Intensive Outpatient Program: A Detailed Guide

Most people can often pinpoint their problem, especially when it comes to their own mental health. “I’m feeling depressed, sad, anxious, etc.” The hard part is knowing what the solution is. If you asked the average person if they knew what an IOP (Intensive Outpatient Program) is, they’d most likely have no idea what you’re talking about.

It’s one of those “gems” in mental health that many people could benefit from at some point in their life. But rarely do they know that such a treatment option exists. Some lucky ones might have a good psychiatrist or therapist that recommends it to them. Unfortunately, a lot of people miss out on this highly effective modality. This guide is here to explain what it is, how it works, and why more folks nowadays probably need it.

What is IOP?

It’s often much easier to show someone what IOP is than to explain it. However, explaining it as an actionable process should give a clear picture of how to define it in the context of a mental health solution. And by “process”, we’re talking about it being more of a plan – a period of time rather than a facility or setting.

IOP is considered an acute (short-term) treatment. It’s for someone who feels like their mental health might be spiraling out of control. Again, someone can usually identify their problem. And someone who is at a breaking point or “spiraling” definitely knows it. It would be a problem that is getting worse, and not going away.

It’s not like psychotherapy or regular med management with a psychiatrist, which can go on for years. That kind of treatment is considered more “maintenance” – keeping someone on the move forward instead of backward. IOP is a clear-cut intervention. The goal is marked improvement in as short a time as possible.

How short?

To put it plainly, there can sometimes be a tentative discharge date established right when someone is admitted to an IOP program. It’s not set in stone, but it gives an idea of the temporary nature involved. Usually 3-12 weeks can be an average duration for someone who is admitted. It all depends on the need and progress of the individual. Sometimes it can go a bit longer…or even much longer in rare cases. In fact, many people return to seeing their own psychiatrist and therapist after discharge. IOP often times works in conjunction with that treatment.

IOP Requirements

The requirements for IOP are fairly straightforward. You must have a mental health diagnosis from a clinical-level licensed individual to be considered for admission. That means a psychiatrist, physician, or nurse practitioner must determine if the level of care is clinically necessary.

Each individual IOP program’s weekly hours can vary, although there are minimum requirements set in place. Treatment requires a minimum of 9 hours of group therapy per week, up to a maximum of 15. The hours for IOP are divided up into 3-hour sessions.

More often than not, there are insurance requirements for admission to a program. Depending on which insurance plan someone has, the facility may be required to obtain prior authorization based upon clinical documentation. If the insurance company determines that it is medically necessary, then they will approve an initial number of authorized visits.

Sometimes the facility may need to provide a concurrent review to the insurance periodically either to obtain more sessions or inform that the member has discharged from the program. Some insurances also require an update if a member misses any sessions. IOP is an “all or nothing” type of treatment.

IOP Schedule

As mentioned, IOP can be anywhere from 9 to 15 hours per week of therapy in a group setting divided up into 3-hour sessions. Typically there will be breaks in the middle of the sessions. These 3-hour sessions are usually 3 to 5 days per week. The days of the week are usually on a consistent schedule.

Since many people admitted are currently working, some programs will offer sessions in the evening hours for convenience. However, some people may go on work leave, depending on whether their psychiatrist determines that it is medically necessary. Remember, IOP is for those who are at a breaking point in their lives. Needing time off can be a very real possibility.

Outpatient Group Therapy

The focal point of treatment will take place in a group therapy setting led by a therapist. The purpose of this intensive counseling will be to help with providing coping skills. Whether someone is dealing with severe depression, anxiety, or struggling with addiction, it’s imperative that they are able to identify triggers to their presenting symptoms. Then they can develop healthy habits to cope with the root problem.

Effective IOP groups will usually have anywhere from 6-15 people. Smaller groups are often designated for therapists who work with a “here and now” model. Larger groups are typically designed for psychoeducation.

Either way, group is a place where those in the program can have a platform to be heard. And they can receive support from both the therapist and others. There are tremendous benefits to therapeutic treatment in a group setting.

Psychiatrist Medication Management

Although the primary treatment will take place in group, there are usually frequent visits with a psychiatrist to determine the effectiveness of medications. They will also continuously assess whether IOP is still the ideal level of care. Depending on the need, psychiatrist visits may be once every couple of weeks or up to several times per week. The goal is to ensure that someone doesn’t escalate to needing a higher level of care.

The doctor is also actively involved in the treatment plan. Usually weekly or bi-weekly, the therapist and psychiatrist will meet to determine the progress someone is making towards their goals. Sometimes goals are met. Then, either new goals are made or the individual is discharged. Sometimes more work is needed on existing goals for the duration.

This IOP process is a dual approach between the two providers, with the patient being the center of treatment. The individual is meant to be an active participant in their treatment plan.

IOP Types

Not all IOPs are the same. There are generally 2 main IOP categories that are recognized by the mental health community. However, there are many types of sub-categories for groups. There can be a post-partum depression group, gambling addiction group, or LGBTQ+ focused group.

Here are the 2 main IOP categories:

Mental Health IOP

The mental health portion of IOP is what we’ve been focusing on a lot here. Usually, someone will have a diagnosis of depression, anxiety, bipolar, PTSD, bipolar, or any other mental health problem. These problems have escalated and can be worked on in a mental health IOP setting. The goal would be to admit, stabilize, and discharge.

Substance Abuse IOP

This type of program would be needed if someone is either in drug rehab, or has been discharged from an inpatient rehab facility. The program structure is generally the same, with group therapy and psychiatrist visits. But substance abuse IOP focuses on the recovery aspect with the individual. It’s a matter of treating them for their addiction with a similar modality as mental health IOP.

That’s not to say that there is no mental health diagnosis like depression or anxiety present. In fact, those problems can lead someone down a path of addiction. Many times, that addiction can be a matter of ineffective coping with either their diagnosis or triggers in their life that “flare up” their symptoms.

Sometimes someone with substance abuse issues might be in a mental health IOP due to co-occurring disorders. If their mental health diagnosis is primary and addiction is secondary (potentially a byproduct), then they might be considered “dual diagnosis” individuals. A psychiatrist or other clinical-level licensed individual will determine the best treatment option for individuals with these co-occurrences.

Conclusion

Although an intensive outpatient program isn’t something most people are aware of, it’s something that most people could benefit from at some point in their lives. Many experience those breaking points and need to be stabilized before things go from bad to worse.

An IOP can provide that short-term stabilization needed so that someone can move on with their life. Upon discharge they can continue their personal improvement with their therapist and psychiatrist. Being provided with that intensive intervention in a group setting is a powerful way to ensure someone receives immediate improvement as soon as possible.

If you or someone you know is in a tough place and would benefit from intensive outpatient treatment, you can contact our IOP staff and we can schedule an evaluation by a psychiatrist to determine if that level of care will meet the need.

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