Intensive Outpatient: Choosing a Level of Care for the Treatment of Substance Abuse

Identifying the need for treatment is a significant step in beginning the journey to recovery, but it can also mean feeling overwhelmed with choosing the appropriate level of care for treatment. It is recommended that an individual partake in an initial evaluation to determine the needs at the time, but it can be comforting to understand those choices available when entering into this first phase of treatment. While the majority of individuals are familiar with detox and residential inpatient, as these are most often portrayed within the media, less talked about is intensive outpatient treatment, which may be sought as a first step, or as a follow-up form of care upon completion of a residential program.  Intensive outpatient treatment references engagement in treatment on an outpatient basis, but with a significant commitment to both groups and individual sessions. On average, intensive outpatient implies three group therapy sessions, all spanning three hours, as well as one individual session for a minimum of one hour, per week. The general premise is to ensure that an individual in early recovery is receiving significant supports from both peers and professionals. While recovery is a process and way of life, early recovery proves to be most critical, as one is still learning to identify cravings and triggers and implement healthier coping mechanisms.

 

For many, the idea of group therapy can feel daunting, but it is an essential piece of the recovery process. Addiction thrives in isolation and while individual therapy offers a framework to begin processing through challenging emotions, it does not always offer enough support to combat the dangers of isolation. By nature, group therapy offers a network of support from individuals facing similar struggles. It provides the opportunity to build connections with peers, while also building upon self-reflection. Growth occurs through both the process of sharing on struggles that may previously have been exacerbated through secrecy, as well as through receiving feedback from others in a manner that begins to reduce shame by removing the perception of both judgment and isolation.

How Group Therapy can Help

The size of a group therapy session varies based upon the location, but always has a least one, if not two, professional facilitators. The facilitator serves to guide the group process by providing a sense of structure through the introduction of a topic or theme. The topic or theme introduced will differ depending upon the facilitator, as well as the needs of the group. Group therapy is meant to allow the members to explore emotionally trying content in a safe space and therefore, it is typically the group members themselves that determine the exact content of the days session. The facilitator ensures that all members are provided with an opportunity to share uninterrupted, with members reminded to abstain from any cross talking. They will further encourage constructive feedback from members of the group and may offer insight or pose questions of their own to further foster reflection. The group therapy process allows for an opportunity for individuals from various backgrounds to relate with one another, creating connections in the recovery journey.

 

Topics may also address the need for psychoeducation based on expanding the knowledge of the disease of addiction. Areas of exploration may be substance abuse as a means of self-medication and the changes that substance abuse creates within the brain. The exploration of this information is meant to provide a foundation for the individual to better understand the internal processes related to addiction. This understanding can serve to challenge the individuals perception of being “damaged or defective” by offering an explanation as to why the cycle of addiction may continue to occur. The disease of addiction affects the limbic system or more informally, the reward system. Structural changes exist that can be brought about by genetics, as well as further altered through environmental experiences. These changes create a heightened reward system that responds to stimuli that it deems to be pleasurable and continues to seek out this level of pleasure. Understanding the structural changes involved can assist the individual working towards recovery in forgiving themselves for their use, as well as provide valuable information in how to challenge the reward system from automatically seeking out previously achieved levels of reward. Intensive outpatient aims to assist in overcoming the sense of shame that may be associated with addiction, as well as identifying how best to respond to cravings.

 

Full Continuum of Care

Intensive outpatient is only one piece of the continuum of care available in the recovery process, but assists in slowing the re-integration process into the community by holding you accountable for your behavior. It further provides an opportunity to acquire essential resources in building a sober support system and is economically feasible, as it is typically covered by insurance. This can be an excellent opportunity to work towards long-term recovery, while offering a variety of services and supports, requiring only the initial call to seek the assistance needed to begin the process towards a new way of life.