A Complete Guide to Intensive Outpatient Programs

What Is IOP? How Does It Work? And How Might It Help You?

If you or a loved one are facing serious mental health challenges, attending IOP (intensive outpatient program) may be just what’s needed.

IOP is one of those “hidden gems” in mental health that many people could benefit from at some point in their life. Some lucky ones might have a good psychiatrist or therapist that recommends IOP to them. But unfortunately, many people aren’t aware such an effective treatment option exists.

This guide is here to explain what mental health IOPs are, how they work, and why more people may benefit from them.

What Is IOP?

IOP is a short-term, intensive treatment designed to get results fast – no matter whether you’re struggling with treatment-resistant depression, severe anxiety, PTSD, or other major mental health challenges.

  • The focal point of treatment is group therapy. This allows you to learn and receive support from others – in addition to the therapist leading the group.
  • Programs usually have 3 sessions per week – each 3 hours in length. (There are also regular one-one-one sessions with a psychiatrist or therapist as needed.)
  • These sessions are led by a licensed therapist. And they’re designed to provide foundation mental health skills and help you work through the specific challenges you’re facing right now in your life.

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

How short? The exact amount of time varies person to person depending on their needs/progress. But typically, people can expect to be in the program (and see results) over 5-12 weeks.

Common Challenges IOP Can Help With

IOP is there to help when it feels like your mental health is spiraling out of control. You may be able to identify your problem or tell you’re at a breaking point. But the problem is still getting worse or not going away. Challenges people work through inside IOP include…

  • Crippling Anxiety
  • Severe Depression
  • Mental Health Crisis
  • PTSD
  • Grief and Loss
  • Substance Abuse
  • Past Trauma
  • Medication Changes
  • Suicidal Thoughts
  • Bipolar/Personality Disorder

If you’re “sick and tired of being sick and tired”, IOP can help you build the skills you need to overcome stress and challenges of life. Call our office today to schedule a consultation.

Is IOP the Right Level of Care For You?

As life-changing as IOP can be, it is not right for everyone. Different situations require different levels of treatment. To help see whether IOP is appropriate for your needs, it’s helpful to compare it to other treatment options.

In general, the more serious your situation, the more intensive treatment you need.

Spectrum of Care for Mental Health
Self Care -> Outpatient Care -> Intensive Outpatient Care -> Inpatient Care

This spectrum is much like with physical health. When you’re in great shape, you only need an occasional visit with your doctor for a checkup (outpatient care). But if someone is suffering from heart failure, they need to get immediate treatment in the hospital (inpatient care). Metal health is the same way. There’s different levels of care for different situations.

Let’s take a closer look at the common treatment options for mental health:

Outpatient Care

This is the least intensive level of treatment. And it’s what most people think of when they think of when it comes to mental health care. (“Outpatient” means you’re not staying overnight in a hospital, psyche ward, or residential program.)

Most often, care takes the form of weekly/monthly visits with a therapist or psychologist. Perhaps you’re working through anxiety, depression, or past trauma. Or maybe you’re looking to grow as a person and improve a relationship. Either way, having the support of a skilled therapist can help you on your journey.

Outpatient care can also include other forms of self-care and personal growth such as working with a coach, attending seminars, or going on a retreat.

For the majority of people, outpatient care is a great option. There’s no shame in getting the help you need to live a happy, fulfilled life. We all face challenges and struggles. And we need the support of others to help us achieve our goals.

Inpatient Care

On the other end of the spectrum you have inpatient care. This means going full-time into a hospital, residential facility, ward, or other center.

While that may sound extreme, having a safe place away from the stresses of life can be helpful. And, patients will have direct support 24 hrs a day from a team of psychiatrists, therapists, and other medical staff. This care can be life-saving, especially in moments of crisis such as:

  • Complete Mental Breakdown
  • Attempted Suicide
  • Psychotic Break
  • Toxic Abuse of Drugs or Alcohol
  • Risk of Self-Harm or Harm to Others
  • Inability to Function or Cope with Life

Depending on the situation, a person may stay at a facility overnight, a few days, a few weeks, or even longer. The goal, however, is to help people recover quickly. Providers want to get their patients to a safe, stable place. Then they’re able to get back to their lives and receive support from outpatient care instead.

Intensive Outpatient Care

IOP is a blend of inpatient and outpatient care. It provides the focused, direct support of inpatient treatment, while still allowing you to live at home during treatment.

This means you can stay connected to your community and support systems while receiving the care you need. And it makes IOP a good treatment option for a variety of situations, including for those on leave from work or school, those needing more support than weekly therapy, or those coming out of hospitalization.

Unlike regular therapy, IOP is an escalated level of treatment for when one-on-one visits with a counselor or psychiatrist don’t quite cut it. (Often, a provider will determine if this level of care is required and evaluate you for a referral.) The program also has a defined time period lasting anywhere from a few weeks to a couple months at the most.

When Should You Consider IOP?

Here are a few situations where IOP can be especially helpful:

Moments of Challenge or Crisis: Sometimes life throws more at us than we’re able to handle. The loss of a loved one, getting laid off, or other traumatic experiences can overwhelm even the strongest people. IOP is an option to help get through those tough periods.

Discharge From Inpatient Care: When you leave an inpatient care facility, such as a hospital or psych ward, IOP is there to smooth the transition back to regular life.

Stepping-Up From Outpatient Care: Regular visits to a therapist or psychiatrist may not be enough to meet your needs. And IOP is a focused program to help those facing treatment-resistant depression, severe anxiety, PTSD, and other mental health challenges.

Medication Changes: Switching or transitioning off of antidepressants, anxiety meds, or other medications can be difficult. Symptoms can include headaches, dizziness, trouble sleeping, anxiety, irritability and more severe depression. Attending IOP can help you manage those symptoms and support you in the transition.

Regardless of why you may joins IOP, the program can help you find stability and inner peace again. And it can help build foundational mental health skills to help you face the stressors and triggers in their life.

Types of Intensive Outpatient Programs

The goals of each IOP will vary depending upon the issue the program is designed to treat. And care is customized to each individual’s specific goals, needs, and challenges. In general though, there are two main types of IOP programs:

1. Substance Abuse IOP: These programs are directly focused on helping those in rehab or who struggle with substance abuse disorders. In the group, people will learn tools to help them maintain sobriety and identify possible triggers for relapse.

2. Mental Health IOP: These programs provide treatment for a range of mental health struggles – such as PTSD, depression, anxiety, and more. The groups provide skills and insights to help people navigate these challenges and start living with more inner peace again. (This is what we offer at Plural Healthcare.)

Note: People in mental health IOP programs may be also struggling from drug or alcohol abuse. The treatment focus, however, is on the primary and underlying issues that drive the use of alcohol or other substances in the first place. (For example, alcoholism can sometimes be an unhealthy coping method for PTSD.)

Mental Health IOP Requirements

The requirements for IOP are 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 needs to determine if the level of care is clinically necessary. And they must recommend IOP as the appropriate care for your situation.

At Plural Healthcare, the first step in our treatment process is a detailed evaluation with a clinician. We use this to ensure IOP is right for you (or your loved one) and to craft a personalized treatment plan. Call today to schedule an appointment.

IOP Insurance Requirements

Often, insurance companies have their own requirements for admission to the program (and to continue attending IOP). These guidelines vary from insurance to insurance, but generally include things like:

  • Significant impairment in daily functioning due to psychiatric symptoms that can’t be managed through a lower level of care.
  • Ongoing IOP treatment is necessary to reduce symptoms and improve functioning (and that being discharged or not doing IOP would likely lead to more intensive level of care).
  • The capacity and willingness to engage in IOP treatment. (This includes regular attendance in the group sessions and showing signs of progress in IOP).
  • Indication that mental health symptoms will improve in a reasonable time period. And will allow a transition back to other outpatient care or community-based services.
  • Living conditions offer enough stability to support ongoing IOP treatment.
  • Appropriate documentation from the IOP provider to support intensive outpatient treatment.

Depending on which insurance plan you have, the facility may be required to obtain prior authorization based upon clinical documentation. If the insurance company determines that IOP is medically necessary, then they will approve an initial number of authorized visits.

Sometimes the facility may need to provide a review to the insurance periodically either to obtain more sessions or determine the appropriate care after discharge. Some insurances also require an update if a member misses any sessions.

What to Expect in an IOP Program

Note: Not every IOP program is the same. The following is largely based on our programs here at Plural Healthcare. But it should still be true of other quality mental health IOPs out there.

Initial Consultation & IOP Treatment Plan

IOP is not a one-size-fits-all treatment. Everything is customized to your specific needs and goals. That’s why you’ll always start by consulting with a trained professional.

They’ll speak with you to learn more about you and your situation, discuss your goals, explore whether IOP is the right option for you, and if appropriate, get your insurance details (to get your treatment authorized and covered by insurance).

Note: If IOP isn’t a good fit for you, we’ll recommend or refer you to other mental health programs, clinicians, or resources so you can get the care you need.

This consultation helps craft a “blueprint for treatment” – what the treatment team uses to help guide you to a better place in your life.

This plan is highly structured and divided up into parts. The first part is filled out by you upon admission into the program. The second part is filled out by the therapist along with the psychiatrist (medical director).

IOP Treatment Plan Part One: Personal Assessment

When you are admitted into the program, you’ll fill out:

  • Your stated goals that we can help you achieve
  • Problems you are facing (there will be options to circle on the form)
  • Your strengths, which will help you achieve your goals
  • Barriers that you think might get in the way

There are no right or wrong answers here. In fact, the answers may change in the middle of treatment. That’s great! It means you’re growing. The important thing is to just keep moving forward.

IOP Treatment Plan Part Two: Clinical Assessment

After you attend your first week of group sessions, you’ll have a one-on-one psychosocial assessment) with the therapist. This will allow the therapist to get acquainted with you, determine where you’re at, and see how to get you to where you want to go.

Your therapist will then then meet with the psychiatrist and care coordinator to fill out the second part of the treatment plan:

  • Goals (could be from 1-3 goals)
  • Objectives (steps to achieve the goal)
  • Interventions (what the therapist needs to do)

Your treatment team will also meet bi-weekly to monitor your progress, assess needs, and change goals if needed. In other words, we’re constantly looking to see how we can best support you.

IOP Schedule

The IOP schedule can be anywhere from 9 to 15 hours per week of therapy in a group setting (split into 3-hour sessions). These 3-hour sessions are usually on a consistent schedule of 3 to 5 days per week.

Since many people admitted remain working at their jobs, some programs will offer sessions in the evening hours for convenience. However, others may go on work leave if their psychiatrist determines that’s necessary.

Additionally, people will have the option of one-on-one visits with either our therapist or their own therapist (if they are already seeing one).

Group Therapy & IOP Curriculum

The focal point of treatment takes place in a group therapy setting led by a therapist.

This intensive counseling is designed to help provide effective coping skills and address whatever challenges people are facing in their life. Whether someone is dealing with severe depression, anxiety, or struggling with addiction, it’s imperative that they can identify triggers to their symptoms. Then they can develop healthy habits and address the root issues.

At first, being in a group may not sound ideal to some people, especially those with social anxiety. But keep in mind that the group will be led by a trained therapist. They will be there to lead the group and to support you every step of the way.

The group also provides a platform for those in the program to be heard. And they can receive support from both the therapist and others. Research shows multiple benefits to therapeutic treatment in a group setting.

Benefits of Group Therapy

  • Discover that you’re not alone. In difficult times, we can sometimes feel like no one else understands what we’re going through. The group gives a chance to hear from people going through similar challenges and experiences as you are.
  • Heal by giving support to others. Helping others can make you more empowered and confident. And research shows it can even boost overall health too.
  • Learn healthier ways to relate to yourself and others. Sometimes when you’re experiencing a mental health condition or traumatic event, your relationships can be affected. The group lets you practice interacting with other people in a safe space.
  • View your problems through a different perspective. In the group, you’ll hear from a variety of people who may look at issues and problems differently than you do. By seeing how others handle those challenges, you can incorporate those strategies into your own life too.
  • Benefit from others who are further along than you. Everyone in the group will be at a different stage in their healing journey. And those other people will offer their experiences and insights for you to learn from.
  • Build confidence. The support and fellowship of other group members is a safety net. You can find the courage to push yourself outside of the group, knowing that you have others to fall back on if you stumble.

Effective IOP groups will usually have anywhere from 6-15 people. And the curriculum will vary depending on the size of the group and type of IOP program.

Smaller groups are often designated for therapists who work with a “here and now” model (sharing raw, honest thoughts and feelings about what’s happening in the moment). Larger groups are typically designed for psychoeducation (with a specific curriculum of tools, coping strategies, and more).

At Plural Healthcare, we aim for a group size of 8-10 people. And we rely on a mix of different therapy models such as hear-and-now, education, and mindfulness.

Psychiatrist Medication Management

It’s critical that your therapy works alongside the medications prescribed by your psychiatrist. With intensive outpatient treatment, medication alone may not be enough to get you to a better place. Therapy alone might not either, in some cases. And it sometimes requires a dual approach, combined with your own efforts.

Under normal circumstances, visits with the psychiatrist for medication management will occur once every week or bi-weekly. Although this depends on where you’re at. Sometimes an IOP member may find themselves mentally in a severe place (also known as “decompensation”). This is not a common occurrence, but we’ll make arrangements for immediate visits with one of our clinical providers during business hours if an IOP member needs it.

Your doctor will always be involved in the treatment plan and treatment updates. This ensures that every time you come back for med evaluation, your IOP treatment doesn’t skip a beat. It’s meant to be a “flow of care” throughout, regardless of which provider you are seeing and for the particular purpose.

Individual Therapy Sessions

Although most of the care in IOP takes place in a group setting, you may also benefit from seeing a therapist one-on-one. This gives you a chance to reflect with the counselor individually on topics covered in group, and discover how they might apply to our own situation.

If you’re already working with a therapist, we strongly recommend you continue to meet with them throughout your treatment. This is for two primary reasons.

  1. Your therapist is someone you already know and trust – and who can offer focused feedback since they’re already familiar with your situation.
  2. Your therapist will provide a constant source of support – not just while you’re in the IOP program – but as you transition out of IOP and beyond.

If needed though, you can either work with our therapist, or we can refer you to a trusted clinician in our network.

Integration Into Your Life

Growth and healing doesn’t just happen inside the group sessions or in conversations with the therapist. It comes when you apply what you learn to your life. In fact, this is a big part of what makes IOP so effective. You stay connected to your normal life and your local support communities.

This allows you to:

  1. Take the tools and insights you get in IOP and immediately put them into practice in your day-to-day life. IOP isn’t about theory. It’s about giving you practical skills you can use.
  2. Address challenges from your life and work inside the program (such as a difficult relationship, a conflict at home, or a source of stress). IOP offers a safe, judgment-free space to work through whatever you’re dealing with in your life.
  3. Rely on your friends, family, and other loved ones for additional support. Yes, the therapist and treatment team at IOP are there to help you every step of the way. But we find the people in your communities can boost your progress in IOP. And they’ll provide vital, ongoing support once you finish with IOP.

Discharge – Back to Self-Care

As strange as this may sound, a major goal of IOP is to get you out of the program. IOP is an immediate, short-term treatment. It’s designed for people in moments of crisis. But we don’t want you to live in “crisis mode” and be in IOP forever. We want to get you back on your feet.

Here at Plural Healthcare, we call this getting “back to self-care”. This is where you can use the tools you got in IOP to thrive and live a meaningful life.

There are two important notes about this though:

First, we strive to only discharge people when they’re ready. The clinical staff will help decide when it’s time to transition out of IOP – based on how you’re doing, your progress toward your goals, and your current needs.

And if you’re not quite ready to leave yet, we’ll advocate for you to your insurance and try to get the extra sessions you need approved.

Second, you’ll still have our support as you leave the program. Your treatment team will help you transition to whatever care you need next.

This often means connecting with an individual therapist or psychiatrist who will help you going forward. (We’ve built up a network of trusted clinicians. So if you’re not working with someone already, we can directly refer you to another provider in the area.)

Some clients may occasionally be dealing with a serious life crisis that requires a higher level of care. And if that’s necessary, our treatment team will work with an appropriate inpatient facility to make sure you get the help you need.

In our experience though, most people in IOP see major improvement. They’re able to step-down to other outpatient treatment options and continue their journey back to self-care.

Find Out How IOP Can Help Your Situation

If you’re dealing with depression, anxiety, PTSD, trauma, or other serious mental health challenges that stop you from living a meaningful life, our IOP program can help.

Let’s Take the Next Steps Together

We understand taking the first step is difficult. There is no shame or guilt in asking for help or more information. We are here to support you in any way we can.

If you’re looking to see if IOP treatment is right for you, or just want more information, contact us now.