Intensive outpatient programs: What’s included?

Intensive outpatient drug or alcohol programs use evidence-based therapies like counseling, education, and group therapy in treating addiction. How different are outpatient clinics from inpatient addiction centers? We review here.

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Experts agree that intensive outpatient programs (IOPs)  can be highly effective in the treatment of addiction. What can you expect during your time in an IOP? And what’s included in the cost of treatment? We review here. Then, we invite your questions about IOPs in the comments section at the end. In fact, we try to respond to all questions personally and promptly.

Basics about intensive outpatient programs

Programs vary in the anticipated length of stay or expected active duration of intensive outpatient treatment. For example, IOPs can last anywhere from a couple of months to a year, or longer. However, many courses of treatment span 12 to 16 weeks before people step down to a less intensive (maintenance) stage of treatment. They may then remain in the maintenance phase for 6 months or more.

The actual number of hours and days per week that people participate in IOPs varies depending on individual needs from six (6) to thirty (30) hours per week. Although intensive outpatient programs generally provide structured programming for 9 hours or more per week spread over 3 to 5 days, some IOPs may provide fewer hours. Some clinicians find that more frequent, shorter visits are of greater benefit to the client than less frequent but longer sessions.

Treatment during intensive outpatient programs

How does intensive outpatient work? Groups form the core of most Intensive Outpatient Programs. Most IOPs place people in several different types of groups during the course of treatment. Broadly speaking, these include psychoeducational, skills-development, support, and interpersonal process groups. Group counseling allows programs to balance the cost of more expensive individual counseling services.

IOP group counseling sessions often are scheduled for 90 minutes, although shorter and longer timeframes also are used. Psychoeducational group sessions often are only half that long (EX. a 30-minute lecture followed by 15 minutes for questions) because they focus on instruction instead of interaction. Generally, the group approach supports people in treatment by:

  1. Providing opportunities for them to develop communication skills and participate in socialization experiences; this is particularly useful for individuals whose socializing has revolved around using drugs or alcohol.
  2. Establishing an environment in which people help, support, and, when necessary, confront one another.
  3. Introducing structure and discipline into often chaotic lives.
  4. Providing norms that reinforce healthful ways of interacting and a safe and supportive therapeutic environment that is crucial for recovery.
  5. Advancing individual recovery; group members who are further along in recovery can help other members.
  6. Providing a venue for group leaders to transmit new information, teach new skills, and guide people as they practice new behaviors.

Intensive outpatient programs stages

There are four (4) primary stages of addiction treatment that occur during your stay in an intensive outpatient rehab. These usually include:

Stage 1: Getting started and feeling involved

During this initial stage of addiction treatment, your rehab counselor identifies how problems with respect to substance abuse have presented themselves in your life. You’ll be assessed for physical, psychological, and social functioning, your family may be interviewed to understand more about your social support network. Also, the counselor explains program rules and expectations and works to stabilize any crises.

Stage 2: Early Recovery

This is the early part of learning about addiction, its impact on your life, and the psychological issues that compel your drug or alcohol use. It’s not an easy time and often demands extreme honesty, involves many emotions, and may be uncomfortable. This stage is highly structured with educational activities, group involvement, and new behaviors to help you develop recovery skills, address lapses, and build a substance-free lifestyle. Treatment during this time will be both individual, one-on-one counseling and consist of group sessions.

Most of the 2-3 hour psychoeducational group sessions have a standard format. The first hour consists of a structured group during which each of the 6 to 14 members is asked individually to report significant emotional or behavioral events since the last meeting (EX., moods, sleep patterns, activities, 12 step meeting attendance, stress, cravings) A second hour is devoted to a modified form of group therapy that focuses on issues of particular relevance to members and encourages their interactions. A third hour consists of didactic instruction on such relevant topics as medical aspects of addiction and relapse prevention techniques.

Stage 3: Maintenance

When you complete stages 1 and 2 of your treatment, it is time to “step down” to outpatient treatment programs and enter the maintenance phase, having demonstrated a commitment to change, been stabilized, become abstinent, and developed relapse prevention skills. However relapse can and does occur during this stage.

A 2-week overlap between former groups and new groups usually helps ease the transition to the longer term, stepdown treatment phases. If possible, you will be placed in more homogeneous groups whose members have similar interests and values as you. Goals of maintaining what you’ve learned include:

  • Solidify abstinence
  • Practice relapse prevention skills
  • Improve emotional functioning
  • Broaden sober social networks
  • Address other problem areas

Stage 4: Discharge to continuing care

This stage is based on a detailed and individualized discharge plan for continuing recovery in the community using available resources.  The goal is for to leave with a realistic plan for ongoing recovery. As part of continuing care services, programs usually sponsor alumni meetings and provide checkup counseling sessions. Periodic, weekly telephone contact can also help you in your recovery. Other aspects of continuing care include:

  • vocational training
  • recreational therapy
  • family therapy
  • medical care

Intensive outpatient programs protocol

While the effectiveness of treatment for specific individuals is not always predictable, recent evaluations of substance abuse treatment efforts are encouraging. All the long-term studies find that “treatment works” – the majority of people struggling with addiction and seek help eventually stop compulsive use and have less frequent and severe relapse episodes.

The most positive effects generally happen while you are actively participating in treatment, but prolonged abstinence following treatment can also be a good predictor of continuing success. So, we’ve compiled a list of the things that can make your stay in an IOP a positive one:

  • be honest
  • consider changes to diet, sleep, and exercise
  • follow suggestions
  • involve family, when possible
  • join a support group
  • take notes
  • trust the process

Intensive outpatient programs costs

The most recent information we could find on the costs of IOPs was based on a survey conducted by Open Minds Consulting, showed the average costs of services from of a few dozen private treatment providers. They found that for a 10-week intensive outpatient treatment, the average cost was around $7,000.
Another survey included a total of 13K American substance abuse treatment programs found that:

  • 4% provide free treatment for all clients
  • 10% offer free treatment to selected clients
  • 38% offer both free treatment and a sliding cost scale
  • 24% don’t offer free treatment, but provide treatment on a sliding scale
  • 27% don’t have either free treatment or sliding scale treatment options


  • 76% of all substance abuse treatment facilities have some form of payment assistance

Low cost Intensive outpatient programs

Even though it’s far less-expensive than inpatient rehab, outpatient care can still be quite expensive. Depending on the length of the program, addiction treatment can cost thousands of dollars prices vary widely.

Tips to help you pay for treatment:

1. Check your health insurance.

You can call the number on the back of your card to get information of your mental health and substance abuse insurance coverage. You can find out what would be the additional costs, including deductible and co-payment amounts.

2. Search for treatment programs that offer sliding fee scale or reduced payment options.

You can find these information at the substance abuse agency in your state, or call SAMHSA’s helpline on (1-800-662-HELP) and ask about affordable treatment options in your close area.

3. Search for scholarships.

Speak with local community leaders, doctors, and people in health services to learn more about sponsorship opportunities for rehab programs. They are out there, you just need to do the asking.

Intensive outpatient programs questions

In this article, we have tried to explain the stages of intensive outpatient programs, as well as clarify more about the therapies and the cost of these services. If you are seeking for more information about other outpatient rehab treatment options, we invite you to check out the link.

We now encourage you to ask questions in the comments section below. We will do our best to answer all relevant questions personally and promptly.

Reference sources: NCBI: Chapter 5—Specialized Substance Abuse Treatment Programs
SAMHSA: Clinical issues in IOT
NCBI: Services in Intensive Outpatient Treatment Programs
NCBI: The outcome and cost of alcohol and drug treatment in an HMO: day hospital versus traditional outpatient regimens
BDAS: Promoting prevention and Recovery
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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