Outpatient Rehabilitation

What is Outpatient Treatment?

Outpatient treatment is any program in which the patient attends treatment without living on the premises of the treatment facility. At the end of the day, he or she returns to their home, a different treatment facility, or a sober living facility. Outpatient treatment attendees have the freedom to spend time with family, work, attend school, and engage in recreational or social activities outside of treatment.

Some facilities define outpatient treatment programs to include intensive outpatient treatment programs (IOPs), which provide the same level of treatment as inpatient programs but have a different structure. In some cases, outpatient treatment is what occurs after the initial detoxification phase of treatment.

How Long Does Treatment Last?

The whole recovery process from start to finish can take anywhere from nine months to a year. It will take less if any of the steps are omitted. Treatment can also be lifelong. Many people with substance use disorder (SUD) need ongoing therapy and support that helps them avoid relapse. Therapies may include individual therapy, family therapy, and group therapy sessions. 

Types of Outpatient Alcohol Rehabilitation Centers

Residential rehabs are popular options for those with substance use disorders (SUD), but they are not the only options. There are varying intensity levels of treatment that suit a variety of lifestyles and addictions. Outpatient programs allow someone to seek treatment, while still maintaining a routine and protecting his or her privacy.

Types of outpatient rehab centers include:

• Regular outpatient
• Intensive outpatient
• Partial hospitalization
• Telehealth treatment
• Group counseling

Outpatient Treatment for Alcohol Use Disorder (AUD)

Outpatient treatment for alcohol use disorder is effective because it provides the support needed by someone with an AUD without interfering with his or her daily responsibilities. These programs offer a wide variety of services that might include:

• Medication-assisted detox
• Alcohol counseling
• Different types of therapies
• Support groups

A comprehensive outpatient treatment program provides the greatest support for dealing with potential triggers and achieving sobriety without completely removing a person from his or her life.

Outpatient Treatment for Substance Use Disorders (SUD)

Outpatient treatment is effective for treating any substance use disorder. However, some SUDs require medically supervised detox before outpatient therapy begins. These programs are effective because they are affordable, flexible, and allow a person to maintain obligations while in recovery.

Treatment Timeline & What To Expect

Treatment for substance abuse disorder usually follows a continuum, which starts with inpatient ‘detox’, and ends with outpatient treatment. Each ‘step-down’ in the level of care becomes less intensive, successively. There are a few options for treatment along the way.

Residential Treatment

Your first stop after discharging from detox might be residential treatment. This is not technically outpatient treatment because you will live in a facility for 30, 60, or 90 days, depending upon how much treatment you need at this level of care.

This is the most intensive treatment, after inpatient. You will have ‘round the clock care, and attend programming all day, every day. Most residential treatment centers will also expect you to participate in 12-step meetings, and have family involvement in your care. Some residential treatment centers are privately owned, while others are affiliated with local hospitals.

PHP

After you have completed residential treatment, the next step-down is partial hospitalization, or PHP. Not everyone who has an inpatient stay will go to residential treatment. Some patients skip this step and go straight to PHP. The PHP is an outpatient program that requires a commitment of usually 4-5 days per week, and approximately 6 hours per day. Expect this program to last for 4-6 weeks.

Many patients find it difficult to work, even part-time while attending a PHP program. This may be a factor to consider when deciding on your outpatient treatment. The advantage is that you can use the coping skills you are taught in treatment and apply them to real-life situations and triggers that you will experience when you go home at night. You will also receive guidance from a therapist and a medical doctor. They will help you navigate relationships and other challenges.

IOP

The next level in the step-down process is called Intensive Outpatient Program, or IOP. The IOP is usually 4-5 days per week, and 3-4 hours per day. Expect this program to last for 3-4 weeks. It is a less intensive commitment than the PHP, but the advantage is that it allows for a person in recovery to gradually start to reintegrate back into a routine, such as working during the day and attending treatment in the evenings.

After completing the IOP program, a patient will begin seeing an outpatient therapist weekly. This may be a long-term relationship throughout the maintenance phase of recovery. The patient will choose an outpatient therapist who is familiar with treating their disorder(s) and specializes in addictions counseling.

Continuing Care Groups

This is the final or maintenance step in the recovery. The goal of continuing care is to provide someone with an outlet to discuss his or her accomplishments and challenges with sobriety. Alcoholics and Narcotics Anonymous are examples of continuing care groups.

Effectiveness of Treatment

Research shows that outpatient treatment for substance use is effective. However, someone with an addiction needs to find the right program for them. The specific needs of the patient, as well as his or her personality, personal history, and strengths and weaknesses all play a role.

To be effective, an outpatient treatment program should have:

• An approach rooted in addiction science
• Access to evidence-based and experiential therapies
• Support for managing co-occurring disorders (a substance addiction and mental health disorder)
• An approach that addresses the whole person and not just the addiction
• Access to a multi-disciplinary team
• A community focused on recovery

Outpatients vs Inpatient Treatment

Inpatient and outpatient treatment both offer benefits. There are also drawbacks to both. It’s important to weigh the advantages and disadvantages of a program before committing.

• Some of the most important advantages of outpatient treatment include:
• Ability to balance work and home responsibilities with treatment
• Less expensive than inpatient treatment
• Allows the patient to interact with and receive support from family members, friends, and other loved ones
• Ability to immediately apply what is learned in treatment in the real world
• The downside of outpatient treatment is that it does not restrict access to substance use with the same level of severity as inpatient treatment. Maintaining sobriety is a greater challenge because of a lack of supervision for several hours a day and one might still be exposed to triggers.

When To Seek Treatment

Substance abuse treatment is an option any time use interferes with a person’s everyday life. Outpatient care is appropriate when someone:

• Is unable to control his or her use of a substance
• Has a desire to quit but was unable to do so
• Spends a lot of time trying to obtain or use a substance
• Experiences cravings, tolerance, or symptoms of withdrawal
• Faces relationship issues or problems with obligations and responsibilities
• Has lost interest in previously important priorities and hobbies
• Cannot attend inpatient treatment due to cost, lifestyle, or level of addiction

How Much Does Intensive Outpatient Treatment Cost?

Intensive outpatient treatment for addiction costs less than inpatient rehab. This is because people live at home and do not need to pay for a room, meals, or 24/7 medical care. 

On average, outpatient programs might cost a few hundred dollars per day, whereas inpatient treatment costs close to $1000 per day. Outpatient treatment costs vary widely and are based on the services offered, the length of treatment, and whether or not someone has health insurance. All health insurance plans offered by the open exchanges created by the Affordable Care Act cover intensive outpatient therapy. Medicare usually covers psychotherapy, pharmacotherapy, and educational sessions, as long as a medical doctor has referred the patient to treatment.