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Requirements of an IOP

Some people who participate in IOPs reside in a sober living home during treatment.

IOPs provide a high level of care, but they are generally more affordable than inpatient treatment or even partial hospitalization programs (PHPs). IOPs offer more flexibility, allowing participants to keep up with other areas of life, such as work, school, or taking care of their family.

Like all addiction treatment programs, IOPs have specific requirements for clients who participate.

Basic IOP Requirements

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Counselor’s Treatment Manual outlines a sample schedule that gives an idea of what you can expect if you or someone you know begins treatment at an IOP.

This is only a sample, and your program may differ depending on your needs.

 Weeks 1-4Weeks 5-16Weeks 13-48: Aftercare
MondayClasses that focus on recovery skills and relapse prevention (3 hours)Relapse prevention (1.5 hours)Day off
TuesdayPeer support group or 12-step meetingPeer support group or 12-step meetingPeer support group or 12-step meeting
WednesdayFamily educationSocial support or family education (1.5 hours)Social support (1.5 hours)
ThursdayPeer support group or 12-step meetingPeer support group or 12-step meetingPeer support group or 12-step meeting
FridayRecovery skills and relapse prevention (3 hours)Relapse prevention (1.5 hours)Day off
Saturday & SundayPeer support group or 12-step meetingPeer support group or 12-step meetingPeer support group or 12-step meeting

As you can see, the schedule gets less intense over time, but it still assumes that you will dedicate a substantial amount of time to treatment. The first 13 to 16 weeks require a daily commitment.

In addition to spending time in a scheduled program on a given day, you can expect homework and handouts for certain sessions. Programs have to integrate many or most of the components of proper care, but there seems to be some leeway regarded how much of these services are included.

What Insurance Companies Have to Say About IOPs

Insurance companies outline what they cover, which can also give you a rough idea of what to expect at an IOP.

  • Inpatient or residential treatment options are usually covered for a period of one to six weeks, depending on your plan.
  • After a certain amount of time, you may be expected to transfer to an outpatient program, which can include an IOP.
  • Some plans may cover partial hospitalization programs, which means you attend a rigorous program about five days week.

Insurance plans generally expect outpatient care to include peer group meetings or 12-step program attendance, therapy (family, individual, or group therapy), education on the effects of substance or alcohol abuse, and medical care.

Attendance Requirements

Oftentimes, specific treatment sessions can be rescheduled based on your needs, but most programs will expect you to let them know if you need to miss or excuse yourself from a session.

Consistently missing or being tardy are considered relapse risks. As far as billing goes, whether or not you pay for missed sessions or not depends on your program.

If you attend a separate center, program fees, including medical care, are included in the entirety of your program fee. Hospital-based services might charge physician fees separately.

Overall, it is best that you participate in your IOP as much as you can, and attempt to reschedule any missed sessions as soon as possible.

Types of Depression


Homework is an important component of some portions of an IOP. You may be given homework related to relapse prevention, and you may be given some exercises in group sessions that you can practice in the outside world. Sometimes you’ll be given recommended articles or books to read.

Every program will be a little different. Ask the treatment coordinator what to expect in this vein.

Treatment Compliance

SAMHSA says that many centers will test you for alcohol or substances upon admission, and they may continue to do so once per week. This may consist of a simple urine or saliva test, but you may receive a more thorough exam if you are suspected of using substances or alcohol again.

There are several ways your therapist may approach a positive drug test or suspicion that you are using again.

  • Observation: A staff member may be in the same room while you provide a urine sample.
  • Discussion of life circumstances: Your therapist may ask about life circumstances, any absences, or different behavior. You have a chance to provide feedback about your experiences in treatment.
  • Increased drug testing: The frequency of urine or saliva tests may increase from once per week to three times per week, for example.

Clients who consistently test positive will be encouraged to talk about what happened. A person will not necessarily be dismissed from the program for signs of drug use, but there will be changes in treatment as a result. Changes may include:

  • An increase in sessions or returning to previous treatment levels.
  • Referrals to a treatment center that is more intensive or even an inpatient or hospitable-based program.
  • Creating a new plan that takes different needs into account to better serve the individual.

Is an IOP Right for Me?

An intensive outpatient program provides a high level of care, but it still offers flexibility to continue living at home. An IOP might be right for you if:

  • You finished medical detox and are transitioning to a lower level of care.
  • You have responsibilities at home or work that you can’t leave behind. IOPs allow you to continue living at home and working, if needed. This makes an IOP especially attractive to people who are the primary caretakers of their family or those who cannot take time off work.
  • You don’t need 24/7 care. If you suffering from co-occurring medical or mental health conditions, you may need round-the-clock care, particularly in the early stages of treatment.
  • You can commit to the requirements of the program. You’ll have support from your treatment team, and they’ll teach you how to maximize your time in the program.

In an IOP, your treatment will be tailored to your needs. All aspects of your care can work to get you closer to stability in sobriety.

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