People dealing with substance abuse and addictions may be treated as an outpatient at hospitals, local general health clinics, their counselor’s offices, local mental health clinics, and even at residential facilities that have outpatient clinics. However, they can stay in their homes throughout treatment. Patients are required to check in with therapists and experts on addiction at the treatment centers regularly for medication and counseling. This check-in policy varies from program to program, and many of them allow check-in in the evenings and on weekends to adjust to patient’s schedules. Patients considering outpatient treatment should know that the addiction treatment therapy is basically the same as inpatient programs but somewhat less intensive. The length of time in the program will vary depending on individual needs.
Outpatient treatment can vary widely. Programs range from low-intensity to very intensive. Low-intensity programs include drug education classes. High-intensity programs are similar to what a patient would experience in a residential program. Several factors are used to decide what level of treatment is appropriate for each patient. How well a patient functions on their own. The patient’s personal support structure of family and friends is also a factor.
According to NIDA, outpatient programs may involve individual counseling, group counseling, and treatment of other disorders or health problems. Intensive outpatient treatment is also called partial hospitalization and involves intensive treatment sessions multiple times a week. According to the Substance Abuse and Mental Health Services Administration, patients may be required to devote up to 30 hours a week in their treatment sessions. Additionally, they can also have 24-hour access to a team of professionals in case of crisis.
Generally, as treatment progresses, the number of sessions will be decreased. After completing partial hospitalization, patients can switch to less intensive outpatient treatment. This involves few sessions per week with a somewhat less intensive focus.
The goal of all forms of rehab is to assist the individual in maintaining sobriety. Addiction is a chronic illness, which means that treatments must be ongoing to prevent a return to using. But, the intensity of the treatment may wane over time.
As the patient’s recovery stabilizes and strengthens, a reduction in the intensity of the therapy allows the patient greater freedom and fewer sessions. It is not uncommon for a patient to start with inpatient treatment, and later move to intensive outpatient therapy. After progress is made at that level, the patient could then reduce the intensity and move to weekly and eventually monthly sessions.
Four out of five addiction treatment facilities in the United States provide some sort of outpatient care according to the 2012 National Survey of Substance Abuse Treatment Services. This is extremely good news, as outpatient programs help people on the road to recovery from substance abuse while allowing them to remain at their jobs, with friends and families, and continuing education.
By working with therapists and care providers during daylight hours at local facilities, patients may return home in the evening. No hospitalization is involved. While maintaining their own residence, patients have access to experts on addiction, counselors and physicians.
Who Should Choose Outpatient Treatment?
Outpatient rehab is an excellent choice for patients who have jobs, classes or other commitments. These programs work best for people with the motivation to participate. Those patients with supportive families and friends are also good candidates for this type of treatment.
Benefits of Outpatient Drug Addiction Treatment
Outpatient rehab is ideal for people who need the support of family and friends to increase their chance of success. For some, being away from home can be detrimental. Outpatient rehab is also often the best option for patients who need to continue to work to support themselves and family.
For students working toward graduation, inpatient rehab allows them to continue with their class schedule while seeking treatment. Many centers offer flexible hours for checking in, and counselor sessions.
Outpatient rehab is generally less expensive than residential care while still providing quality substance abuse counseling. Health insurance is accepted at outpatient treatment facilities and covers the cost of most of the treatments.
Like all treatment options, outpatient rehab is confidential. In fact, in can increase privacy by alleviating the need to explain an extended absence from work or school.
Options for Treatment
As a follow-up to more intense treatment programs, such as inpatient programs, outpatient treatment has a proven track record for aiding with continued abstinence. Patients throughout the United States should have no trouble finding a treatment facility close to home. Because every patient is different, each facility will design a program that works for each individual, tailor-made to their needs.
This means that each person’s treatment plan will vary, depending on the person’s background, personal circumstances, and progress in recovery.
Individual counseling is a valuable tool for rehabilitation. Counseling addresses the addiction, and it addresses other aspects of a patient’s life in which he or she may be struggling. Such struggles can include relationships, jobs, and even illegal activity. Counseling can help the patient develop coping strategies for remaining abstinent. Counseling can also facilitate attendance in group therapy and appointments with medical practitioners. SAMHSA refers to several different kinds of therapy.
- Cognitive behavioral therapy (CBT) is a form of therapy that focuses on solving specific problems. CBT takes a practical approach to changing the way people think and patterns of behavior. It is a hands-on approach to problem solving and is generally a short-term therapy.
- Contingency management (CM) is a type of therapy using the theory of operant conditioning. CM therapy includes determining the stimuli and conditions under which a patient is likely to use. The therapist and the patient then work together to come up with a system of rewards and consequences to help the patient associate positive experiences with remaining sober.
- Motivational Enhancement Therapy (MET) is a short, goal-oriented strategy, which may be used by itself or as a part of a broader course of counseling is. MET is rooted in the principles of motivational psychology and designed to produce quick change that comes from within. Practitioners use the patient’s own goals and resources to build a plan for recovery. Counseling is usually provided in a one-on-one environment, but can also be conducted in small groups of people dealing with common issues. Motivational incentives specific to each individual can be used to motivate and reinforce behaviors that help a patient refrain from substance abuse.
- Group counseling is a popular and effective addition to successful substance abuse treatment. Often group counseling is paired with a 12-Step program. According to NIDA, group therapy can be extremely effective, especially when alongside individual counseling. Also, The Taylor and Francis Group indicates that weekly participation in a 12-Step group program significantly improves a patient’s chances of maintaining sobriety. Counseling groups give patients the opportunity to share their experiences, hear from peers, and try out new patterns of behaviors in a safe environment. In a group setting, a patient can see that he or she is not alone in their struggles.
- Intensive outpatient program (IOP) is not a live-in treatment program, but it still requires a significant time commitment. Intensive outpatient programs usually meet three or more days a week for 2-4 hours a day or more. Relapse prevention the primary focus of IOP. These outpatient programs can be scheduled around a patient’s job or school commitments.
- Medications are available that can assist in the treatment of some substance abuse disorders. Some medications can reduce cravings while others may be administered to lessen the discomfort of withdrawal. However, not all substance abuse cases are treatable using medications, according to SAMSHA.
- Lectures and educational programs may also be helpful to patients by helping them better understand their addiction, its causes and risks for relapse. Outpatient clinics will offer such programs, and can assist the patient in choosing educational opportunities suited to their specific needs.
- Brief intervention is only appropriate for those patients who are at risk for drug abuse or drug addiction. It is not appropriate for anyone who has already developed a serious problem with substance abuse. Brief intervention is a preventative measure consisting of several appointments with a healthcare professional to discuss the harmful effects of substance abuse and strategies for decreasing current use before it becomes a significant problem.
- Family support is vital to the success of substance abuse treatment programs. When parents, siblings and partners learn how to communicate and interact in a supportive, healthy manner, it increases a patient’s chance for continuing recovery. Building trust between a patient and his family and also learning to set boundaries helps in the recovery process. Family members are encouraged to attend educational programs that will help them be more supportive.
- Case management services through a case manager offer valuable links to services and resources in the community. This makes it easier and less stressful to find such services as vocational counseling, housing, transportation, healthcare clinics, childcare providers, and continuing education. Treatment is most successful when helps to restore a sense of competence to the patient. Returning to a productive life is a key to long-term success.
- Other services may include vocational training and parenting skills training. By helping the recovering patient with skills needed to return to a healthy life, their chances of continued sobriety is further increased.
- Relapse Prevention is an important stage in a patient’s rehab experience. Addiction has been identified as an illness that requires long-term management. Relapse begins before the patient resumes substance abuse. Relapse is often preceded by a series of behaviors that serve as warning signs. If a patient is taught what warning signs to look for, they can predict an upcoming relapse, and therefore, prevent it. Understanding the relapse process can help people in recovery to develop a plan for identification and prevention of a relapse. Therapists and patients discuss how relapses occur, what factors can contribute to relapse, and signs that a relapse may be coming. Together, they will then develop a plan of prevention. This plan should address strategies to handle situations that occur every day, and also high-risk situations.
Overcoming Possible Drawbacks
The major drawback to outpatient treatment is that the patient will not be fully removed from the everyday temptation to use. For this reason, outpatient treatment typically works better for those whose addictions are not as severe.
Participants in high-intensity outpatient programs might continue to live at home. For this situation to be successful, a significant effort must be made on a daily basis. The amount of time and effort required to overcome addiction might mean that patients are not able to return to work. They may not have the time to focus on childcare or other daily tasks that are part of a normal life. And yet, patients may find they have unstructured free time in the evenings and on weekends that may lead them back to unhealthy choices.
On the other hand, low-intensity programs often provide a much smaller amount of therapeutic contact. Low-intensity program patients will be assigned to a counselor, and go to sessions multiple times per week. They may participate in group sessions in the evenings. This leaves more time for jobs and daily responsibilities. This allows the patient a more normal life. Again, this leaves the patient with plenty of free time which could lead to unhealthy habits.
A certain amount of free time is included in outpatient programs, by their very nature. Therefore, outpatient programs are best suited to patients with a supportive family and social structure. A deep desire to recover is also a must. The term many experts use for motivated patients with a strong support structure is “high functioning addicts.” These patients are able to avoid some of the more dangerous aspects of addiction from having an impact on their lives. They still need assistance to get better, but they also tend to have what it takes to live at home and face daily temptations while trying to recover from addiction. This isn’t the case for all addicts at all times, but for some, this kind of care is best.
These additional therapies can provide people with skills they can use to beat back stress. They can help people get back in touch with their inner strength and creativity. This, in turn, can help a recovering addict resist an urge to use whenever it might strike.
Outpatient programs cannot provide the sort of around-the-clock supervision that is provided by an inpatient program. It is unlikely that someone living on the grounds of a residential treatment facility can just slip off-site to meet up with a dealer or go to a bar for a drink. Help is available on a twenty-four-hour basis. The environment of residential facilities is completely sober. For many, this is a key to a successful recovery. For very severe cases of addiction, residential care might be vital to success. For some, this sort of intensive care is needed, and can only be found in inpatient treatment programs.
Another option, on the spectrum between inpatient and outpatient therapy, is a Sober Living facility. Sober living facilities are group residences that allow the patient to continue in their daily lives while providing a safe, temptation-free environment to live. These facilities have professionals on staff to help the patient stay on their path to recovery. These facilities also give patients a chance to test their new coping skills in a safe, supportive environment.
The social aspect of this type of care can also be beneficial for some patients. Patients who have many drug-using friends and family members may find that getting away from that community removes many of the temptations to use. By making new friends who are better role models for sobriety they can learn how rewarding a sober life can be.
Pros and Cons
As reported in the Journal of Addiction, quantifying the effectiveness of inpatient versus outpatient care is difficult. Many studies comparing inpatient and outpatient effective use different criteria to determine the value of the treatments. Additionally, each patient is unique, and what works for one patient will not necessarily work for another. Comparing two different patients on the success of lasting sobriety might not result in information that can be applied to treatments for every person.
However, some easily understood pros and cons of the various types of treatment can make the selection process a more straightforward. Talking with a healthcare professional about those pros and cons, many of which have been mentioned in this article, will help the patient decide which program is best for them.
Wait times and delays
The media often reports that people seeking treatment can be expected to wait weeks or even months for an opening in a particular local inpatient addiction treatment center. If a person suffering from addiction lives in a community with high drug use and few treatment clinics, the demand for treatment may be greater than the local facilities can handle. This could mean the patient could experience a delay from the time they admit that they need help, and when help is provided. For these, enrolling in an outpatient program may allow them to get the care they need without delay. In this situation, getting outpatient care means getting some level of care at least.
How to Make a Selection
With so many factors to take into account, many patients might find it difficult to choose the treatment program that is best for them and will most likely lead to success. For this reason, patients should seek the help of an addiction counselor before making a commitment to a type of treatment. Experts such as psychiatrists, addiction counselors and interventionists can assess each patient’s needs based on the severity of the addiction and the patient’s motivation to get better.
These professionals can make recommendations about which type of treatment is best suited for each patient. Someone suffering from addiction is not expected to understand what treatment would be best for them any more than a patient suffering from a broken leg or pneumonia. Addiction is an illness, and treatments for illnesses are best left to those who have the experience and training to do just that. And so, the decision to seek inpatient or outpatient treatment should be made with advice from a trusted expert.