level 2 and that means it’s one of the lower levels of care.
What Happens During an Intensive Outpatient Program?
IOPs involve a variety of addiction treatments and therapies to address the challenges of addiction. Most include group, individual, 12 Step and alternative therapy methods. IOP treatment may also include medication management, vocational training and case management.
Medication Management & MAT Options
As part of an IOP, some programs offer medication assisted treatment (MAT) in addition to therapy. This can be done via telehealth or in person.
MAT uses specialized medications that reduce physical cravings for certain drugs or alcohol, making it easier for you to stay sober as you build the skills for long-term sobriety in therapy. The medications that are often prescribed include buprenorphine, methadone and naltrexone. It is important to note that you will need to do therapy alongside MAT to receive maximum benefits.
Group Therapy
Group therapy (including 12 Step groups) is a central component of most intensive outpatient programs. The goal of these sessions is to provide mutual peer support, teach participants how to socialize without the use of substances, and develop other sober life skills.
The types of groups may include:
Skills Development
Allows participants to practice specific behaviors in a safe setting
Psychoeducational
Teaches participants about addiction and techniques for problem solving
Refusal Training
Provides role-playing for participants to practice how to say no to substances
Relapse Prevention
Helps participants identify triggers and learn how to manage them
Family
Teaches participants about the effects of substance abuse on relationships and how family members can support each other
Individual Therapy
Individual therapy sessions allow participants to dig deeper into the issues covered in group therapy. The most common methods used during individual therapy include cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, the Matrix Model and 12 Step facilitation. Individual therapy typically takes place on a weekly basis but it may happen more often during early treatment.
Alternative Therapies
Individual and group therapies involve a lot of verbal communication and interaction. To tap into other healing methods IOPs may offer alternative therapies as well. These treatments may include adventure therapy, art therapy, equine-assisted therapy and music therapy.
Benefits of an Intensive Outpatient Program
There are multiple benefits to an IOP treatment plan, including:
- Affordability: IOPs are more affordable when compared to the price of inpatient treatment. Because participants live at home, treatment costs do not need to cover housing, meals and other amenities.
- Support: IOPs allow you to enjoy constant contact and support from loved ones. In contrast, inpatient programs may require separation from family and friends while you live at the rehab facility.
- Structure: An IOP offers a higher level of structure than traditional outpatient programs. This structure is helpful for developing healthy patterns of living in early recovery.
- Practice: IOPs offer the opportunity to practice recovery skills in real time. Participants can apply strategies in the real world that they are learning in treatment, while still engaging in the IOP.
- Flexibility: With an IOP schedule, you have the flexibility to meet and maintain daily responsibilities.
- Evidence based outcomes: IOPs can have similar benefits to inpatient rehab when it comes to abstinence rates. Although an IOP does not provide 24-hour care, it is still an intensive service that has a multitude of benefits for people dealing with addiction.
- Versatility: With IOPs, there are options to step up or down in treatment based on what’s going on with you in your recovery journey. If you need a higher level of care, you can be referred. Or if you are needing a lower level of care, your clinicians can step you down to outpatient services.
Who Is a Candidate for IOPs?
If you are interested in IOP services you need to understand that there are “ideal candidates” when it comes to who this type of treatment would best benefit. This level of care is ideal for those with a mild to moderate relapse risk and those whose sobriety is manageable without 24-hour medical oversight.
IOPs are also for those who are more independent and are able to follow their individual treatment plans in and out of treatment. If you have safe, substance free housing, reliable transportation and motivation for change you could be a good candidate.
When a Higher or Lower Level of Care May Be Safer
In some cases, someone might need a higher or lower level of care than an IOP.
If you are experiencing serious withdrawal symptoms or mental health issues like suicidality or if your addiction is severe and you aren’t confident you can stay sober without support available around the clock, then you might need to upgrade to inpatient rehab or a partial hospitalization program (PHP).
If your addiction is mild and you don’t need as many hours of treatment as an IOP involves, you may be a good fit for traditional outpatient services. Your treatment team will conduct periodic ASAM assessments to ensure you’re getting treatment at the least restrictive effective level.
Comparing Inpatient Rehab and IOPs
Inpatient treatment requires participants to live on-site. The facility provides 24/7 care while you are in treatment. Services include meals, medical care, housing, and recreation.
An intensive outpatient program allows you to live at home while you are receiving treatment. You go to the facility only during treatment times, then return home. Rather than 24/7 care, IOPs usually offer between 9 and 20 hours of treatment per week.
Comparing Outpatient Rehab and IOP
Both IOPs and outpatient care provide treatment at a facility while you live at home. However, intensive outpatient programs involve more hours of treatment each week than standard outpatient treatment.
The higher level of care from an IOP is often necessary for people with more severe substance use disorders or little support at home. Outpatient treatment, on the other hand, is appropriate for individuals with few mental health issues, a solid support system and less severe addiction.
Specialized Tracks & Populations
Dual Diagnosis (Mental Health + SUD)
If you are experiencing mental health issues in addition to a substance use disorder, you could benefit from integrated treatment for both. This typically includes methods such as cognitive behavioral therapy, dialectical behavior therapy or trauma focused therapies.
This therapy addresses mood disorders, relapse concerns and other mental health issues like anxiety and depression. In some cases, people develop a substance use disorder due to self medicating their mental health symptoms. If that’s you, consider finding a dual diagnosis program that addresses both.
Gender-Specific & LGBTQ+ Affirming Programs
These specific programs offer a safe space to process gender based stigma and discrimination, and they give you the safety and familiarity of being around people of the same gender or sexual orientation.
These programs can also provide education and discussion opportunities on topics such as reproductive health, hormones, or minority stress. These types of groups can also point you in the direction of other affirming programs with this specific population to help you feel more connected.
Teens, Young Adults & Collegiate Tracks
Teen, young adult and college programs provide a developmentally tailored and age appropriate approach to treatment. They also help address issues associated with these ages like peer pressure and academic stress.
They may emphasize family involvement, and these services can be offered in schools as well to help reach more students. Some of these programs might also give you an opportunity to give back to the community and engage in peer support for others in your age group who are dealing with similar issues.
Professionals, Veterans & First Responders
These programs are designed for those seeking treatment due to their jobs or the need to protect their professional licensure or security clearance. It also creates a confidential space to share related issues such as burnout, moral injury, PTSD and vicarious trauma with others who understand.
Some professional programs offer treatment options with others in the same field as you so you have a sense of commonality and can relate to one another.
Costs, Insurance & Payment Options
One of the most common questions people ask when researching treatment options is “how much does rehab cost?” Here’s what you can expect to pay for an IOP and some options to help cover those costs.
How much does IOP cost?
The typical private pay is around $250 to $600 per week depending on your specific services. If you are receiving treatment at a non-profit or community mental health agency you could qualify for reduced fees or grants to fund treatment.
Without insurance, the out of pocket cost for IOP treatment is between $250 and $600 per week.
Keep in mind that these prices are without health insurance. If you have insurance, the price range is different, and it’s important to speak with your provider to understand the cost that you could pay out of pocket and what insurance will cover.
Coverage Under the Affordable Care Act & Private Insurance
Due to the Affordable Care Act, you could receive treatment at little to no cost. The ACA specifies addiction treatment as an essential health benefit, which means that nearly all insurance plans must offer comparable coverage to medical care. Medicaid expansion plans also typically include IOPs with a minimal copay.
If you have insurance, your provider will collect your policy information, check the deductible and visit limits, and submit the needed clinical notes for approval.
When seeking treatment, you should ask about network status and surprise billing protections so that you know what you can expect to pay. Insurance will also check your progress notes to verify the need for treatment.
Life After IOP
The recovery journey doesn’t end after you complete an IOP. It’s important to receive ongoing support to help sustain your sobriety. This is available through a variety of programs.
Transition to Standard Outpatient, Sober Living or Aftercare
Once you complete IOP treatment you’ll step down to other services. Those can include individual therapy or connection to NA/AA and SMART Recovery meetings. Therapy sessions are often conducted on a weekly basis.
In some cases individual therapy will be monthly depending on your specific need and provider availability. You could also be connected to a sober living home that offers a substance-free living space that helps maintain accountability.
By engaging in these various aftercare services you can safely transition from treatment to daily life, without having to navigate everything on your own.
Alumni Programs & Peer Support Networks
Some programs offer alumni groups and other events to stay connected to others in recovery. These groups typically meet monthly and have socials or gatherings to celebrate your progress and your recovery in a positive way.
They also offer service opportunities in the community to build recovery skills. You could have the chance to become a peer mentor to guide others in your shoes that need a positive person in their corner.
Relapse Prevention Planning & Ongoing Monitoring
IOP programs teach you ways to prevent relapse and maintain sobriety. Some of those techniques can include craving journaling, coping skills awareness and urge surfing exercises.
They will also teach you different techniques such as HALT trigger awareness which helps teach you how to identify triggers and work through them to create a positive outcome. They’ll also teach you how to identify triggers and work through them.
Some IOPs will also offer check-ins at 30, 60 and 90 days post discharge.
Frequently Asked Questions About Intensive Outpatient Drug Rehab
An IOP typically lasts 90 days. However this timeframe could be longer, depending on each person’s unique situation. Participants usually visit the rehab facility three or four times each week. Each visit typically lasts three hours for a total of 9 to12 hours of treatment per week. Some programs require up to 20 hours of participation per week.
Most IOP treatment occurs during weekdays. Many IOPs offer day and evening programs to provide greater flexibility for participants to meet job and family responsibilities.
Yes you can attend work or school during treatment. IOP offers flexible treatment options to best fit your specific needs and schedule. Your FMLA protections with your job supports attendance. Many IOPs offer evening and weekend sessions to allow you to attend school or work while in treatment.
Most insurance will cover an IOP when it is medically necessary. It is important to check on your copay and deductible amounts so you know how much you’ll be paying out of pocket. Some insurance will put a cap on the number of visits you are allowed.
Relapses can occur during treatment and your clinician may increase your session frequency or refer you to a higher level of care such as inpatient rehab if you are at risk or have relapsed. Most clinicians understand the recovery is not linear and will try to work with you based on what is best for you.
Some locations offer virtual options for IOPs, and they can be as successful as in-person care. It is best if you have privacy and a good internet connection so there are no interruptions. Care providers in IOP also understand that attending virtually might be the only option for someone to receive treatment.
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