What does the research say about Intensive Outpatient and Day

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Treatment working as well or better than residential treatment for alcohol and drug abuse and addiction:

“Treatment on an outpatient basis allows a more valid assessment of environmental, cognitive and emotional antecedents of drinking episodes and drinking urges on the part of the patient, and allows the patient to test new coping strategies while still within a supportive counseling relationship. These conditions would be expected to foster greater generalization of learning in treatment to the patient’s natural environment” (Annis, 1986, p. 183).

 

What are some of the different features of outpatient treatment which create better outcomes than in residential treatment setting?

  • Therapeutic and supportive relationships are not disrupted in outpatient treatment.
  • Therapeutic rapport with therapists, psychiatrists, prior sobriety supports and physicians are maintained.
  • Strengths and assets at work, home, recreation can be built upon during the course of outpatient treatment.

 

Isn’t learning new skills and avoiding drug and alcohol use at home more difficult than in a clean and supervised environment?

  • Rather than learning in a nice clean laboratory, apply the new skills directly into your life now. Outpatient treatment provides a much greater “take-home” advantage.

 

The benefits of getting sober at home actually enable newly sober people to

  • Practice new skills immediately in real-life situations;
  • Apply new discoveries, ideas and behavioral changes- practice improves retention;
  • As clients and families learn more effective coping, communication and relationship skills, they can “practice” these skills both in treatment and at home
  • Clients and families receive support and validation from each other while expanding their lasting sober supports in outpatient settings. Relationships can be maintained and won’t be disrupted at discharge as in residential treatment.

 

While you participate in an intensive outpatient or day treatment program for alcohol and drug abuse and addiction, what sober resources are found at home different from those in a residential program?

  • Outpatient treatment mobilizes available supports (family, therapist, psychiatrist, family doctor, and/or mutual support organizations) rather than creating temporary and artificial supports that will be removed once a residential experience ends.
  • Indigenous recovery supports are identified and activated during the course of outpatient treatment.
  • The transition from active outpatient treatment into social support and recovery maintenance is much less abrupt than with residential treatment. Social support gains are generalized into real life.
  • Clinical changes, recovery supportive resources, therapeutic and professional relationships are likely to be maintained.

 

Addiction creates casualties and long-lasting problems. How is this wreckage handled differently in an outpatient setting treating substance use disorders?

  • People coming to terms with an addiction often face mounting financial, vocational and domestic problems- “wreckage”.
  • Treatment should not add to those mounting bills, unnecessary absence from work and home.
  • Rehab should instead help move you into the solution- toward resolving the “wreckage” of your addiction.

 

Why is residential treatment so widely recognized as the way to get sober?

  • Residential treatment will produce better profit/ development margins for the business owner/ provider of care if critical business volumes can be achieved.
  • The higher operating costs, administrative time, and professional oversight of residential components draw decision-makers to focus on their residential treatment at the expense of their less complex and less lucrative outpatient services.
  • It is clear to the margin-oriented administrator that short-term financial gains will be best made from a residential model if only the beds can be filled.