Should you go to an outpatient rehab? INTERVIEW with David Lisonbee

Are you considering inpatient or outpatient rehab? The following Q&A with David Lisonbee addresses some of the questions you may have.

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Are you looking to go to rehab? Check out our conversation with David Lisonbee, President and Chief Executive Officer of Twin Town Treatment Center. He helps bring light to questions like: Should I choose outpatient or inpatient rehab? When it is better to use inpatient rehab? How do you decide on a specific type of program?

For this and more, read on. If you like to add or share anything about the subject, please leave us a message in the comment section.  We try to respond to all legitimate questions or queries with a personal, prompt reply.

ADDICTION BLOG: Hello David, thank you for joining us. To begin, what control of choice do people really have in choosing their own rehab? What typically happens in the process of going to rehab?

TWIN TOWN TREATMENT CENTERS: People encounter many obstacles and need to consider personal variables before engaging in treatment for substance use disorders. Some variables are within their control and may surmount to freedom of choice, others are outside of their control. All of the following factors can play a part in making a decision where someone turns for help.

  • severity of illness
  • history with the disease
  • age
  • living environment
  • social support
  • finances
  • treatment mandates (legal, employer, parental, child-care),
  • work
  • school
  • health status

ADDICTION BLOG: Please describe to us the kinds of activities typically included in an outpatient rehab.

TWIN TOWN TREATMENT CENTERS: Outpatient treatment usually consists of approximately three hours per day for a minimum of three days per week of group education, counseling, cognitive-behavioral assignment, case management and mutual support activity. Exercises in new recovery promoting ideas and behaviors are practiced directly in a person’s normative environment. The therapeutic take-home of outpatient treatment is 100%.

ADDICTION BLOG: What is the main difference between an inpatient rehab and an outpatient program? What kind of services are similar?

TWIN TOWN TREATMENT CENTERS: Patients in outpatient treatment live unsupervised at home or in a sober living residence. Outpatients practice what they gain during treatment sessions directly in their homes with their families and at work with their boss and co-workers. The process of learning and growing in recovery during outpatient treatment is organic.

ADDICTION BLOG: What would you say is the main advantage of inpatient rehab compared to an outpatient program?

TWIN TOWN TREATMENT CENTERS: Inpatient day-to-day rehab assists containing out-of-control behavior, including psychiatric symptoms. During inpatient treatment patients focus only on what is being taught- daily life triggers and distractions are minimized.

ADDICTION BLOG: What would you say is the main advantage of outpatient addiction treatment compared to an inpatient program?

TWIN TOWN TREATMENT CENTERS: Therapeutic gains in outpatient treatment are immediately translated into a patients life. In other words, the therapeutic take-home is 100%. Normal life triggers and stressors are encountered and patients learn to use peer support and the tools of recovery in real time. More on advantages of outpatient treatment here.

ADDICTION BLOG: Can any patient be referred to an outpatient program, or do you sometimes refer them directly to residential addiction treatment?

TWIN TOWN TREATMENT CENTERS: If a person needs physical detoxification, lives in a toxic living situation, or presents and inability to stop using for a twenty-four hour period, patients are referred to residential treatment. Any signs of dangerous psychiatric symptoms preclude outpatient as a treatment alternative.

ADDICTION BLOG: One of the main benefits of a residential program is the distance and isolation from possible enablers. Another benefit is to live 24-7 with people that understand and share the problem. Calm and peaceful surroundings are somewhat helping the treatment. In your opinion, how should outpatient treatment facilities compensate for the lack of such features?

TWIN TOWN TREATMENT CENTERS: Recovery happens inside of a person and one builds a sober life in the real world. A lasting sober support network is built at home which allows for long-term sobriety. Without establishing a personal focus on recovery with a sound sober support network, recovery will not last. This happens in real time during outpatient treatment while professional and peer supports are available.

ADDICTION BLOG: Can/Should outpatient treatment be coordinated with sober living to be more cost effective than inpatient rehab? Is there any other model/combinations of treatment that can be used as a replacement for residential rehab?

TWIN TOWN TREATMENT CENTERS: Each person has their own set of assets and capacities. Some benefit from “Florida Model” of sober living plus outpatient. Some benefit from residential treatment. Others get sober in outpatient programs. People even get sober by doing A.A. only.

ADDICTION BLOG: What about relapse prevention? What best practices should any rehabs be practising?

TWIN TOWN TREATMENT CENTERS: Sound relapse prevention has to happen from day one throughout treatment. It’s easy to get sober. Staying sober is the challenge! Strategies such as Gorski, Miller, CBT, etc. should be integrated in REAL TIME while a person encounters the real life triggers and stressors. It’s easy to be sober in a serene environment.

ADDICTION BLOG: Is there anything else you would like to share with our readers?


There is much written and published regarding treatment outcome and from what I have seen, there is no clear winner between residential and outpatient, between CBT, MET or 12-Step Facilitation. What matters is the relationship established between the person being helped and the people helping.

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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