Intensive Outpatient Program (IOP)
An intensive outpatient program (IOP) is a type of addiction recovery program that someone often attends after they complete an inpatient or residential treatment program. However, some people use an IOP as their primary form of rehabilitation. Additionally, some people seek an IOP after transitioning out of a partial hospitalization program (PHP), while residing in a sober living home, or to refresh relapse prevention skills months to years after rehab.
Intensive outpatient programs generally require between 9 to 20 hours of treatment every week, for 2 months to 1 year. 1 Programs often provide therapy in groups, 2,3 and people in the program visit the facility for sessions and return to their homes or other outside living arrangements at the end of the day. The number of therapy sessions may be reduced over time as the person progresses through the program.
Is an IOP Right for You?
Many people who attend IOPs have completed inpatient rehab or a partial hospitalization program for substance abuse. 2 In these instances, IOPs provide a transition out of more intensive care while still maintaining support. However, anyone with a drug or alcohol problem can attend these programs.
People who are typically a good match for intensive outpatient have the following characteristics: 1,2
- A willingness to attend counseling sessions regularly
- Have a network of friends or family members who support their recovery
- Live near the intensive outpatient rehab
- Have means of getting to and from treatment sessions (in some cases, programs will provide transportation)
- Have less acute mental health issues, if any
- Have fewer and less serious medical issues that require attention
- Have their own therapist or psychiatrist outside of the program
- Are less at risk for relapsing
Services and Treatment Approach
The majority of IOP treatment consists of group counseling, including family therapy and/or couples therapy.
- Assessment. IOP rehab generally begins with an assessment of the individual’s condition, including substance abuse and medical histories. This evaluation helps providers develop a treatment plan.
- Therapy. Once the treatment plan is in place, the majority of IOP treatment consists of group counseling, including family therapy and/or couples therapy. IOPs may also cover relapse prevention, stress management, assertiveness training, and parent skills training. Although individual counseling may be a component of intensive outpatient substance abuse treatment, it is often not the focus. Some people seek out additional individual counseling while in an IOP. 3
- Additional treatments and services. Adjunctive therapy can be an important part of treatment. Some centers offer art therapy, dance, drama, crafts, and sculpture to help people relax and take their mind off of addiction. IOPs may also offer acupuncture, massage, biofeedback, meditation, or yoga. This can help improve an individual’s emotional and psychological functioning and help them handle triggers or stressors. 3
- Medication. In IOP treatment, some individuals benefit from medications that will help them remain drug-free and prevent relapse. For example, medical providers may prescribe Antabuse (disulfiram) for people who are recovering from an alcohol dependency. Other medications that may be used include methadone, buprenorphine, and naltrexone. 3 These medications can help ease withdrawal symptoms and prevent relapse. Medications can be given on site, and medical staff monitor the individual’s condition. People who have more severe withdrawal symptoms are usually required to detox before they begin treatment in an IOP.
- Aftercare. When the person in treatment and the program staff determine that the person has completed their treatment goals, the staff will help them set up a plan for ongoing care and support. This plan could include regular appointments with a therapist, 12-step meetings, or a personalized relapse prevention plan to follow.
Some intensive outpatient programs conduct routine drug screenings and urine tests to ensure that the person is meeting treatment goals and that the therapy is effective. 3
Cost, Insurance, Payment
IOPs mainly use group counseling, which is a low-cost approach to treating addiction. During an intensive outpatient program, you will not live at the facility – making the cost of treatment less than inpatient, where you pay for food and housing.
The cost of treatment will depend on factors such as the length of time you spend in treatment, where the program is located, and your insurance coverage. Many private insurance plans cover outpatient treatment.
If you want to pay out of pocket, you can ask treatment centers whether or not they offer payment plans. Many facilities can work with you on payment structures, and some even offer treatment on a sliding scale – meaning that you pay what you can.
If you have public insurance, here is a breakdown of what will be covered:
- Medicare: Will cover drug/alcohol abuse treatment if you seek care at facilities that take Medicare, if your services are deemed medically necessary, and if your doctor sets up your treatment plan.
- Medicaid: Medicaid will cover services for inpatient, outpatient, and mental health. But coverage varies by state. Even though these services are covered, not all facilities accept Medicaid.
If you don’t have insurance to cover intensive outpatient substance abuse treatment, you can visit healthcare.gov to check your eligibility and sign up.
- Substance Abuse and Mental Health Services Administration. (2004). What is Substance Abuse Treatment? A Booklet for Families.
- Centers for Medicare & Medicaid Services. (2009). Impacts Associated with the Medicare Psychiatric PPS: A Study of Partial Hospitalization Programs.
- Substance Abuse and Mental Health Services Administration. (2004). Chapter 4. Services in Intensive Outpatient Treatment Programs.