Are Outpatient Programs Effective? The Proven Benefits of Outpatient Rehab

Outpatient rehab may be an alternative to hospitalization or inpatient rehab, or may be a “step down” in care after more intensive rehab. One of the primary benefits of outpatient rehab is that is allows you to attend addiction treatment while living at home.

Treatment facilities recognize not everyone can attend in-person treatment. So today, they are expanding treatment settings and services to ensure anyone can receive benefits of outpatient rehab, even if they can’t leave home.1 This service has become vital during the COVID-19 pandemic, when in-person treatment have become less accessible and some outpatient services have become remote.

What Is Outpatient Treatment?

Treatment services exist for every stage of alcohol use disorder. The most intense, structured level is inpatient detox and rehab provided in a hospital environment. Here you receive supervised withdrawal management and monitoring around the clock by a team of professionals, including doctors, nurses, and counselors.2

Outpatient treatment programs offer the same services as an inpatient program but are for those who do not require medical care throughout the day during detox and therapy.

Partial hospitalization programs (PHPs) provide at least 20 hours of individual and group therapies each week, along with medication management. These same therapies can be given in intensive outpatient programs (IOPs) but offer fewer hours each week.2

Study results show that programs like intensive outpatient treatment effectively treat alcohol use disorder. They can lead to a reduction in alcohol misuse and an increase in the amount of time someone spends in treatment. It also allows treatment teams to work with someone in their home environment, practicing real-time relapse prevention skills.3

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Who Is Outpatient Treatment For?

Is outpatient rehab effective for everyone? There is little recent research on the people who may benefit most from outpatient treatment for alcohol use disorder. However, researchers report that there are observable trends in who is most likely to be enrolled in outpatient treatment, including:4

  • Women are more likely to be referred to outpatient therapy than men.
  • People who self-identify as “Caucasian” are referred less often to outpatient programs than people of all other racial and ethnic identities.
  • Individuals entering rehab on a referral from the criminal justice system are more likely to enter an outpatient program.
  • A person of color who uses state-offered insurance, is older, and does not have a college degree is the most likely person to be referred to outpatient treatment.

Certain racial and ethnic demographics are most likely to initiate treatment and complete the entire treatment program:5, 6

  • White Americans who report that they have higher education levels are the most likely to enter treatment.
  • White people complete treatment at higher rates than Native Americans, Latinos, and Black people enrolled in the same type of treatment programs. Asian Americans have the highest rates of treatment completion.
  • Black people and Latinos are less satisfied with alcohol addiction treatment they receive than white people.

Some of these trends have definitive causes backed by research. For example, researchers found that Black and Latino individuals completed treatment less often due to higher levels of unemployment and housing instability, which impacted their ability to attend programming. However, the same study could not determine an evidence-backed cause for the alcohol treatment disparity for Native Americans, nor the increased completion rate for Asian Americans.6

Many potential reasons could create these disparities, including if current rehab programming does not have the resources or cultural competency to provide holistic addiction treatment to people of color. People of color may also encounter systemic bias, racism, or financial and healthcare barriers when attempting to obtain and complete addiction treatment programs.

Researchers note that better insurance, such as increased Medicaid funding for intensive treatment programs, and cultural training are strongly indicated as improving the likelihood of raising treatment completement rates for non-white Americans.6

There is no evidence of gender differences among those who complete outpatient treatment.4

What Are the Benefits of Outpatient Treatment?

Outpatient treatment is just as effective as an inpatient program for alcohol and substance use disorders.

Outpatient rehab has short-term and long-term benefits.

Short-term benefits include: 3

  • Reducing misuse of alcohol
  • Learning early recovery skills
  • Meeting peers in recovery
  • Learning coping skills
  • Building a support system

Long-term benefits of outpatient rehab programs include less problem severity, more periods of abstinence, more time spent in treatment, and more engagement and practice implementing new skills in a home environment.3

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How Successful Is Outpatient Rehab Therapy?

The various outpatient treatment programs use therapies proven to aid in alcohol recovery include the following.

Medication-Assisted Therapy

Medication-assisted therapy (MAT) may be used during detox to reduce the severity of symptoms and afterward to reduce the risk of relapse. FDA-approved medication assists in easing withdrawal symptoms and cravings. Studies show medications like naltrexone reduce alcohol misuse and relapse. 2

Behavioral therapies are used in combination with medications to increase recovery success.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a form of talk therapy. It is the most widely researched and utilized evidence-based therapy in addiction treatment.

Compared to recovery treatment methods with no specific treatment and minimal treatment, CBT is 15-20% more effective at helping participants remain abstinent.4

Technology-based cognitive-behavioral therapy for alcohol use disorder reduces alcohol misuse when supplementing other treatments or used as a stand-alone treatment.

Self-help and therapist-led technology programs showed the same reductions in alcohol misuse as traditional CBT in the first three months. After that, an increase in reductions occurred among the therapy alcohol online group participants.7

Dialectical Behavior Therapy

Dialectical behavioral therapy (DBT) is a form of behavioral therapy that focuses on regulating the emotions of those with high-risk co-occurring disorders. Studies show DBT is most effective in women with borderline personality disorder having suicidal ideation. 8

Studies show that DBT is more effective than the standard treatment therapies in helping someone adhere to treatment recommendations and helping reduce parasuicidal behaviors and the number of hospital stays.9

Mindfulness-Based Relapse Prevention

Benefits of outpatient rehabMindfulness-based relapse prevention (MBRP) teaches you to be present at the moment and aware of thoughts and feelings and how they affect behavior. A review of studies shows participants receiving MBRP have significant increase in the number of days abstinent, as well as a reduction in the number of drinks consumed daily, self-reported cravings, withdrawal symptoms, and rates of relapse.10

Motivational Enhancement Therapy

Motivational Enhancement Therapy (MET) study results indicate motivational enhancement therapy leads to a significant reduction in alcohol misuse. In one study, 73% of participants in MET were abstinent at the six-month follow-up.11

Other motivation-enhancing therapies like contingency management may be used. Contingency management uses incentives as motivation to remain abstinent. Clinical studies show voucher-based programs lead to more prolonged treatment engagement, extended periods of abstinence, and better ability to complete daily living responsibilities. 2

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) can help prevent relapse through acceptance when you have cravings and commitment to using learned skills to overcome them. 12

Multiple studies on ACT on various populations, including veterans, college students, and inmates, show a significant reduction in the number of days of heavy alcohol misuse and the number of alcoholic drinks consumed.13

Supplemental Therapies

Supplemental therapies include couples and family therapies, 12-step and other peer support groups, creative expression therapies like art and music, pharmacotherapy, case management, and incentive activities. Each shows effectiveness in improving alcohol and substance use disorder recovery.14

Couples and family therapies, like behavioral couples therapy, prove in studies to help sustain abstinence, improve relationship functioning, reduce intimate partner violence, and reduce emotional problems of children in the family. 2

Twelve-step facilitation groups are statistically proven by Project Match, the most extensive study on alcohol use disorder treatment, to increase abstinence and reduce remission rates at one and three-year follow-ups. 2

Levels of Outpatient Treatment and Their Benefits

Multi-level outpatient treatments are accessible as a continuum of care step-down journey or by entering treating at a specifically indicated level. Levels include:15, 16

  • Primary care includes medical doctors or clinics with connections to addiction treatment programs. The benefits of primary care include medical staff providing prevention and early intervention resources. Primary care professionals can complete a general screening and assessment and make referrals.
  • Individual outpatient counseling is a level above primary care. Your doctor may refer you to have a more extensive evaluation by an addiction specialist. If recommended for individual outpatient counseling, treatment usually occurs once a week.
  • Intensive outpatient programs (IOPs) provide treatment services on a schedule that allows you to fulfill personal and professional responsibilities while attending. One of the most significant benefits is that therapists can help you apply what you learn to real-life experiences as they happen.
  • Partial-hospitalization programs (PHPs) provide even more opportunities for learning each week. Daily services allow you to receive higher-level care without inpatient treatment by providing medical supervision and crisis stabilization.

Inpatient hospitalization care is available for those who don’t have support at home to help them for the periods of the day when they are not in treatment. This level is the best choice if you need around-the-clock medical care and support.

You can receive the benefits of outpatient rehab too. Our phone lines are open 24/7 at 800-839-1686Who Answers?. If you are ready for addiction treatment, talk to a treatment specialist today about your options.

Resources

  1. Lee, J., Kresina, T. F., Campopiano, M., Lubran, R., & Clark, H. W. (2015). Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care. BioMed Research International, 2015, 137020.
  2. Substance Abuse and Mental Health Services Administration (2016). Early Intervention, Treatment, and Management of Substance Use Disorders. Facing Addiction in America: The Surgeon Genera’s Report on Alcohol, Drugs, and Health. Washington (DC): US Department of Health and Human Services.
  3. McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014, June 01). Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. Psychiatric Services, 65(6), 718-726.
  4. Bazargan-Hejazi, S., De Lucia, V., Pan, D., Mojtahedzadeh, M., Rahmani, E., Jabori, S., Zahmatkesh, G., & Bazargan, M. (2016, December 19). Gender Comparison in Referrals and Treatment Completion to Residential and Outpatient Alcohol Treatment. Substance Abuse, 10, 109-116.
  5. Acevedo, A., Garnick, D., Ritter, G., Horgan, C., & Lundgren, L. (2015, September 18). Race/Ethnicity and Quality Indicators for Outpatient Treatment for Substance Use Disorders. The American Journal on Addictions, 24(6), 523-531.
  6. Saloner, B., & Lê Cook, B. (2013). Blacks and Hispanics are Less Likely Than Whites To Complete Addiction Treatment, Largely Due to Socioeconomic Factors. Health Affairs (Project Hope), 32(1), 135-145.
  7. Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J. S., & Carroll, K. (2019). A Meta-analysis of Cognitive-Behavioral Therapy for Alcohol or Other Drug Use Disorders: Treatment Efficacy by Contrast Condition. Journal of Consulting and Clinical Psychology, 87(12), 1093-1105.
  8. Smith, A. & MacDougall D. (2020, November 06). Dialectical Behavior Therapy for People with Borderline Personality Disorder: A Rapid Qualitative. Ottawa (ON): Canadian Agency for Drugs and Technologies on Health.
  9. Carroll, K. M. (2014). Computerized Cognitive-Behavioral Therapy. Alcohol Research: Current Reviews, 36(1), 127-130.
  10. May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical Behavior Therapy as Treatment for Borderline Personality Disorder. The Mental Health Clinician, 6(2), 62-67.
  11. Ramadas, E., Lima, M. P., Caetano, T., Lopes, J., & Dixe, M. (2021). Effectiveness of Mindfulness-Based Relapse Prevention in Individuals with Substance Use Disorders: A Systematic Review. Behavioral Sciences, 11(10), 133.
  12. Foxcroft, D. R., Coombes, L., Wood, S., Allen, D., Almeida Santimano, N. M., & Moreira, M. T. (2016). Motivational Interviewing for the Prevention of Alcohol Misuse in Young Adults. The Cochrane Database of Systematic Reviews, 7(7), CD007025.
  13. Dieperink, E., Fuller, B., Isenhart, C., McMaken, K., Lenox, R., Pocha, C., Thuras, P. & Hauser, P. (2014). Efficacy of Motivational Enhancement Therapy on Alcohol Use Disorders in Patients with Chronic Hepatitis C: a Randomized Controlled Trial. Addiction, 109(11), 1869-1877.
  14. Osaji, J., Ojimba, C., & Ahmed, S. (2020). The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. Journal of Clinical Medicine Research, 12(10), 629-633.
  15. McKay, J. R., & Hiller-Sturmhofel, S. (2011). Treating Alcoholism as a Chronic Disease: Approaches to Long-Term Continuing Care. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 33(4), 356-370.
  16. The Association for Ambulatory Behavioral Health. (2021). Standards and Guidelines for Partial-Hospitalization Programs & Intensive Outpatient Programs.

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