Intensive Outpatient Program
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.
Intensive outpatient programs are designed to provide extra support to those who do not require 24-hour supervision or intense daily 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.
What Is an Intensive Outpatient Program?
According to ASAM’s continuum of care, intensive outpatient program (IOP) is a higher level of care than standard outpatient treatment, which typically involves just a few hours of treatment per week.
An IOP generally consists of a minimum of 9 hours of treatment (or 6 hours for adolescents) each week. The treatment provided in an IOP is appropriate for people with multidimensional needs but who are stable enough to continue living at home. IOPs involve a significant number of treatment hours but are often flexible enough to allow the patient to continue attending to their personal responsibilities. For example, IOP treatment may be delivered after school/work or on weekends or during other convenient times.
IOP services most often involve group sessions of various kinds to provide education, skill enhancement, counseling, and peer support for continued abstinence from substance use.
Who Should Participate in an IOP?
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.
An IOP may be a good option for you if you have a job and a good deal of social support at home. IOPs are also sometimes recommended for people as a step-down form of treatment to continue support after the completion of a residential rehab or even a partial hospitalization program (a more intensive outpatient option).
If you’re not sure whether an IOP is the right next step for you, speak to an addiction professional or a doctor. If you’re currently in another program, talk to your treatment team about your plan and what they feel is right for you based on how you’re progressing in your recovery.
Description of Intensive Outpatient Treatment Level of Care
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:
- Presentations providing information on substance abuse issues
- Skills development, such as stress management or substance refusal training
- Discussion among members of the group about specific issues and resolution
- Peer support: building a network that aids in motivation and self-confidence
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.
Intensive Outpatient Treatment and the Continuum of Care
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.
Should I Choose an IOP Over Residential Treatment?
There are several benefits of intensive outpatient programs, including the ability to stay at home and to keep up with your normal duties and activities, such as work, school, hobbies, etc. IOPs often tend to be quite a bit more affordable than residential treatment, as well. But for some people, residential treatment is the best option for them because it provides around-the-clock support and supervision.
For people whose lives have been thrown into chaos by addiction, the structured daily schedule of a residential program provides the necessary framework for them to get their lives back on track. An IOP provides a good deal of treatment during the week but there will still be many times when the person is left on their own. This may be difficult for someone in the beginning stages of recovery from a substance use disorder, especially one that is very severe.
A treatment professional can discuss your needs with you and help you make a decision about your care. You may also call us at any time at to discuss your substance use and ask questions about treatment.