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Outpatient care is one of the most commonly utilized options in addiction treatment. Less expensive than most comparable inpatient treatment programs and allowing for a return home each night, outpatient programs can feel more accessible to clients who have families who depend upon them, work or school commitments, or are otherwise interested in maintaining a flexible schedule while undergoing intensive treatment for addiction.
Like inpatient treatment options, there are a range of styles and types of outpatient rehab programs, and depending upon the individual needs of the patient, one may be more appropriate than another. It is important to take the time to get to know your loved one’s options in treatment and make an informed decision before enrollment. All outpatient treatment programs are not created equal, and connecting with the facility that provides the right resources for your loved one’s needs is imperative.
Like inpatient treatment, the goal of every outpatient program is to:
In some cases, choosing an outpatient treatment program can be a positive choice when the person living with addiction has dependents at home who require care. It is not always possible to find alternative care solutions for young children, special needs family members, or older adults, thus without outpatient treatment, many would feel powerless to seek any treatment at all.
However, it is important to note that care of dependent family members is not a reason to avoid seeking a more intensive inpatient addiction treatment program if that is what is needed to heal. If there is an alternative option for care of dependents that would facilitate the needed treatment, it is always preferable to make that choice, no matter how uncomfortable or initially difficult, rather than put the sobriety and health of the client at risk – and risking the safety of dependents at the same time. Caregivers must take care of their own health and wellbeing before they can effectively attend to the needs of others, and that is no less true when the disorder in question is addiction.
Not exactly. An intensive outpatient treatment program may require five hours or more of treatment and therapies, and those are scheduled daily. Many are group workshops and support groups, thus the times cannot be shifted to accommodate the scheduling needs of individual participants on a regular basis. It may be possible, however, for an occasional change to be accommodated as long as it only impacts the schedule minutely – but that is usually only in the event of a personal or family emergency and/or later in treatment when the person has demonstrated a strong commitment to recovery. Additionally, it may not be as difficult to navigate scheduling to accommodate work if a less intensive outpatient treatment program is undertaken.
It is important to note that it is possible to work or attend school while enrolled in an outpatient treatment program – even an intensive program. Though the program schedule may not bend to support the outside schedule of participants, it is possible for clients to choose classes and jobs that can be worked around the treatment schedule and thus be supported in treatment as they stabilize in independent sobriety.
Different programs will ask participants to commit to different levels of participation at different stages of recovery. Under most circumstances, the highest level of commitment (e.g., the most days and hours per day) occurs in the first weeks of recovery. After the client stabilizes and demonstrates sobriety through clean drug tests, a lesser time commitment is required.
In the case of intensive outpatient treatment programs, participants may be asked to attend a minimum of five hours per day of therapies and treatments, five days per week with weekends off. In other cases, the number of hours per day may increase up to eight in order to facilitate a four-day per week program. In still other cases, the outpatient program may require that participants take part in 12-Step meetings, support groups, or personal therapy sessions on the weekends or in the evenings in addition to program requirements. Every program is different, and it’s important to find out what is expected prior to enrollment.
An intensive outpatient treatment program is, as it sounds, often more intense in terms of its treatment offerings as compared to a standard program. An intensive outpatient treatment program will often offer access to a wider range of therapeutic options, require clients to maintain a higher level of daily therapeutic commitment for longer, and demand more frequent demonstration of continued sobriety through required drug tests than a standard outpatient program.
Additionally, an intensive outpatient treatment program will often provide a measured step-down approach. For example, an intensive outpatient treatment program may require new clients to attend six hours of therapies and treatments five days a week for four months, then go to four-day per week with five hours of treatment per day for three months, then step down to two or three days per week with four hours of treatment until finally the client is only attending alumni meetings and/ or support groups at the outpatient program and offered ongoing aftercare support.
By comparison, a standard outpatient program may offer more flexibility in terms of the dates and times of therapy sessions. Additionally, there may not be a significant “step down” in number of hours of required therapeutic interaction per week between phases of treatment or long-term support in aftercare.
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Comparing Outpatient OptionsComparing Inpatient to Outpatient
Some outpatient treatment programs – especially intensive outpatient treatment programs – offer aftercare support for a year or more after clients complete the program. Most will help clients to create aftercare plans, making use of ongoing therapeutic resources in the community when they leave outpatient treatment, and then provide the option of returning to treatment at a reduced cost (or for free) for a finite period should relapse occur.
Other outpatient treatment programs play a very small role or do not offer support at all to alumni who complete their programs. They may offer alumni support groups as an option or host community 12-Step meetings that are open to alumni, but they may not provide ongoing support for clients in long-term recovery.
Many do. The 12-Step program is a resource that is offered on an outpatient basis as well as incorporated into many inpatient and intensive outpatient treatment programs. The familiarity of the structure of these meetings, the lingo, and the open offer of support as well as its wide availability throughout the world make it an excellent resource for clients.
One of the main challenges of attending an outpatient treatment program over an inpatient rehab is that, should the urge to relapse strike outside of treatment hours, the client may feel unsupported and more likely to drink or get high. When clients are familiar with and engaged with the 12 Steps, however, not only do they have the option of seeking out a meeting – often, any time of the day or night in some urban areas – but they may also be able to call or otherwise connect with a “sponsor,” someone in the program who has successfully worked the steps and offered to be there for support.
Insurance companies are required to cover the cost of treatment for drug and alcohol addiction by law. The laws do not state, however, how that treatment should be defined. That is, the style of treatment, the duration of treatment, or whether or not that treatment is provided on an inpatient or outpatient basis is not stipulated, nor are there any guidelines to assist in determining what should and shouldn’t be covered. In general, treatment must be proven to be “medically necessary” by the prescribing physician; thus, it is often far easier to get coverage for outpatient care than it is to get coverage for residential care because it is less expensive.
In some cases, it is possible to get addiction treatment medications through a physician at an outpatient treatment center. However, depending upon the type of medication, it may beyond the scope of practice of the facility, and people in need of medication may need to seek medical care at an outside program.
Medications typically used during detox, such as maintenance medications, are strictly regulated and may only be prescribed and distributed under specific circumstances and by professionals who are trained to do so. Though it may be possible to find outpatient treatment programs that incorporate medical care into their program or are affiliated with a medical care facility, in most cases, medical support during detox and for underlying physical ailments must be acquired through alternate means.
All outpatient programs are different and offer different resources to participants, but most outpatient programs – like most inpatient programs – offer some level of support to family members who are willing and able to be involved in the healing process of their loved one. Some support options provided may include: