Outpatient treatment programs allow clients to attend structured treatment sessions and then return to their own environments each night. The majority of individuals in treatment for substance abuse or addiction will spend the bulk of their treatment time in some form of outpatient treatment, whether medically assisted treatment, therapy, counseling, or support group participation.
Clients typically attend scheduled treatment sessions at times that are arranged to allow them to go on with the normal routine of their daily lives. There are several advantages to participation in an outpatient treatment program:
- It is typically less expensive than a residential or inpatient treatment program.
- Outpatient programs provide their clients with more freedom, though in some cases, this could be a disadvantage.
- Outpatient care allows clients to maintain other commitments to work, family, school, or other important activities.
- Outpatient treatment programs may provide a higher level of privacy. The client in an outpatient program does not have to explain long periods of absences to important people in their lives or to their bosses.
- Outpatient treatment, like residential or inpatient treatment, also allows clients to develop a support network of peers.
The quality of treatment between outpatient and inpatient programs is basically equivalent, though variables occur between specific programs. Just being in an inpatient program or an outpatient program is no indicator of the quality of treatment that an individual will receive. Any form of treatment provided in an inpatient program, except for isolation or strict around-the-clock supervision, is provided in outpatient treatment programs.
- Medically assisted treatment or pharmacotherapy: This treatment involves the use of medications or other medical techniques to assist the individual with negotiating the detox process, diminishing cravings for drugs, treating other psychological disorders, and addressing medical issues.
- Psychosocial interventions: These treatments, which are more commonly referred to as counseling or therapy, address the client’s attitudes, feelings, habits, and other behaviors in an individual setting (a one-on-one situation with a therapist), in a group (a number of individuals with similar issues being treated by one or more therapists), or in a family environment (a therapist and family members together in the same treatment sessions). These interventions include a number of well-known interventions, such as behavioral therapy, Cognitive Behavioral Therapy, interpersonal therapy, etc.
- Self-help groups: These types of groups are not run by licensed therapists but are run by other individuals with the same or similar issue who have experience in the recovery process. These groups are designed for encouragement, mutual support, and participation in a structured program of recovery that can assist individuals in inpatient treatment, before outpatient treatment, during outpatient treatment, and long after the formal treatment process has run its course.
Who Benefits from Outpatient Treatment?
Since nearly everyone who gets involved in treatment for substance use disorder will eventually spend at least some time in an outpatient treatment program, the answer to the above question is that anyone can benefit from outpatient treatment.
There are several considerations when deciding whether one should choose an outpatient treatment program over initially getting involved in inpatient treatment. There are also several situations where one may wish to initially begin in a residential or inpatient program. A few these include:
- If a person is expected to go through severe physical withdrawal symptoms from alcohol, benzodiazepines, or narcotic medications, the initial detox program may be most successful on an inpatient basis. That way, the person can receive 24-hour supervision for the period of time that the withdrawal and detox process take. Individuals experiencing severe withdrawal symptoms may be prone to relapse. In addition, severe withdrawal from alcohol or benzodiazepines can be associated with potentially fatal consequences that require extremely close observation.
- Some individuals who have severe substance use disorders may have co-occurring disorders, such as depression, bipolar disorder, PTSD, psychosis, etc. Many of these serious cases will often be more appropriate for inpatient treatment, until all of the initial issues occurring in the person can be stabilized. Once all members of the treatment team agree that the person is stable enough to transition to outpatient treatment, that can be arranged.
- Some individuals have living environments that are detrimental to recovery, and these people may be very vulnerable to relapse in the early stages of treatment. Although everyone will need to get out in the real world at some point, some environmental factors are so severe that isolating the person from them while they establish their recovery program can be useful. This can be performed in an inpatient program that protects the individual from these outside influences. Some of the factors might include severe family strife, an abusive home situation, numerous failed times at recovery, or being homeless. In some of these cases, individuals can transition from inpatient treatment to a halfway house or some other protective environment.
- Some individuals just may not feel that they can live up to the commitment of recovery in the early stages. These individuals can get admitted to a residential treatment program that can help them develop the skills they will need to cope.
Specialized Outpatient Treatment Programs
There are a number of specialized and more intense outpatient programs that are available for individuals who need them. A few of these include:
- Intensive outpatient treatment: This type of treatment is designed to deliver inpatient intensity and focus, and still maintain the person in an outpatient milieu. An intensive outpatient treatment program meets for a minimum of three days a week for 2-4 hours at a time. In order to qualify as intensive outpatient treatment, the program must deliver a minimum of nine hours of treatment per week on an outpatient basis. Many of these programs will meet 4-5 days a week for 2-4 hours or more. These programs are typically useful for individuals with severe substance use disorders, multiple interacting factors including environmental issues, co-occurring disorders, and other issues that need specific, focused, interventions. The treatment sessions are scheduled around the person’s work schedule and other activities.
- Partial hospitalization program: Individuals with medical complications or psychiatric issues can be involved in a partial hospitalization program where they meet in the hospital 3-5 days a week for 4-6 hours a day.
- The Florida Model: This is really more of a residential type of treatment. Clients live in a supervised residential housing center connected to a treatment facility.
Another form of specialized outpatient treatment is aftercare. Individuals who complete a detox program or a formal therapy program for recovery from a substance use disorder have completed a major life accomplishment. However, many individuals find that the few months that they spend in treatment cannot fully address every issue that will come up in the future. Aftercare programs provide a continuation of support and counseling once the process of therapy and treatment are completed.
Because most individuals who use insurance to pay for their treatment are only allotted a specific number of sessions, and most individuals in treatment cannot afford the expense of seeing a therapist or counselor for years, the formal treatment process is typically completed within several months and often well under one year. However, the recovery process is ongoing and continues to develop throughout the person’s life. There is no “cure” for an addiction, and a large number of individuals relapse even after they complete treatment. Because of this, an aftercare program is essential. This outpatient program is available to the individual for as long as the person needs it, and in many cases, this may be a lifelong endeavor.
Aftercare programs occur in a variety of different forms, including such things as ongoing group meetings held by a therapist, social activities for recovering individuals, and 12-Step meetings that can be attended indefinitely. Aftercare is the bridge that helps individuals in recovery apply what they learned in treatment, develop new skills and coping methods, and address important issues throughout the recovery process.