Outpatient programs vary widely when it comes to their methods, treatment philosophies, and the resources each facility offers. However, what all outpatient programs have in common is the shared aim of helping people recover from debilitating substance use disorders. They also work to treat underlying issues that may be triggering a person’s addiction, which range from interpersonal difficulties to mental health disorders. Outpatient programs make use of a wide range of therapeutic modalities to ensure that a person gains the self-understanding and coping techniques they need to maintain long term sobriety and a quality life.
When a new client first arrives at an outpatient program, the first thing they can expect is an initial evaluation. During the initial evaluation, a case worker or outpatient treatment team will assess the client’s general condition. Important factors they take into consideration include which drugs a person habitually uses, how long they’ve used them, their age, physical health, mental health, and whether or not there is a family history of addiction.
Quality outpatient programs also take an interest in clients’ lifestyles, relationships, and the quality of their social support systems at home. These questions help OP staff identify a client’s needs so that they can develop a comprehensive and individualized treatment plan suitable for their unique circumstances.
Many people enroll in outpatient programs after initially getting sober at a more acute kind of treatment program, such as an IOP or PHP, but some also begin outpatient programs as a first line treatment for addiction. When applicable, outpatient programs begin by supporting a client as they withdraw from drugs and alcohol. This detox period is essential, since it is difficult for anyone to develop the tools and skills they need to stay sober unless they are clear headed.
However, quality outpatient treatment programs recognize that physical abstinence from drugs and alcohol is not sufficient for a person to stay sober in the long term. Once a person has stopped using drugs and alcohol, that is when the real work can start and they can expect to begin making progress.
Recovering from a substance use disorder at an outpatient program means working to develop new skills, coping strategies, and behaviors. To prevent relapse, outpatient programs also work with clients to help them identify triggers to which they are particularly vulnerable, so that they can develop alternative ways of responding to stressful situations.
Outpatient programs also help clients address underlying issues that may be complicating their addictions. Mental health conditions, financial problems, and relationship issues can all directly affect substance abuse, and it is therefore important that an outpatient program address all of these aspects of a person’s life. During the course of outpatient treatment, clients not only develop a strong program for sobriety, they also work to build new lives for themselves that are joyous, fulfilling, and free.
To that end, outpatient programs utilize a wide range of treatment methods and offer diverse services to their clientele. Quality outpatient programs use evidence-based treatment methods that are backed by the latest research in addiction treatment. Clients at outpatient treatment programs, no matter their background, make considerable progress while participating. Not only can they tackle their addictions from every angle, the flexibility of outpatient programs also allows clients to put their newfound skills into practice in their lives in the outside world.
Some of the more common addiction treatment methods found in outpatient programs are listed below.
Group therapy programs are a crucial component of addiction treatment at the vast majority of outpatient programs. Research shows that group therapy is equally effective as individual therapy, but it also possesses its own particular benefits. Taking part in group therapy sessions provides clients with opportunities to work on their communication skills and build important relationships with other people who are also working hard to recover from addiction. By reenforcing healthy ways of interacting in a safe, supportive, and trigger-free environment, group therapy allows clients to learn from the perspectives and experiences of others. Participants learn new sober skills, come to a better understanding of themselves, and develop stronger sober social support systems.
Outpatient programs generally provide a diverse array of distinct group therapy meetings, each with a different methodology and end goal. Types of group therapy offered at OPs include:
- Psychoeducational group therapy. This type of group therapy is by far the most common. It involves a clinician leading a group to help them better understand the condition they all suffer from. By learning more about addiction, physical dependence, and the causes of addiction, individuals can develop a new set of tools for dealing with the challenges and problems that occur in early recovery. Participants also learn to rethink unhealthy beliefs, such as the belief that addiction is caused due to lack of willpower.
- Family group therapy. Family groups provide opportunities to OP clients to heal or develop relationships with family members. Improving relationships with family members is a crucial aspect of addiction treatment, since many people are driven to substance abuse in the first place due to dysfunctional family relationships.
- Skills training groups. At skills training groups, OP clients can work on and practice their new coping strategies in a safe, trigger-free, and supportive setting. Skills training groups often also cover pragmatic life skills, such as how to behave in a job interview.
- Relapse prevention groups. Relapse prevention groups are designed to help OP clients recognize their own personal triggers. By identifying these triggers, they can begin to develop alternative ways of responding, rather than reacting automatically by reaching for drugs or alcohol. For many, preventing relapse is simply a matter of developing an awareness of these high-risk situations and learning to manage them.
Individual therapy is also utilized in most outpatient programs. Individual therapy helps clients reflect on their experiences and come to a better understanding of the underlying problems that might be motivating their substance abuse. For example, many people turn to drugs or alcohol because they suffer from untreated or undiagnosed mental health conditions such as ADHD, depression, or anxiety. Therapists not only help people learn to cope with these underlying conditions, they also help people develop plans for dealing with common addiction triggers.
The most commonly used therapeutic modalities for addiction are cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT). Both therapeutic approaches are based on the premise that an individual’s thinking patterns exert a direct effect on their emotions and behavior. CBT and DBT help patients identify their problematic thinking patterns and develop new ways of responding to their distressing emotions. As a practical and solution-focused treatment method, cognitive-behavioral therapy helps relieve clients of their obsession with drugs and alcohol, providing them with a new skill set for responding to cravings. Individual therapy also provides clients with an essential source of emotional support while dealing with the inevitable challenges of early sobriety.
12-Step Programs and Support Groups
The vast majority of outpatient programs recommend, encourage, or require that clients attend support group meetings. The most common and research-backed type of support group are 12-step programs. 12-step programs include meetings of Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, among countless others. These programs are designed to give people opportunities to connect with a larger community of people in recovery. Members work to eliminate their obsession with substances by actively helping each other.
At 12-step meetings, and even secular meetings like SMART Recovery, individuals in early recovery as well as those with many years of sobriety can continuously benefit from other members’ experience, strength, and hope. 12-step programs are available throughout every city around the world, and in Los Angeles there are hundreds of meetings at all hours of the day throughout the city. There is no charge for meeting attendance.
It is common for outpatient programs to offer complementary therapies as well. CAM stands for “complementary and alternative medicine.” This umbrella term refers to a wide range of treatment practices that is designed not to replace, but to supplement traditional addiction treatment methods. Examples of CAM therapy include music therapy, yoga, art therapy, meditation, and even pet therapy. These practices can help improve people’s peace of mind, sense of connection to the world, and help them rediscover the joy of living without the crutch of psychoactive substances.
Outpatient programs recognize that an important aspect of long term sobriety is being able to meet personal life goals. Individuals who are in active addiction often struggle to find or maintain employment, get out of debt, or manage their finances. Legal problems are common. Addiction can prevent people from developing essential communication and social skills as well, and the antisocial behavior that addicts engage in can damage relationships, leading to conflict and isolation. Treatment centers operate on the belief that sobriety is a trivial improvement if it is not accompanied as well with significant life changes. For this reason, outpatient programs work with clients on an individual basis and in group settings to improve their general life skills.
Medication-assisted treatment (MAT) is an addiction treatment modality that involves a combination of behavioral therapies, some of which are listed above, alongside prescription medication. Individuals who are detoxing from alcohol and drugs often suffer from severe withdrawal symptoms, which can complicate the recovery process. These symptoms can trigger people to relapse and, in the case of benzodiazepine and alcohol withdrawal, be life-threatening.
Prescription drugs such as buprenorphine and methadone (for opioid withdrawal) or acamprosate and naltrexone (for alcohol withdrawal) can help people get off dangerous recreational drugs. These medications reduce painful withdrawal symptoms and mitigate cravings. During medication-assisted treatment at an OP, clients engage in behavioral therapies in order to develop the skills and coping tools they need to stay sober. When appropriate, a physician can supervise their withdrawal from their medications. This withdrawal involves a gradual tapering process that is designed to be as smooth as possible.