Residential rehab provides the most comprehensive level of treatment and requires you to remove yourself from all your normal activities of daily living until the program is complete.
An intensive outpatient program (IOP) allows you to attend to some of your responsibilities, like family, work, or school, while also committing to a treatment program. You can live at home or in a sober living home while participating in an IOP.
Residential rehab is often the first type of rehab that comes to people’s minds when they think about drug treatment programs. Residential treatment provides around-the-clock care in a non-hospital setting for an extended period of time.
The two main types of residential treatment are:
- Long-term residential treatment. Sometimes referred to as therapeutic communities, long-term residential treatment typically lasts 6 to 12 months. Participants live on site for the duration of the program and follow a highly structured treatment plan focused on examining false beliefs, taking accountability for their actions, and building a new set of skills that will lend to a healthy and sober life after treatment.
- Short-term residential treatment. Short-term residential programs also provide highly structured treatment, but for only three to six weeks at a time. They are often modeled around the 12-step approach to addiction treatment. With such a short treatment program, aftercare planning and ongoing participation in support groups following treatment, such as 12-step programs, is vital.
Intensive Outpatient Treatment
According to the National Institute on Drug Abuse (NIDA), IOPs can be as effective as residential programs, depending on the characteristics and needs of the individual. Outpatient programs vary greatly in the level of services that are provided.
Low-intensity programs are unlikely to provide enough opportunities for the level of personal development that needs to occur in order to make a full recovery. The focus of these programs is primarily on drug education.
An intensive program provides a high level of services that allows individuals to participate in a range of treatment options for an extended period of time. It provides a treatment option that is a step down from residential treatment and helps people in recovery transition back into their daily lives.
IOPs offer a minimum of nine hours of weekly addiction treatment. This care is often delivered in three-hour sessions three times per week.
IOPs offer the following benefits:
- Psychological counseling
- Behavioral and social support
- The option to live at home during treatment
- The ability to continue working
- Treatment sessions that are scheduled around your work hours
- Aftercare services
No matter what type of treatment program you are considering, there are many features that are the same.
First and foremost, the goals of all treatment programs are quite similar. All programs aim to help participants quit using drugs and equip them with the tools they need to maintain a life of sobriety.
There are a number of aspects of addiction treatment that are incorporated into most rehab programs. Similarities between residential rehab and IOPs include:
- This is evidence-based treatment that educates patients on how their addiction issues have affected their lives. Residential rehab and IOPs both emphasize psychoeducation in order for all participants to gain a better understanding about their personal histories with addiction.
- Individual counseling and group therapy play a significant role in the recovery process by providing the opportunity to explore your personal challenges and benefit from the support of your peers.
- Care for co-occurring disorders. Both residential treatment programs and IOPs are equipped to treat co-occurring mental health issues. Integrated treatment for co-occurring disorders, where all comorbid issues are addressed simultaneously, is most effective.
- Family support. Both residential programs and IOPs are likely to invite loved ones to participate in family therapy sessions to explore how the family dynamics may have contributed to addiction and to repair relationships that were damaged during active addiction. The goal is to improve communication and support the individual in their recovery process.
- Aftercare planning. Comprehensive rehab programs, whether residential options or IOPs, typically create an aftercare plan with patients before the formal treatment program ends. Treatment professionals will work with patients to identify sources of support that will help the individual maintain sobriety. Components of an aftercare plan may include ongoing therapy, participation in peer support groups, and healthy lifestyle activities.
While both residential rehab and intensive outpatient programs can bring about similar outcomes for patients, they have many differences.
- Level of care: The primary difference between residential rehab and IOPs lies in the intensity of the program. Residential rehab provides the most intense level of care since you reside on the premises around the clock. The entire focus is on recovery-related activities since you are not participating in other aspects of your life. With an IOP, you are still able to live at home, care for family members, work, and participate in social activities. You simply have to make sure you are at the treatment center for your scheduled sessions. Again, IOPS generally involve at least three treatment sessions per week, lasting three hours.
- Detox services: Typically, IOPs do not provide medically assisted detox. Since participants do not live on site during treatment, IOPs cannot provide the level of medical supervision needed to safely assist someone struggling with certain types of substances through the detox phase. For people interested in attending an IOP but who also need to detox, participation in a detox program prior to entering an IOP is a possibility. Some facilities offer inpatient medical detox services and then transition patients to an IOP once withdrawal is complete.
- Price: Residential rehab programs are the most expensive form of treatment since you reside in the facility around the clock. The added expenses of lodging, meals, and 24-hour staffing increase the overall bill. Because IOPs are typically only open during business hours, and you only have to attend for a few hours per day or week, the costs are significantly lower. You live at home, and meals are not provided by the facility, so this reduces overall costs. Talk to your insurance provider about which type of program they will cover. Sometimes, it is required that you first attempt an outpatient addiction treatment program before a residential rehab program will be covered.
Sample Treatment Schedules
If you are trying to decide between attending a residential treatment program or an IOP, consider the daily treatment schedule for each type of program. The programs offered at each treatment facility will vary in their details, but the below schedules will give you an idea of what to generally expect with each type of treatment program.
A sample schedule of a day in residential treatment may look like this:
- 7 a.m. – Breakfast
- 8 a.m. – Yoga and meditation
- 9 a.m. – Addiction education session
- 10 a.m. – Group therapy
- 12 p.m. – Lunch
- 1 p.m. – Individual therapy session
- 2 p.m. – Expressive therapy session
- 3 p.m. – Health and wellness activity
- 5 p.m. – Dinner
- 6 p.m. – 12-step meeting
- 7 p.m. – Free time (time for quiet reflection)
- 9 p.m. – Bedtime
A sample IOP treatment schedule may include these aspects:
- Three to five days of treatment per week, with three hours of treatment per day
- Treatment sessions offered during the day or in the evening, depending on your desired schedule
- Regular participation in individual, group, and family therapy
- Ongoing case management
- Participation in aftercare clubs or programs following graduation
As you can see, the schedule at a residential treatment program is significantly more structured than at an IOP.
Residential rehab and IOPs take different approaches to the recovery process, but both types of treatment focus on giving you with the tools you need to maintain sobriety following treatment.
How to Know if an IOP Is Right for You
If you are considering entering addiction treatment, there are a few things to consider to determine if an IOP is right for you. You may benefit from an IOP if you:
- Do not require medical detoxification.
- Do not need 24-hour supervision to help you stay sober.
- Have a strong social support system.
- Have a job or family that you cannot take time away from while receiving treatment.
Comparable Outcomes for Both Forms of Treatment
Studies have shown comparable positive outcomes for people who participate in residential rehab and IOPs. Graduates of both types of programs have shown a substantial reduction in drug and alcohol use in both the short term and the long term.
In order to select the best program for you, be honest with yourself about which level of care and structure will benefit you the most. Talk to staff members of prospective programs about your situation. They can weigh in on the best program structure for your circumstances.