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Outpatient Treatment Centers

Treatment for an alcohol or drug problem often entails removing the client from the parts of their life that contribute to the desire to abuse illicit substances.

For some clients, they have some things that work in their favor to the point where a clean break is not necessary. Outpatient treatment centers are a way for these clients to control and manage their addictive impulses while still being a part of the outside world.

What is Outpatient Rehab?

Outpatient rehab is a form of alcohol or drug rehabilitation in which patients visit an addiction treatment center, hospital, mental health clinic, or behavioral counselor on a regular basis during specific days of the week. Outpatient programs usually include some forms of individual and group counseling and are most suitable for individuals who do not require detoxification or around-the-clock supervision.

A key difference between outpatient and inpatient programs revolves around living arrangements during treatment. Whereas inpatient (or residential) programs offer 24-hour care and require full-time residence at a treatment facility, outpatient programs allow you to live at home while receiving treatment. Consequently, individuals in outpatient rehab face minimal disruption to their normal daily routines while still being able to participate in a peer-oriented, structured therapeutic program.

This form of rehab can work for those who abused their drugs of choice in small amounts or for a short period of time (for example, if a friend or family member recognized the warning signs of addiction and had a conversation, or staged an intervention, at the earliest possible moment).

A client who is in this stage of an addiction will still experience withdrawal symptoms, but not nearly as severe as one who needs inpatient treatment.

If a doctor feels their patient is capable of weathering withdrawal without lasting psychological or physical damage or a fear of relapse, they might suggest outpatient treatment and recommend an appropriate facility.

Many outpatient programs offer sessions during evenings and weekends in order to accommodate the schedules of clients. Outpatient treatment allows the client to resume (or continue) meeting the demands of their life, including work and school responsibilities, and spend time with family while still making time for rehabilitation and counseling.

American Addiction Centers, is also offering telehealth services from the comfort of your home

And that could mean a substantial amount of time; clients are still expected to show up for regular treatments, counseling sessions, and group meetings, participating as fully as possible, doing regular homework assignments, and otherwise engaging in the same activities that an inpatient client would.

Such a schedule could account for several hours every day or even an entire day, which might require taking a day off work or sacrificing half a weekend.

How Does Outpatient Treatment Work?

The length and nature of outpatient visits depend on the state of the client’s substance abuse. To better determine what type of therapy is required, outpatient treatment is usually broken down into categories.

Structures of Outpatient Treatment Programs

  • Intensive outpatient treatment is focused on relapse prevention, and it shares a few similarities with the services of inpatient programs. Clients in an intensive outpatient program usually check in for three days a week, for 2-4 hours at a time.
  • Partial hospitalization outpatient treatment is offered to clients who have a stable living environment but require ongoing observation of severe medical conditions or severe psychological issues. These programs are typically offered at hospitals, where clients will have to check in for 3-5 days a week, for at least 4-6 hours a day.
  • Therapy and counseling on an outpatient basis tend to be combined with other forms of rehabilitation or used as ongoing follow-up services after discharge from inpatient programs.

It could be broken up into two evenings of 90-minute sessions conducted back to back (a group meeting, perhaps, followed by a class on psychoeducation, which may involve the attendance of family members).

The third evening could have 30 minutes of one-on-one counseling, 90 minutes of family therapy, and 60 minutes of skills training (like communication, social, and interpersonal skills, to learn to say “no” to the offer of a drink).

What are intensive outpatient programs?

While in an intensive outpatient program (IOP), a client’s goal will be to refine his or her plans for reintegrating fully into society. This is achieved through therapy and classes that teach healthy coping skills and relapse prevention strategies.

This type of outpatient program is similar to inpatient programs in the way that treatment follows a fairly structured schedule. Unlike inpatient rehab, participants in an IOP do not reside at the rehab facility during their treatment. Patients can live at home with their family or they can choose to stay in a sober living home or group home, a house or apartment where a group of individuals in recovery live together and provide each other with advice and support.

IOPs generally require participation between three and seven days a week. According to the American Society of Addiction Medicine, initial intensive outpatient treatment should require clients to have “a minimum of nine hours of therapeutic contact per week.” This could be, for example, three hours of treatment on three days (or evenings) of the week.

Benefits of Outpatient Treatment

couple in therapy

Outpatient programs are ideal for individuals who need the support of family to increase their chance of success. The example of the psychoeducation class is an illustration of how family involvement and the mechanics of outpatient treatment overlap.

Psych Central explains that during outpatient treatment, a client is not separated from family members, as would be the case for inpatient treatments. Spouses/partners, children, parents, siblings, etc., will see their loved one in the morning, at the end of the day, and during therapy.

Multiple layers of involvement and engagement with the client during the treatment process is a huge component of recovery, and the education and insight that come with family members (or even close friends) coming along to treatment sessions, and seeing the effects of the treatment bear out on a day-to-day basis, can be a massive boost to the client.

Since outpatient programs place a great deal of emphasis on health and recovery in the client’s own life, the involvement of aftercare support groups is a big component of entrusting a client with outpatient care. While inpatient clients would be expected to join and attend groups like Alcoholics Anonymous, regular involvement with such groups for outpatient clients takes on extra dynamics.

The less demanding time commitment and flexible scheduling of outpatient rehab is also extremely beneficial to those that financially support themselves and their family and cannot afford to take an extended absence from work. These are also important factors for students working toward graduation who wish to minimize the disruption to academic courses while receiving treatment.

Another benefit of outpatient treatment is the cost of treatment, which is generally much less expensive than inpatient care. Due to this lower cost, the treatments provided during outpatient rehab are also more likely to be covered through health insurance.

How long does outpatient treatment last?

Addiction is a complex disease that can affect people in very different ways. Therefore, treatment should be customized to fit each person’s unique needs. How long someone is in an outpatient program will vary based on many things, such as drug of choice, pattern of addiction, time spent with a substance use disorder, and any co-occurring disorders.

Challenges of Outpatient Treatment

For many people and families, the thought of staying in an expensive facility, living with other recovering addicts, going to meetings, and participating in group activities for an extended period of time (as long as several months) can seem intimidating and tedious.

For these individuals, outpatient rehabilitation is often the preferable option (compared to inpatient treatment). It costs less and is less intrusive on everyday life than inpatient treatment.

Being a client at an outpatient treatment center is not for everyone, no matter how appealing it may seem. Regardless of inpatient or outpatient status, a client is still in recovery, and this means being prone to the temptation to relapse.

Relapsing in Treatment

Relapsing during outpatient treatment can threaten to undo weeks of progress and hard work.

A post-treatment world can be confusing and frustrating, even for a client whose addiction was not severe enough to warrant inpatient therapy. Psychology Today calls overconfidence “addiction’s blind spot.”

Many people in recovery—some of whom received outpatient treatment—relapse because they felt that they were in complete control of their impulses and temptations.

Outpatient therapy is a big responsibility because the freedom to go home means that the client has to stay firm on the lessons learned in rehab. The doctor has to trust that the client will be able to live cleanly on their own (albeit with a little help). It is crucial that people in outpatient rehab do their best to avoid relapse triggers and surround themselves with supportive families and friends during their time away from the treatment facility.

The likelihood of relapse is a significant factor in determining whether a client can safely live at home without jeopardizing the pharmacological and psychological treatments of therapy. Any problems or deviation, especially if the behavior becomes consistent, could see the outpatient status being terminated and the client encouraged to check into a residential treatment center for inpatient care.

Relapse can demonstrate that the client is not yet ready to be entrusted with the full benefits of outpatient therapy. In these instances, admission to an inpatient treatment center is the next logical course of action.

Outpatient clients are no less prone to relapse than inpatient clients, and aftercare support groups are there for both.

Does outpatient treatment include detox?

Detox as a period of early abstinence, in situations where doing so would not be excessively uncomfortable or potentially dangerous, might be incorporated into certain outpatient substance abuse recovery programs. However, many outpatient treatment programs focus primarily on behavioral therapies and may be less equipped to provide the medical monitoring and, if needed, medical interventions required to keep someone safe and comfortable during withdrawal.

A more specific question might be whether a medical detox can take place on an outpatient basis. Though some of the more relatively intensive outpatient programs—partial hospitalization, for example—might be equipped to administer medical detoxification and withdrawal management protocols for program participants, given the risks of severe withdrawal symptoms and potential withdrawal complications associated with several substances (including alcohol and opioid drugs), many medical detox programs will take place in an inpatient or residential treatment setting.

Paying for Outpatient Treatment

Results from the 2018 National Survey on Drug Use and Health identified financial issues (including a lack of health care coverage and not being able to afford the cost of treatment) as one of the biggest barriers to entering a drug rehab program. The relatively affordable prices of outpatient therapy make it a more viable option for many families looking to help their loved one.

By their nature, outpatient treatment centers charge less for their services than inpatient facilities, as there is no need to provide accommodation and meals to clients. These facilities often focus entirely on conventional behavioral treatment approaches, while leaving the client free time to meet their daily obligations to family, work, and/or school. Similarly, outpatient treatment centers typically do not offer detoxification services, such as IV drips or associated medications, although such resources may be on hand in the event of an emergency.

Instead, outpatient treatment costs mostly go toward the basic services of counseling and therapy sessions, addiction classes, and onsite drug tests. While some inpatient facilities offer amenities like swimming, art classes, yoga, or nature excursions, outpatient treatment centers are often not set up to go in those directions, so clients do not have to pay for such services.

Notwithstanding the lower costs, some clients may still struggle to cover the bill, especially those who do not have appropriate health insurance coverage. For that reason, many outpatient treatment centers will offer some form of financial assistance to clients, such as sliding scale payment plans, financing options, and other services that may be available to eligible low-income or low-urgency clients.

For those who are simply unable to pay for outpatient treatment, such as the unemployed and homeless, there is the option of finding one of the free drug rehab programs that are available through various federal or state-funded agencies and nonprofit organizations.

Many states offer various forms of drug and alcohol rehab services through public mental health or substance abuse treatment centers. Program eligibility requirements vary by state, but will usually include things such as verification of income, lack of insurance, and residence in the state.

Many faith-based organizations offer free addiction treatment programs to members of the community that are in need of assistance. These include organizations like the Salvation Army, Catholic Charities, and Celebrate Recovery. A good source of information on faith-based rehab programs is the Substance Abuse and Mental Health Services Administration (SAMHSA), which provides an online resource for the more than 800 faith-based community partners within its Community Substance Abuse Prevention Partnership Program.

The Department of Veteran’s Affairs (VA) offers free alcohol and drug rehab treatment to eligible veterans through its Veterans Alcohol and Drug Dependence Rehabilitation Program. These programs are provided at VA medical centers and clinics and include various services such as detoxification, rehabilitation therapies, and psychiatric care.

How to Find Outpatient Treatment Centers Near Me

There are some important questions that anyone considering outpatient treatment should ask before selecting a program. These include:

  • Does the rehab facility treat my specific substance use disorder?
  • Does the rehab facility treat co-occurring disorders?
  • What are the types of therapies offered? Outpatient treatment should incorporate a range of talking therapies (more formally referred to as psychotherapy) that include various forms of behavioral therapies (such as cognitive-behavioral therapy and dialectical behavior therapy). These can be done in group or one-on-one settings.
  • Is the location of the rehab facility in close proximity to where I live? Although the point of outpatient rehab is to maintain the freedom to live at home during treatment, you will need to commute from your home to the facility several times a week for the duration of the program. A facility located nearby would be most convenient and encourage participation.

There are tools provided by the government that can help you during your search for an outpatient treatment center. For example, SAMHSA provides a Treatment Services Locator search tool through its website that can find nearby treatment centers based on your home address. Your search can also be narrowed down by using filters based on your specific requirements.

Is outpatient treatment right for me?

Outpatient treatment centers aren’t for everyone, but for those clients who do not have severe addictions, cannot afford residential programs, or can’t take an extended leave of absence from work or school, this method of therapy can be very effective and feasible.

Outpatient rehabilitation simultaneously address substance abuse recovery and occupational and social functioning, an approach not adapted by inpatient programs (for the good of the clients who require the services of inpatient facilities).

For the right kind of clients, outpatient programs can reduce the severity of co-occurring substance abuse and mental health concerns while boosting sobriety and educating family and friends on the challenges and opportunities of recovery.

If you are uncertain about whether or not outpatient treatment is right for you, please seek the help of trusted expert (such as an addiction counselor or interventionist) before you commit to a specific program.

The Rise of Outpatient Treatment

getting treatment

More and more clients are being referred to outpatient treatment centers. Advances in pharmacology and psychology have created an environment where increasingly effective and efficient substance abuse remedies can be delivered in an outpatient setting, without the need for clients to stay overnight.

Hospitals and Health Networks reports that changes in insurance reimbursement policies, as well as the rise of alternative payment models (like accountable care organizations, which are groups of doctors, hospitals, and healthcare providers voluntarily working together to give coordinated, high-quality care to eligible patients), have made providers step up by delivering increased healthcare standards across the spectrum, putting outpatient and inpatient services on a more even keel.

Research findings published in the International Journal for Quality in Health Care identified eight characteristics of ideal psychiatric outpatient care:

  1. Accessibility of the care
  2. Contentedness with treatment
  3. Relationship between staff and client
  4. Continuity of care
  5. Professionalism of staff
  6. Client information and co-influence
  7. Treatment environment
  8. Cost of care

The study also found that the staff’s empathetic qualities (being interested in the clients, listening to them, understanding them, and respecting them) were valued the most by clients.

 

Last Updated on June 18, 2020
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Michael Kaliszewski, PhD
Dr. Michael Kaliszewski is a freelance science writer with over 15 years of experience as a research scientist in both academia and industry.
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