Substance use disorders are pervasive and can affect everyone. Research has demonstrated that about one in ten Canadians reports having a substance use issue, and these individuals include professionals, those who are employed or self-employed and those who have other daily responsibilities and commitments such as homemakers and caregivers. At times, substance use disorders are problematic to the point that the individual needs to seek help from addiction counsellors and mental health professionals. Traditionally, when substance use is problematic, residential programming has been the conventional option for addiction treatment. However, taking an extended amount of time off could be a barrier in getting the help that is needed, especially for those who are employed or have daily commitments. It is for this reason that treatment providers also offer Intensive Outpatient Programs (IOPs). For those in need of addiction treatment, IOPs allow people to work and honour their daily commitments while also attending regular, outpatient treatment sessions in order to address their problems and to learn the tools that can help them maintain sobriety.
Outpatient programming is not for everyone but when appropriate, it can be a meaningful and effective treatment option to address a serious health issue such as a substance use disorder. As with any other treatment programs, recommending an IOP must be part of the individual’s treatment plan. This means taking into consideration any physical, emotional or behavioral problems relevant to the person’s care. The treatment plan must consider the needs of the client and begins with a comprehensive assessment of the individual. Once the assessment is complete, a professional can decide on the best level of care that will meet the client’s needs.
There are multiple factors that must be considered when determining whether or not someone is a good match for an IOP. For example, one of the primary considerations is the level of medical need such as a history of withdrawal symptoms, as well as existence of medical conditions that require monitoring. Professionals will also consider whether or not the individual has other emotional/cognitive/behavioral problems that may require closer attention by a mental health professional. In order to meaningfully participate and keep up with the program, the person must also have a sufficient level of motivation to be able to maintain sobriety while attending scheduled meetings. This often means that the client must have a stable and supportive home environment that will be able to foster a successful recovery.
IOPs typically take a group approach, providing clients with opportunities to learn from and support one another while developing communication skills and socialization experiences that do not involve the use of drugs or alcohol. Such programs that cultivate a supportive environment, also establish a safe and trusting relationship between group members, as well as the counsellor. Those that are further along their path of recovery can provide guidance and support for newer members, helping them refine the new skills and tools they are learning.
Clients typically participate in a variety of groups that make up an IOP program. Such groups can include psychoeducational sessions or lectures, where individuals can begin to understand the nature of addiction and how it has been impacting their mind, body and social life. These sessions are often also accompanied by relapse prevention and skills training, as well as a selection of videos that may help clients with their understanding of the material. Other groups may consist of teaching some very concrete skills such as assertiveness training, refusal techniques and stress management strategies.
As with any other treatment program, intensity and client retention are vitally important for outpatient programs. Research shows that successful outcomes are closely related with the length of program and how often clients are able to attend. It is also important that once the client completes the intensive component, they attend regular aftercare meetings and create a close network of supports that will help them maintain a successful recovery going forward. Such meetings can also serve as a safety net in case the person begins to struggle and may require more intensive support in order to prevent a full on relapse.
Successful outcomes also depend on client’s individual characteristics. For example, research has found associations between severity of substance use and treatment success. There is also something to be said about how long someone has been struggling with an addiction, the severity if their cravings and how many previous attempts at treatment may have had. Finally, symptoms of co-occurring mental health problems such as depression or anxiety can also impact an individual’s recovery. Overall, it is best to leave the decision of selecting an appropriate treatment modality to a professional who is able to consider a variety of factors that may be contributing to the maintenance of the addiction. However, when appropriate, participation in an IOP can be a realistic, meaningful and effective means of addressing alcohol and substance use disorders.
