Outpatient Treatment

Levels of Outpatient Treatment

The intensity of outpatient treatment ranges from weekly brief contact to daily full-day programming. Standard outpatient treatment generally consists of one to two weekly sessions of 30 minutes to 2 hours per session. One common structure is weekly 1- to 2-hour group counseling sessions accompanied by periodic individual contacts for treatment plan review, crisis management, urine drug monitoring, individual or family counseling, or all of these components. Such a program generally takes place over 3 to 12 months. Another common structure is one to several contacts weekly to obtain opioid maintenance medication, combined with periodic individual counseling or case management sessions. This type of treatment may last from several months to several years or longer. The standard outpatient setting is also used to implement brief treatment options for individuals at risk for substance abuse or with mild substance use disorders. Such brief therapies are often administered in weekly sessions over 4 to 8 weeks.

Intensive outpatient treatment provides services for those with a substance dependence diagnosis who need higher-intensity treatment than standard outpatient provides but do not require a residential treatment setting. In most cases, clients are in the early days of abstinence when entering intensive outpatient treatment and benefit from more and longer sessions. Clients attend treatment several hours per day several days per week, and treatment generally continues for 1 to 3 months. One widely used regimen is treatment sessions on three weekday evenings and one weekend half-day for 6 to 8 weeks, with most of the treatment taking place in the group setting. Clients are typically given assignments to complete outside of treatment hours, providing them with ongoing engagement in the treatment process while offsite. Intensive outpatient treatment allows clients to continue to fulfill many daily life functions, such as attending to work and family responsibilities, while getting needed treatment.

Day treatment is often recommended when clients are experiencing moderate to severe symptoms of both substance abuse or dependence and one or more comorbid psychiatric disorders. Day treatment programs, which are typically hospital based, provide [Page 669]services throughout the daytime (and often into the evening) on a daily basis. This allows programs to meet the needs of clients with complex symptomatology without the expense and life disruption of inpatient hospitalization. This treatment environment also supports medication compliance where applicable. (Note: The term partial hospitalization has been used to indicate both hospital-based intensive outpatient treatment and hospital-based day treatment. To avoid confusion, this term is not used in this entry.)

...