People addicted to alcohol, heroin, prescription drugs or a behavior like gambling are often encouraged to think of their addictions as chronic conditions that can’t truly be cured. Instead, they’ll learn to manage their disease. In other words, they won’t receive an intensive treatment that begins, ends and restores them to health. Instead, they’ll receive intensive therapies that may wax and wane depending on the symptoms they’re feeling at that moment. This is the same sort of treatment provided to anyone with a chronic condition. People with diabetes, for example, might receive therapies throughout their lives in order to keep their diseases at bay.
In an article written in the journal Addiction, the authors outline this concept, and then begin to question the necessity of providing residential or inpatient care to someone for addiction. Someone with diabetes, the authors suggest, wouldn’t enter a formal residential or inpatient treatment program for the disease. Instead, that person would receive care on an outpatient program. Perhaps, the authors suggest, this would also be a good way to treat people with addiction disorders.
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The Concept of Outpatient Care
At its core, an outpatient rehabilitation program is designed to provide addiction treatment services to people who don’t live together. Residential or inpatient programs require people to move in and receive therapy while they live within the confines of the center. In an outpatient program, the addicts continue to live at home. There are two types of outpatient care programs: intensive and non-intensive.
According to the Substance Abuse and Mental Health Services Administration (SAMSHA), an intensive outpatient care program requires addicts to participate in some form of therapy for at least nine hours per week. Typically, the programs require people to participate for three hours at a time, three days out of the week. This can vary widely, however. In fact, an article published by the website PsychCentral reports that some intensive programs require addicts to participate for 70 hours per week or more.
A non-intensive program, by contrast, requires people to participate for fewer than nine hours per week. SAMSHA reports that many people stay within the intensive format for 12 to 16 weeks, and then they step down to the non-intensive stage. They may participate in the non-intensive stage for six months or more.
Some people enter outpatient programs when they’ve completed their drug or alcohol detoxification programs. They have no drugs or alcohol coursing through their veins, and they’re ready to learn more about how to maintain this state for the rest of their lives. Some people, however, enter outpatient programs when they’ve completed both detoxification and an inpatient or residential addiction program. These people have learned the fundamentals of addiction management in their inpatient program, and now they use the outpatient program to strengthen their skills and build on those lessons they’ve already learned.
Outpatient treatment programs do much more than require the addict to simply show up and passively receive services. Instead, outpatient programs attempt to look closely at the addict’s entire life, and how the addiction can be managed in a holistic way. In other words, while an inpatient program might focus on helping an addict move past an addiction-related crisis, an outpatient program is designed to help an addict put his or her life together.
As a result, while therapy and group meetings form the core of many outpatient programs, many offer a wide variety of other programs, including:
- Job counseling
- Family therapy
- Health care
- Parenting skill-building courses
- Legal services
According to the National Institute on Drug Abuse, all of these components have a role to play in addiction, and by addressing all of these aspects, therapists do their part to help remove barriers that could stand in the way of a full recovery. Many studies suggest that treatment options that address many aspects of the addict’s life tend to provide better results. In fact, authors of an article published in Recent Developments in Alcoholism go so far as to write that “…continuing care treatment might be improved by placing greater emphasis on addressing co-occurring problems and facilitating the identification and strengthening of patients’ skills, interests, and talents…” This is a sort of care that goes above and beyond basic detoxification. The addict develops a deep sense of what is important, and how it can be preserved.
Benefits of Outpatient Care
Outpatient care for addiction can be significantly less expensive than inpatient care. For example, a study published in the journal Evaluation Review in the year 2000 found that inpatient care in Washington State cost twice as much as outpatient care. It’s easy to see why this would be the case. In an outpatient program, the facility provides no food, no shelter and no amenities. The staff isn’t required to stay on site 24 hours per day, and the building that houses the services doesn’t need to be heated at night. Add up all of these small costs and the results can be significant.
In addition, there are some people who have strong family ties and a vast support group they can lean on in troubled times. They can utilize this network during their recovery, and in the process, they can make the network even stronger and more cohesive. This could make a relapse less likely, as they have an entire network on the alert and ready to step in. Removing these people from their supportive group could, actually, do more harm than good.
Drawbacks of Outpatient Care
Multiple studies have demonstrated that people do better in inpatient programs than outpatient programs, but according to an article published in the journal Addiction, many of those studies were small in size and had other problems that could cast doubt on the results. It’s clear that some people don’t benefit from outpatient programs.
The following people may not truly succeed in an outpatient program:
- Those with poor social contacts
- People who can’t drive or have poor access to public transportation
- Those who live with people who abuse drugs or alcohol
- People who live with others who are physically or mentally abusive
- Those who are homeless
In addition, there are some people who face such severe problems as a result of their addiction that they just need an intense amount of help to get back up on their feet. They may have medical or nutritional problems that must be addressed, mental health challenges that are spinning out of control or cravings that are so intense that they know a relapse of addiction is likely. For these people, an outpatient program just isn’t likely to provide enough support at that time. It’s not a failing, but it is a fact of life. These people may need the intense and intensive help an inpatient program can provide.
The Importance of Choosiness
In an inpatient program for addiction, a person might work with multiple therapists, all at the same time, in order to get the required information. In an outpatient program, by contrast, a person might work with just one counselor or perhaps two. This one person can have a profound influence on the addict, so it’s extremely important to find someone that is the right match for the person who needs treatment. For example, a study published in the Community Mental Health Journal found that some people dropped out of their outpatient programs due to disputes with their counselors. Some even dropped out because they just didn’t like their counselors. It’s important for the addict to stay in therapy in order to truly heal, so it’s equally important to find a counselor the addict likes and will agree to work with over the long term.
In addition, it’s important for addicts to understand what the program will entail before they enroll. Some programs require the addicts to submit a urine sample before they can participate in counseling sessions, for example, and some addicts resist this idea. Other programs depend heavily on a 12-step model of recovery (commonly used by groups such as Alcoholics Anonymous) and some people find this form of therapy to be overly religious. It’s important for the addict to choose a program that has components that he or she can agree to.
According to a study published in Current Psychiatry Reports, outpatient programs that last for a year or even longer tend to produce the best results, and people often stick with programs that they do not consider overly intrusive. It may sound obvious, but this program is something the addict is expected to work on possibly for the rest of his or her life. It pays to be choosy, and find just the right match, so the addict is encouraged to follow the treatment protocols to the letter.
If you’d like more information on outpatient rehab programs, located all over the US, contact us today. We can connect you with a high-quality, evidence-based program that can help you achieve lifelong sobriety.