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The American Society of Addiction Medicine (ASAM) placement criteria describe a continuum of care that matches the appropriate level of treatment to people struggling with substance abuse or addiction.
These criteria include five basic levels of treatment based on an individual’s degree of abuse, readiness to change, and other factors that determine the need for more or less intense treatment.
Level II treatment – Intensive Outpatient/Partial Hospitalization Services – includes two levels of care that are less intense than residential treatment, but more intense than standard outpatient services. Of these, intensive outpatient programs are designed to provide extra support to those who do not require 24-hour supervision or intense daily treatment, as is provided in partial hospitalization services, but who still need some regular guidance to manage relapse risk.
As defined by the Substance Abuse and Mental Health Services Administration’s Treatment Improvement Protocols, intensive outpatient treatment programs include services designed to provide a consistent level of support for those who are able to function living at home and performing regular daily tasks, such as attending school or going to work, but who still need structured treatment to some degree.
These services most often involve group sessions of various kinds to provide education, skill enhancement, counseling, and peer support for continued abstinence from substance use. These sessions take place during evenings or on weekends so the people involved in this level of treatment can participate in normal daily activities while still maintaining focus on treatment.
According to the ASAM Continuum’s description of intensive outpatient services, this level provides at least nine hours per week of treatment. This time is spent engaging in various sessions, including:
Peer support groups, such as 12-Step programs, are an integral element of this level of care, providing advice and shared experiences that can help each person improve relapse avoidance skills.
Another element of SAMHSA’s Treatment Improvement Protocols provides a reminder that intensive outpatient treatment is not meant to be a separate service, but instead is part of a continuum of care that provides customized services for each individual based on that person’s specific treatment needs at any given time. That means this level of care can be used in various stages of treatment:
Entry point: For a person entering treatment who has a stable home environment and some ability to self-manage, but who still needs support, intensive outpatient treatment can be the initial treatment level.
Step down: When a person who has been in residential treatment is ready to begin a transition back to living at home and re-entering typical daily life, intensive outpatient treatment can be the next step of support.
Step up: If an individual in a basic outpatient program is found to need more intense care, but does not need the immersion of inpatient treatment, intensive outpatient care can provide the additional support and structure needed.
Residential treatment programs that follow the ASAM placement criteria often provide access to these intensive outpatient programs as part of the aftercare element of the individual’s treatment plan. In this way, these programs provide a continuous support structure to help the individual manage recovery and avoid relapse, no matter what stage of treatment the person is in, enabling a more stable recovery.
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