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Intensive Outpatient Programs: Early Intervention Can Mitigate the Need for Residential Treatment


The American Society of Addiction Medicine defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Similar to other chronic illnesses such as cancer and diabetes, addiction, if left untreated can develop into a more severe condition over time.  The negative impact of addiction can range from physical and emotional damage, to severe life impairment and even death.  This progression of the disease can occur over many years, however it often begins with use of a substance to induce a desired mood change.  The discovery of this perceived benefit can then lead to the individual’s misuse of the substanceor using to the point of intoxication in order replicate this sensation.  Substance misuse can further progress as the individual exploits this relationship between the substance use and its desired outcome.  This would be considered substance abuse, and the individual may continue to use the substance even despite the fact that it is beginning to interfere with their life, impact their work or personal relationships.   If not addressed, substance abuse can then develop into a substance use disorder. Individuals struggling with a severe substance use disorder often require a greater amount of the substance in order to feel the same effect as the first use, and negative physical symptoms such as withdrawal may occur if the substance use is discontinued. As the illness progresses the difficulty to stop using the substance increases. 

The development of an addiction is often characterized by negative consequences such as DUIs, performance issues at work or family concern. Some of these consequences can serve as warning signs that the substance use is becoming out of control. By recognizing the warning signs and realizing that perhaps one’s substance use has progressed to misuse or even abuse, an individual can be proactive in avoiding the progression of the illness and prevent further negative physical, mental and social consequences. Early detection of the illness however may require insight into the personal problems that fuel the substance abuse.  Help from a professional addiction counselor may be a necessary means of addressing the substance use issue. It is important to get help and there is a range of treatment options available depending on the severity of the problem. For those appropriate, treatment is possible without having to attend a residential rehabilitation program. For example, mild and moderate substance use disorders can be effectively treated within an outpatient context.  One possible option is an Intensive Outpatient Program (IOP).

Components of an IOP include group process and counselling, psycho education on the disease of addiction and recovery, relapse prevention, cognitive behavioural therapy, aftercare planning and substance use monitoring.  The goal of the IOP is abstinence from mood altering substances, and therefore clients will learn to establish relapse prevention tools, but they will also begin to address underlying issues associated with the substance use and bring them to the surface. This can help them understand what is perpetuating the addiction and help to find other means of coping with stress or relationship issues, for example.

Family-SupportdollsAn intensive outpatient program is well suited to individuals who are motivated to address their substance use issues, before they further impact their health and well-being. They are also ideal for individuals who have supportive home environments, with loved ones who will encourage them in their recovery. While addiction is a very serious health issue, the good news is that it can be effectively treated, especially in its early development. Participation in programs such as an IOP, can be an important and meaningful way to address substance use issues before they lead to more severe problems.

Intensive Outpatient Programs: A Flexible Option for Addiction Treatment Could be the Solution

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.

An Innovative Practice on treating patients with substance abuse on an outpatient basis

I can’t take time off work but I know I need professional help with my alcohol or drug problem.

What if I don’t need to be in a residential treatment program for alcohol or drugs- what are my options?

What if I can’t afford an addiction residential treatment program?

These are examples of issues and questions that arise when our clinical team is assessing and helping an individual with an alcohol or drug problem. Sometimes individual counselling or an intensive residential rehab program for alcohol and drugs are not an option.

Bellwood Health Services can still help.  Bellwood’s research and clinical team have designed a new innovative program, called the Intensive Outpatient Program for individuals who need an intensive treatment program but due to personal, financial or work obligations cannot enroll in an intensive long-term residential rehab program for substance abuse.

Some of the exceptional key features of this program are:

The Intensive Outpatient Program is suitable for individuals in the GTA area.

This program offers several of the intensive residential treatment benefits but at a fraction of the cost!

Suitability for this program must be assessed and determined by our Intake and Assessment Clinical Team.

To learn more about this program, please visit:

Addiction recovery is one phone call away. Simply give us a call 24/7 days a week: 1-800-387-6198. Conveniently, we also offer online