Flexibility and Accessibility: Choosing Outpatient Rehab Instead of Inpatient
Outpatient rehab is a drug and alcohol treatment for mild to moderate substance use disorders in a setting that allows you to live away from the treatment facility while attending the treatment program. Many programs treat only either drug or alcohol abuse, while some deal with both issues.1
Outpatient treatment programs come in various forms that are different in terms of intensity, length, and type of service. The main objective is to provide treatment, education, support, and counseling while allowing participants to live at home.
In this article:
- Types of Outpatient Rehab
- Reasons to Choose Outpatient Rehab
- Is Outpatient Rehab Recommended?
- What to Expect When You Go to Outpatient Rehab
- Duration of Outpatient Rehab
- Types of Therapies Used
- Structure of the Day in Outpatient Rehab
- What Happens After Outpatient Rehab?
Types of Outpatient Rehab
There are two main types of outpatient treatment programs, each with a particular focus and structure but with the same overall goal: sobriety.2
Day programs: Day programs are considered the most intensive type of outpatient treatment. They provide the most structure and services during treatment. There may be five to seven sessions per week for a specified number of hours each day.
Intensive outpatient programs (IOP): This type of treatment works by creating an individual treatment plan with clearly defined and measurable goals. As you meet these goals, the requirements and commitments decrease over time. An IOP typically has a more flexible schedule and can accommodate employment and other responsibilities through daytime or evening sessions.3
Reasons to Choose Outpatient Rehab
Many factors typically influence the choice of outpatient rehab over inpatient treatment. These include the following.4,5
Flexibility: Outpatient programs can typically be designed according to your schedule. This is important if you continue to work and or hold significant commitments. Outpatient treatment programs help you continue fulfilling your responsibilities, including working, going to school, or remaining with the family. Outpatient rehab may be offered to teenagers or young adults due to this flexibility. Outpatient services may include being connected to a safe and sober living home environment if you do not live in a substance-free home.
Affordability: Outpatient rehab is typically less costly than residential care. Most facilities accept insurance. For many patients, finances to play a major role in determining whether inpatient or outpatient treatment is more appropriate.
Family support: Many people benefit from having family members nearby and involved in recovery. Outpatient treatment also typically has a strong family therapy component, allowing you and your loved ones to address family issues.
Real-world practice: Because you continue to live at home, you can try out what you are learning in outpatient rehab and apply it immediately in real-life situations at home, at work, and with friends.
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Is Outpatient Rehab Recommended?
The recommendation of outpatient rehab over inpatient treatment depends on certain factors. Outpatient alcohol rehab is a good option if you need flexible treatment options to work around your schedule and have the following:6
- Mild to moderate substance use disorder
- High level of motivation to achieve sobriety
- Established support system
Inpatient treatment may be recommended to treat a severe addiction to certain substances like heroin or oxycodone to help with detoxification and withdrawal.7 Also, if you have been struggling with substance use of any kind for a longer time, then inpatient treatment may be a better alternative.
What to Expect When You Go to Outpatient Rehab
The initial phase of treatment in an outpatient rehab setting consists of an evaluation designed to give the treatment staff essential information about you to provide the appropriate level of care.7
The screening process in an outpatient alcohol treatment program begins as soon as you arrive, typically within 24 hours. You will meet with a psychiatrist, case manager, therapist, and nurse for a comprehensive evaluation to determine exactly what you need and how best to provide that. Information taken during the assessments will be used to customize a treatment program.
A physician will meet with you to conduct a complete physical exam and determine the severity of your substance use disorder and whether or not your needs can best be met in an outpatient rehab setting. The physician will also determine if you need detoxification before beginning outpatient drug treatment.
A physician or other mental health professional will evaluate your mental health and whether or not you may be dealing with co-occurring mental health issues, such as depression and anxiety. This is important to help establish appropriate treatment goals and expectations.
Duration of Outpatient Rehab
Each person’s addiction is different, so the amount of time for outpatient rehab will also be different. The length and intensity of outpatient programs vary according to your needs.2
An average outpatient rehab program lasts at least three to four months. The program will typically meet from three to seven times per week with the number of days per week decreasing over time. Most such programs include multiple sessions for as long as three hours per day and a single individual therapy session per week.
Types of Therapies Used
Many outpatient treatment options are available. The most common therapies in outpatient rehab include the following.8
Group therapy: This approach is often considered to be the foundation of change in outpatient rehab. Group therapy gives you the opportunity to connect with others in treatment by sharing experiences and receiving feedback from fellow participants. Counseling groups can help you share your experiences, listen to others’ issues, and try new behaviors in a safe environment.
Cognitive-behavioral therapy: This is a method of psychotherapy focused on helping you change your thought patterns to bring about positive behavioral change. This approach helps you identify maladaptive thoughts that can result in unwanted behavior like drinking or using drugs. This is an important way to learn about triggers and how to prepare to face and deal with them in a healthy manner following treatment.
Contingency management: This is a type of therapy that reinforces positive behavioral changes. You will receive rewards in treatment that will strengthen your abstinence by reinforcing such things as attending group sessions or having a negative drug analysis.
Motivational enhancement therapy: This type of counseling uses your resources and motivation to build a goal-oriented recovery strategy with actionable goals. This allows you to measure your progress on specific recovery behavior.
Relapse prevention: This approach is a type of educational and experience-based treatment designed to build up positive behaviors. Relapse begins before you start using again so teaching you to recognize warning signs can help in overcoming potential relapses.
Educational programs: These programs will help provide knowledge and resources in recovery to help you maintain sobriety. It will provide educational information on a variety of topics like the disease of addiction and the effects of drug and alcohol use on the body and the brain.
Recreational therapy: This gives you the opportunity to learn about the importance of recreation in living a sober life. You can develop new, healthy life skills by engaging in activities like music, art, physical exercise, and other similar endeavors to help replace your previous involvement in drinking.
Structure of the Day in Outpatient Rehab
The start to a typical day in an outpatient rehab program is similar to what might be expected from inpatient rehab.2 The day may typically start a little later than it would for inpatient rehab, perhaps around 10 a.m.
The first scheduled event often is a session of case management or individual therapy. This allows you to check in with your case manager or therapist regarding progress you have made or to focus on issues that may have come up and set goals for the day of treatment.
Then, there is likely to be group therapy along with an opportunity to participate in another group activity, such as recreational therapy or a session of contingency management. You may also participate in a 12-step recovery group.
After lunch, there will likely be another group session. This one may focus on a particular area like sexual abuse, stress management, family issues, or other important issues. Following this could be an educational group or perhaps a recreational therapy group.
Additionally, family therapy may be held once per week in which your family will attend and family issues will be addressed. Overall, you may participate four to six hours per day for three to five days per week. This time commitment may decrease over time as you make progress.
What Happens After Outpatient Rehab?
Preparation for your discharge from an outpatient program begins early by establishing an aftercare plan.2 This allows you to focus on the issues that you will face after leaving outpatient drug rehab. You, your case manager, and any family members participating in family therapy sessions will review the plan. You will have a strategy for dealing with the triggers that could lead to relapse and prepare to face those triggers whenever they do occur.
The treatment staff may refer you to an aftercare program that typically includes attending Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) and getting a sponsor.4 Your case manager will address issues of where you will live. If living at home is not recommended, they will help make alternative arrangements, such as living at a sober living residence. You will discuss employment so that you have a job to go to or a plan for gaining employment.
At the end of the day, sobriety is up to you with outpatient rehab providing the setting, treatment, and support to develop the skills needed to live sober and to implement the changes for success.
If you or a loved one is considering outpatient rehab for drug or alcohol abuse issues, call 877-640-2220 Who Answers? for assistance.
- National Institute on Drug Abuse. (2018). Types of treatment programs.
- McCarty, D., Braude, L., Lyman, D.R., Dougherty, R.H., Daniels, A.S., Ghose, A.S., & Delphin-Rittmon, M.E. (2014). Substance abuse intensive outpatient programs. Psychiatric Services, 65(6), 718-26.
- Mayo Clinic. (2021). Addiction services.
- National Institute on Alcohol Abuse and Alcoholism. (2021). Support and treatment.
- National Institute on Alcohol Abuse and Alcoholism. (2021). Treatment for alcohol problems: Finding and getting help.
- National Institute on Drug Abuse. (2018). How effective is drug addiction treatment?
- National Institute on Drug Abuse. (2018). Principles of effective treatment.
- National Institute on Drug Abuse. (2018). Behavioral therapies.