More About Outpatient Programs
Outpatient treatment is behavioral health care you attend while living at home or in a recovery residence.
It addresses substance use disorders, mental health conditions like depression and anxiety, and eating disorders. You attend individual therapy, group sessions, family work, and medical or medication appointments, then go back to your own bed, your job, and your family in between.
The National Institute on Drug Abuse notes that outpatient treatment varies in the types and intensity of services offered, from low-intensity programs that offer little more than education to intensive day treatment that can be comparable to residential programs in services and effectiveness.1 The American Society of Addiction Medicine organizes that range into Level 1 outpatient treatment and Level 2 intensive and high-intensity outpatient treatment.2
Types of Outpatient Programs
Outpatient programs differ mostly in how many hours a week they run and how much medical support they provide. Here’s how the levels of care compare.
- Standard outpatient (OP). One to three sessions a week of individual or group therapy. This works well for milder symptoms or as a step down after more intensive care.
- Intensive outpatient (IOP). Structured group and individual therapy that runs at least nine hours a week for adults and six hours a week for adolescents.3 Sessions are often scheduled mornings or evenings so you can keep working or going to school.
- Partial hospitalization (PHP). The most intensive outpatient option, typically four to eight hours a day, five days a week. PHP fits people who need daily clinical support but have a safe, stable home environment.
- Outpatient detox. Medically supervised withdrawal management delivered through frequent visits instead of an overnight stay. It can be a good fit for people with a lower risk of complicated withdrawal.
- Medication-assisted treatment (MAT). Medications including methadone, buprenorphine, and extended-release naltrexone for opioid use disorder, and naltrexone, acamprosate, and disulfiram for alcohol use disorder, paired with counseling.4 Most people receive these through outpatient clinics.
- Virtual outpatient care. Therapy and group sessions delivered by video. This opens up options if you live far from a program or can’t travel regularly.
- Continuing care. Lower-intensity sessions, alumni groups, and recovery coaching that keep support in place after a more intensive program ends.
Who Outpatient Treatment May Help
Outpatient care may be a good fit if you recognize yourself in one of these situations.
- You have alcohol, opioid, or another substance use disorder, and a clinician determines you don’t need intensive detox support or a residential program.
- You live with depression, anxiety, PTSD, or another mental health condition, and one weekly therapy session doesn’t feel like enough support.
- You have co-occurring substance use and mental health conditions that need coordinated treatment.
- You have an eating disorder and though a clinician determines you don’t need intensive residential treatment, therapy doesn’t feel like enough.
- You are a teen or young adult who wants to stay enrolled in school while getting treatment.
- You are working or caring for family and can’t leave your responsibilities.
- You’re stepping down from residential treatment and want extra structure while you rebuild your routine.
Outpatient care may not be the right fit for someone needing round-the-clock detox support, someone with a severe or long-lasting substance addiction, or anyone experiencing suicidal ideation with plans for suicide. In those situations, an inpatient or residential program can provide round-the-clock support first, and you can step down to outpatient care afterward.
What to Expect in Outpatient Treatment
While every program won’t follow an exact format, you can generally expect these steps when you reach out to an outpatient provider.
- Intake and assessment. A clinician reviews your history, symptoms, medical needs, and support at home, then recommends a level of care. This usually takes one appointment or phone call.
- Schedule assignment. You get assigned days and times to come in for treatment. The schedule shows where to go and what you’ll be doing during each time block.
- Therapy. Outpatient programs commonly use cognitive behavioral therapy, dialectical behavior therapy, contingency management, motivational enhancement therapy, family therapy, and 12-step facilitation.1 Group counseling is a core part of most programs, but you’ll also have individual sessions.
- Medical and medication coordination. Many programs include psychiatric care, medication management, and coordination with your other providers.
- Step-down planning. Many outpatient programs start planning your ‘graduation’ as soon as you start. You may move to a less intensive level of outpatient care, or transition into regular therapy sessions.
Outpatient Care Compared to Other Levels of Care
The main differences between levels of care are where you sleep, how many hours of treatment you get, and how much medical supervision is available between sessions.
- Outpatient vs. inpatient and residential treatment: inpatient care means living at the facility with 24-hour staffing. Outpatient care means living at home. SAMHSA reports that intensive outpatient outcomes are comparable to residential services for people with a lower risk of withdrawal and less severe symptoms.3
- IOP vs. PHP: both are outpatient, but PHP includes more hours of treatment and more clinical oversight. Our IOP vs. PHP guide walks through how to choose between them.
- Outpatient vs. sober living: sober living provides substance-free housing and peer accountability, not clinical treatment. Many people do both at once.
- Outpatient vs. weekly therapy: a single weekly therapy session is a form of outpatient care, but structured outpatient programs add group work, medical support, relapse prevention, and case management on a set schedule.
How to Choose an Outpatient Program
When you compare programs, these questions tend to separate a good fit from a poor one.
- Is the program accredited by the Joint Commission or CARF, and licensed in its state?
- Does it treat co-occurring mental health conditions, not just substance use?
- Can it prescribe and manage medication, including medications for opioid and alcohol use disorder?
- Do the session times actually fit your work, school, or caregiving schedule?
- Is it in network with your insurance, and what will you owe out of pocket?
- How does the program involve family, and is family therapy included?
- What does the step-down plan look like when your hours decrease?
- How long has the program operated, and what do current reviews say?
Cost and Insurance
What you pay for outpatient treatment depends on the level of care, the length of your program, whether medication is part of your plan, and where the program is located.
Outpatient care generally costs less than residential treatment because you’re not paying for housing and overnight staffing. SAMHSA reports that when people are placed appropriately, intensive outpatient outcomes are comparable to inpatient treatment at nearly half the cost.3
Most health insurance plans cover outpatient behavioral health services, and federal parity law requires many plans to apply no stricter limits to mental health and substance use benefits than they apply to medical benefits.5 Coverage still varies by plan and by program, so confirm the details before you enroll.
Does Outpatient Treatment Work?
Research finds that outpatient care can really help.
SAMHSA reports that intensive outpatient outcomes are comparable to residential services for clients with minimal risk of acute withdrawal, limited medical complications, and less severe psychological symptoms, and that IOP is as effective as inpatient and residential programs for most people in that group.3
Find Outpatient Care Near You
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