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Outpatient Rehab Timeline
Timelines for outpatient treatment will vary from person to person due to a variety of factors, including their physical and mental health status, the specific type of outpatient program selected, and the level of effort and commitment put forth. However, there are general sequential steps and procedures found in most outpatient program timelines that are detailed below.
The first step in outpatient treatment is to receive a biopsychosocial assessment from a licensed mental health or substance abuse professional. The initial evaluation generally takes a few hours and helps determine which level of treatment is necessary. They use the following criteria for matching someone with partial hospitalization treatment (PHP), intensive outpatient programs (IOP), or standard outpatient treatment.
Anyone with the potential to experience severe withdrawal symptoms needs medical supervision during detox. Symptoms of withdrawal will vary for every person, and for some, they may include seizures, delirium tremens, delusions, changes in blood pressure, and tachycardia.
The presence of pre-existing medical conditions can affect the level of treatment necessary to fully treat the condition, the substance use disorder, and any possible effects of the two.
Alcohol and drug withdrawals often cause a person to feel depressed and anxious. There is also a psychological withdrawal component to detox. If left untreated, the risk for relapse increases. A person with a dual diagnosis must receive treatment for both disorders simultaneously for the best outcome.
Readiness To Change
If someone is not completely ready to change, they may benefit from outpatient motivational counseling before entering a detox program. Those who succeed are often ready for the physical, mental, social, and familial changes that are often necessary for a full recovery.
Someone with a high potential for relapse will likely benefit from more intensive outpatient services, such as a PHP, where they can receive daily support and accountability from both peers and clinicians. Someone who is not likely to relapse may benefit from less restrictive therapies, like intensive or standard outpatient services.
Current Living Environment
Someone living with family or friends who continue to use drugs or alcohol will benefit more from the most intensive treatment, possibly inpatient treatment, to eliminate the temptation for relapse. Once they learn relapse prevention skills, they can transition to outpatient services.
Someone living in a healthy, sober environment with family support may start treatment on an outpatient basis.
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The second step in outpatient treatment is to begin the recommended program and participate in individual, group, and family therapies over the next four to six weeks. Participants may also take part in 12-Step meetings, medication-assisted therapies (MAT), alternative therapies, and specialized treatment for co-occurring disorders.
The first few weeks are a period of adjustment and discovery, as a person may delve into their addiction and any other issues that could deter recovery.
As someone moves into the third step of treatment, individual and group therapies focus more on relapse prevention, early recovery, stress management, and numerous life skills. Participants enter an education and training phase, preferably for at least four weeks, that prepares them with realistic techniques for avoiding relapse. Family therapy may begin to ensure a person has the right kind of support when they return home.
The final step is to create an aftercare plan, which may involve meeting with a case manager to establish real-world resources a person can use after discharge. Resources include childcare, job training, transportation, housing, community support groups, GED or education assistance, and mental health or medical appointment maintenance. The longer someone works on these tasks, the more prepared they will be to re-enter society confidently to avoid relapse.
Understanding The Length Of Outpatient Treatment
The length of outpatient programs is often 30, 60, or 90 days. Some people need at least four months to complete a program, while others complete it in six to eight weeks. Many people choose to complete the entire continuum of care, starting with detox, and then transition into inpatient for 90 days or more, then into an outpatient program for at least 90 days. Some people stay in an outpatient program for a year or longer. These timeline fluctuations show how personal the treatment and recovery journey can be.
How long a person stays in outpatient treatment depends on several individual factors, including:
Some people enter outpatient treatment needing MAT to help them detox. The types of substances used, length of use, quantity, and severity of withdrawal symptoms help determine how long a person needs MAT.
Stage Of Recovery
A person just starting the recovery process may need more time in outpatient treatment than someone transitioning from an inpatient program. One person may need more detox services than others. Those with multiple short-term treatment experiences may realize they need a long-term program, sometimes lasting more than a year. Someone who relapsed after years of sobriety may benefit from standard or intensive outpatient services to get back on track.
Outpatient programs generally work around a person’s lifestyle so they can continue working, maintaining their home and families, and getting treatment. Someone who can only attend therapy once or twice a week may need more time than someone who can attend daily intensive programs.
Type Of Outpatient Program
Standard outpatient programs between a participant and therapist meet once or twice a week, depending on treatment needs. IOPs meet at least three times every week for at least three hours. A PHP is the most intensive outpatient program that meets daily, at least five days a week, for five or more hours.
Participants and their treatment team in all outpatient programs set goals to accomplish before discharge. Length of outpatient stay may depend on reaching these goals, which can take longer for some people.
Many people with substance use disorders also have mental health issues. Research shows treating mental health and substance use disorders simultaneously is more effective than treating them separately, though doing so may extend a person’s time in outpatient treatment.
Ability To Pay For Treatment
Paying for an outpatient program can affect the length of stay if the insurance plan doesn’t cover services. However, many treatment facilities offer sliding scale fees, payment plans, and scholarships to help someone stay in treatment for as long as possible.
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Outpatient Treatment Statistics
The most recent treatment data from the Substance Abuse and Mental Health Services Administration (SAMHSA) showed:
- There were 617,975 discharges from outpatient treatment across the United States among those ages 12 and older.
- Participants referred to outpatient by a substance use treatment provider stayed an average of 137 days.
- Those referred by someone in the criminal justice system stayed an average of 131 days, while self-referrals averaged 90 days in outpatient programs.
- Approximately 165,642 intensive outpatient discharges occurred, with 39,416 participants ages 12 and older completing the program.
- The average stay overall was 91 days, with school, employer, and criminal justice system referrals staying over 100 days.
- Of the 142,540 outpatient Opioid therapy program participants, roughly 25% completed a program in an average of 151 days.
Advantages Of Longer Outpatient Programs
Longer outpatient programs can give a person more time to focus on healing, learning new skills, and creating an aftercare plan that sets them up for success after discharge. Additional advantages include:
- More support controlling long-term withdrawal symptoms and cravings.
- More treatment for co-occurring mental health disorders.
- More time away from the stressors and triggers of the home environment.
- More time to learn how to live with structure and routine.
- More time around supportive peers.
- More time to discover which therapies are most successful.
While often necessary, detox alone is usually not enough treatment for long-term recovery. It can take the brain over a year to heal from the damage drugs and alcohol do to it. Retraining the brain for recovery is necessary, and a person can achieve it best when they remain in longer outpatient programs.
What Impacts The Length Of Stay?
What makes a person stay in or leave an outpatient program is usually very personal and depends on internal and external influences. These influences can include:
- Social Stigma: Someone may feel like staying in treatment longer than a few weeks will make them look bad.
- Personal Traits: Low self-esteem, identity challenges, and the fear of privacy loss can affect the length of program a person will commit to. It’s also possible that someone may not feel worthy of receiving long-term care.
- Fear: Fear of withdrawal, pain, loss of relationships, jobs, children, or housing can all impact the length of stay.
- Relationships: Both supportive and unsupportive relationships can impact the length of stay. Employers may pressure someone to return to work sooner than they are ready. Parents may not want to be away from their kids any longer, and intimate partners may talk someone into leaving too soon.
- Cost: People may worry about financial issues that could arise if insurance does not cover outpatient treatment or if no discounts or scholarships are available.
- Schedule: The time the program is available may conflict with other obligations. This can often affect those who are the sole financial providers in their household or caretakers of children or other family members.
The progress someone makes in reaching their treatment goals significantly impacts the length of stay. Periodic evaluations between participants and therapists help focus on improvement areas and recognize accomplishments that keep someone moving forward.
Seeking Outpatient Treatment?
If you or a loved one is suffering from a substance use disorder and feel like outpatient treatment could help, contact a treatment provider today to learn more about the treatment options available to you.