Learn / What Is an IOP: Questions and Answers
In the context of mental health, IOP stands for “intensive outpatient program.” But what does that phrase mean? What is an IOP, after all?
IOPs offer more intensive care than weekly therapy sessions, but more flexibility than inpatient rehab. These programs are a great option for many people—but are they right for you? This guide can help you decide whether an IOP would be a good fit.
Intensive outpatient care is an approach to addiction1 or mental health recovery. In an IOP, patients live off-site but attend therapy during the day. Unlike inpatient treatment, this approach lets you go about your life while you heal. You can go to work or school, see friends, and even live at home.
During the program, you’ll work with several mental health and addiction specialists. You might also attend classes to learn important life skills. Some IOPs include recreational activities, like going to the beach or seeing a movie.
IOPs can also serve as transitional care after you finish residential treatment, but before you return home. In that case, you might stay in a sober living home during the program.
IOPs are a common treatment option2 for many mental health issues. They’re especially effective for certain diagnoses:
However, your diagnosis isn’t the only thing that determines what type of treatment you need. IOPs might be a good fit for several types of clients:
IOPs aren’t right for everyone. Certain people require more intensive treatment:
Like residential rehab, every IOP for mental health is different. It’s important to look for a program that aligns with your unique needs and goals.
Most IOPs offer several different services:3
For adult clients, IOPs include at least 9 hours of treatment per week.4 For teens, they include a minimum of 6 weekly hours. Beyond those thresholds, the exact number of treatment hours varies widely.
The length of your treatment depends on your progress. Many IOPs last 12-16 weeks. However, you can choose to end treatment early or stay in the program longer.
You’ll begin your IOP with a comprehensive health assessment.5 Your provider will use this information to design a care plan that meets your needs.
In the assessment and planning process, you may work closely with a case manager. They’ll determine which services you need, and organize your schedule. They might match you with a therapist, enroll you in life skills classes, or connect you with other service providers outside the program.
If you live at home during your IOP, you’ll have more access to friends and family than you would during inpatient rehab. And if you live in group housing, you’ll be close to other people in recovery. To maximize the benefits of these environments, IOPs encourage clients to build strong relationships.6
You can achieve this in a few ways. For instance, you might attend family therapy or join a support group. You can also practice your new coping skills in the context of work, school, and friendships outside the program.
Experts at the Substance Abuse and Mental Health Services Administration (SAMHSA) note that IOPs “should not be the sole approach for any client;7 instead, they need to be one step along a continuum of care.” During initial treatment, your care team will help you plan for what comes next.
The transition out of an IOP may be less jarring than the end of inpatient treatment. While your schedule will change, you won’t have to move right away. You can stay in touch with your immediate support network, including members of your care team and other people who attended the program.
IOPs for addiction typically include specialized services:
Although IOPs can treat addiction, this type of care has an extra level of risk. When you first enter recovery, you might not have a strong support network. Or, you might have close relationships with people who encourage you to use drugs. If you live at home throughout treatment, maintaining those relationships can increase your risk of relapse.9
You don’t have to begin recovery with an IOP. For example, you might attend a medical detox program or inpatient treatment center first. In that case, an IOP might be part of your stepped-down care plan. This approach gives you time to kickstart recovery before you begin rebuilding your community at home.
In an IOP for mental health, you can live at home while you attend intensive treatment. These programs connect you with mental health experts and with other patients who understand some part of your experience. You may not have the same diagnosis as the people around you, but you can still share mutual support.
IOPs for mental health may focus on a specific therapy, instead of using a wide range of treatments. For example, people with personality or mood disorders often benefit from dialectical behavioral therapy (DBT).10 If you’re healing from one of these conditions, you can look for a more specialized treatment program.
IOPs and partial hospitalization programs (PHPs) are 2 different types of treatment. The key difference between them is the amount of time patients spend in therapy. PHPs offer more intensive care,11 including at least 20 weekly treatment hours.
Despite their differences, PHPs and IOPs have a lot in common:
Unlike inpatient care, IOPs allow you to integrate your treatment experience into your daily life. This approach has several advantages:
Data shows that IOPs are as effective as residential care12 for people with addiction. In both approaches, 50-70% of patients maintain abstinence after treatment.
Both residential care and IOPs may be less effective13 for people with co-occurring disorders or physical health issues. For these patients, experts recommend attending an IOP in addition to more intensive treatment.14
These programs can also have positive side effects that go beyond their primary goals. One anonymous client explains how treatment in an IOP empowered her to support her community:15
“If I were to tell myself from a few months ago how much we’ve changed, I’m not even sure that she’d believe me. It gives a hope that I haven’t had in a long time and I couldn’t be more grateful for the family I created here. And with everything I’ve learnt, I’ve also been able to tell my friends who are also going through hard times some of the things I’ve learnt and they really liked them!”
As you research IOPs, remember that every program is unique. You can choose a center based on your unique needs. To start your search, consider a few criteria:
Many insurance plans will cover this type of treatment. Because IOPs don’t provide round-the-clock care, they’re often less expensive than other programs.
IOPs are available at nearly 50% of all addiction treatment centers16 in the U.S. Whether you’re looking for a program near your home, your residential rehab, or somewhere else, there are plenty of options available.
IOPs can help you recover from addiction and many mental health issues. However, they’re not for everyone. To determine whether an IOP might be a good fit, you can start by responding to a few questions:
Your answers will help you prepare to speak with an expert. Contact an intensive outpatient program to find out if this type of treatment meets your needs.
Yes—to some degree. Your care team is legally bound by privacy laws. However, the administration may disclose some information to your insurance provider if they’re covering your treatment. What’s more, the other patients in your program aren’t obligated to keep anything confidential. And if you all live in the same area, you may even have mutual friends. While providers may encourage clients to respect each other’s privacy, they can’t control what happens outside of treatment.
It depends on your program. Talk to your provider’s admissions team to learn about your options. The good news is that most insurance plans cover some amount of addiction treatment. And because these programs are less expensive than residential treatment, insurers are even more likely to cover IOPs.
Some providers are experimenting with remote IOPs. Preliminary research suggests that this type of treatment might be effective. However, we need more data to know for sure. Because telehealth is so new, it’s hard to predict what its effects will be in the long term.
“Substance Abuse: Clinical Issues in Intensive Outpatient Treatment A Treatment Improvement Protocol TIP 47.” U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/sma13-4182.pdf
TY - JOUR AU - Falabella, Genevieve AU - Johnides, Benjamin AU - Hershkovich, Arielle AU - Arett, Jacob AU - Rosmarin, David PY - 2021/06/01 SP - T1 - CBT/DBT-Informed Intensive Outpatient Treatment for Anxiety and Depression: A Naturalistic Treatment Outcomes Study VL - 29 DO - 10.1016/j.cbpra.2021.05.001 JO - Cognitive and Behavioral Practice ER -
Substance Abuse and Mental Health Services Administration. (2021). Clinical Issues in Intensive Outpatient Treatment for Substance Use Disorders. Advisory
“Substance Abuse: Clinical Issues in Intensive Outpatient Treatment A Treatment Improvement Protocol TIP 47.” U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/sma13-4182.pdf
Substance Abuse and Mental Health Services Administration. (2021). Clinical Issues in Intensive Outpatient Treatment for Substance Use Disorders. Advisory
Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 8. Intensive Outpatient Treatment Approaches. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64102/
Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 8. Intensive Outpatient Treatment Approaches. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64102/
Center for Drug Evaluation and Research. “Information about Medication-Assisted Treatment (MAT).” FDA, May 2023. www.fda.gov, https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat.
Lookatch SJ, Wimberly AS, McKay JR. Effects of Social Support and 12-Step Involvement on Recovery among People in Continuing Care for Cocaine Dependence. Subst Use Misuse. 2019;54(13):2144-2155. doi: 10.1080/10826084.2019.1638406. Epub 2019 Jul 19. PMID: 31322037; PMCID: PMC6803054.
Ritschel LA, Cheavens JS, Nelson J. Dialectical behavior therapy in an intensive outpatient program with a mixed-diagnostic sample. J Clin Psychol. 2012 Mar;68(3):221-35. doi: 10.1002/jclp.20863. PMID: 22422561.
“Understanding Substance Use Disorder Treatment: A Resource Guide for Professionals Referring to Treatment.” National Center on Substance Abuse and Child Welfare (NCSACW). https://ncsacw.acf.hhs.gov/files/understanding-treatment-508.pdf
McCarty D, Braude L, Lyman DR, Dougherty RH, Daniels AS, Ghose SS, Delphin-Rittmon ME. Substance abuse intensive outpatient programs: assessing the evidence. Psychiatr Serv. 2014 Jun 1;65(6):718-26. doi: 10.1176/appi.ps.201300249. PMID: 24445620; PMCID: PMC4152944.
Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 8. Intensive Outpatient Treatment Approaches. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64102/
Moos RH, King MJ, Patterson MA. Outcomes of residential treatment of substance abuse in hospital- and community-based programs. Psychiatr Serv. 1996 Jan;47(1):68-74. doi: 10.1176/ps.47.1.68. PMID: 8925349.
Evans-Chase M, Kornmann R, Peralta B, Gliske K, Berry K, Solomon P, Fenkel C. Understanding Treatment Needs of Youth in a Remote Intensive Outpatient Program Through Solicited Journals: Quality Improvement Analysis. JMIR Form Res. 2023 May 3;7:e45509. doi: 10.2196/45509. PMID: 37133910; PMCID: PMC10193218.
Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2020. Data on Substance Abuse Treatme
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