Intensive Outpatient Programs (IOP)
Intensive outpatient programs (IOPs) differ from their traditional outpatient counterparts in terms of time commitment and therapies offered.
An IOP is, as the name implies, a more advanced form of care. Enroll here, and you’ll spend more time in treatment. You might also access group therapies that aren’t always available in a traditional outpatient program.
What Happens in an IOP?
Treatment communities have strict guidelines to follow as they develop their programs. Insurance companies and regulatory agencies require it. To be defined as an IOP, an organization must provide a minimum of nine hours of treatment each week, and it’s typically delivered in three sessions that last for three hours apiece.
In an overview article published in the journal Psychiatric Services, the authors suggest that some programs offer lengthier programs, so their clients spend more time in therapy each week. Others provide a step-down program, so your therapy hours might decline as your sobriety strengthens.
When you’re not in therapy, you’re either living at home or in a sober community. You’ll have time to work, care for your family, nourish your hobbies, and otherwise go about your life.
The Substance Abuse and Mental Health Services Administration (SAMHSA) says that most work done in IOPs happens in group formats. Groups range from 8 to 15 members, and sessions are split into thirds.
- First third: Each person discusses a current issue or problem.
- Second third: The group discusses one issue or works on a skill.
- Final third: The facilitator sums up the lessons and assigns homework.
You might attend group meetings to help you:
- Learn about addiction. Psychoeducational groups give you a safe space to learn about how substance abuse develops and the problems it can cause. You’ll learn how to identify negative thoughts that lead to drug use.
- Practice sobriety. Skills-development groups help you learn how to avoid relapse, speak up for yourself, and manage stress.
- Hone communication skills. In process-oriented recovery group meetings, you work with people at the same stage of recovery. You learn how to relate to others and resolve conflicts without violence or substance use. You’ll also learn how one person’s actions can change the feelings and behaviors of many.
- Heal damaged relationships. It’s possible and quite common that your addictions harmed your relationship with your family or the people you loved. You’ll need their love and support as you recover. Family therapy helps you work through the choices you made and the pain you all feel. You can emerge from these sessions with a deeper understanding, and you can build skills that help you communicate clearly in your sobriety.
You may also spend time in individual counseling sessions, SAMHSA says, but you may only spend an hour or two per week here. Most of the time, you’ll work in groups.
This communal format helps you learn how to communicate with and tolerate others in a sober environment. That could be critical for you if you only feel comfortable with others when you’re intoxicated.
You may also feel inspired by the people in your group sessions. They’re working through sobriety just as you are, and they may have lessons you can learn from. For some people, this aspect of IOPs is the most rewarding and beneficial of the entire program.
Who Goes to an IOP?
There are two main groups of people who benefit from an IOP. The first is new to recovery, and the second is actively working on sobriety.
If you’re in the first group and your sobriety is new, you might choose an IOP over an inpatient program if you:
- Have a strong and supportive sober network to lean on. In a study in the Journal of Substance Abuse Treatment, researchers found that women enrolling in inpatient programs had more drug-using friends than those choosing IOPs. They needed the sober support of around-the-clock care. Even in the event you do have drug using friends, if you have that network at home, you may not need this inpatient level of help.
- Have work obligations. Enrolling in inpatient care means stepping away from work and home until you’re better. That could be impossible for people in some careers. An IOP gives you support, while letting you attend to your life.
- Want to learn as you go. An IOP encourages homework and practice. You’ll put your skills to work every moment you’re not in your treatment program. You can’t do that while in the protective bubble of inpatient care.
If you’re in the second group and you’re already progressing to sobriety, you might use an IOP as part of your recovery spectrum. You’re leaving your inpatient program, but you’re not quite ready to step all the way back to a traditional outpatient level of care. An IOP works as a middle path, so you still get a lot of help without all the structure of inpatient care.
Paying for an IOP
Insurance plans can and do offer coverage for addiction treatment. But most have restrictions on the type of treatments they will offer, and some require you to choose a program that’s been vetted in some way.
For example, if you’re hoping to use Medicaid to pay for an IOP, the journal Health Services Research suggests that you’re likely to get your plan approved if you choose a program that is publicly funded. Private plans may not be accepted, but public programs just might.
If you’re using private insurance, your company may have agreements with specific care providers. These relationships keep costs down. The insurance company agrees to refer patients, and the care provider gives a discount in return. You’ll need to choose a provider in this network to get the best deal.
Insurance plans are complicated, and it isn’t unusual for people to feel confused about what is and isn’t covered. Most care providers have staffers who can walk through insurance complexities with you. This person can call your company, investigate your options, and tell you what is and isn’t covered. Typically, there is no charge for this help.
In addition to using insurance for IOP programs, you might choose to use personal savings, go through a loan provider such as Prosper, or even ask for a flexible payment plan. It’s recommended to call a program to ask about all your payment options, and to run a verification of benefits to see if you will have out-of-pocket expenses.
What Else Supports Your Recovery?
At one point, we thought of recovery as a set of stairs. You started on the highest step, and you walked down to a sober state. Now, we know that recovery isn’t linear. You might walk up and down a few times until you find your fit. And often, you feel best when you’re standing on several stairs at the same time.
While you’re enrolled in an IOP, you’re getting help for your addiction. But you might also benefit from:
- Support groups. Unlike the meetings you’ll attend in your IOP, support group meetings aren’t run by professionals. Peers get together to talk, learn, and encourage. You will have a chance to share your story and get advice, and you’ll offer your support to others who are also battling addiction. You might use these meetings to help you through a rough patch in your recovery, or you might go to meetings every day to keep you on course.
- Sober homes. Sometimes, your home is full of relapse triggers. The people you live with, the environments in which you used drugs, and your memories can all spark cravings. Sober homes let you live with others who are also in recovery in a clean environment. Rules ensure that everyone stays sober and safe while living there. This could be an ideal place for you to heal.
- Vocational training. Your job gives you a sense of purpose, as well as a place to go each day. But years of substance abuse can erode your skills and make finding a job very difficult. Some IOPs offer vocational training to get you back on track. Others refer you to community programs where you can get the help you need.
- Parent training. If your little ones emerged during your addiction, you may not have a healthy relationship. You may not know how to take care of them and support them. Training either in your IOP or in the community can help you learn how to be a better parent.
- Alternative therapy. Acupuncture, yoga, and massage can ease pain and remove a relapse trigger. Art and music therapy can help you tap into your strength and creativity. You might lean on these classes within your IOP, or you could seek them out in your community as another tool to support your sobriety.
- Medical management. Pain is the source of many types of addiction. And substance abuse can destroy your physical health as well as your mental stability. Your doctor can be an ally in your recovery and help you regain the strength and vitality you may have lost. Your doctor can also review your progress in recovery and ensure that you’re on the right track.
There are many facets involved in your recovery, and all of them are important as you journey toward sobriety. Don’t think of them as tasks you must complete. Instead, think of them as opportunities to learn more about your body, your community, and yourself.
The more tools you use, the more you will learn, and the stronger you will grow.