Alcohol Rehab: Outpatient Programs
When you or your loved one is struggling with an alcohol use disorder (AUD), you may be unsure about the various types of treatment options available. You may have heard about inpatient and outpatient treatment programs but aren’t sure which is right for you. Inpatient treatment means 24/7 treatment in a rehab program, whereas, in outpatient treatment, you go home at night after participating in treatment sessions for several hours each week.
While outpatient treatment is a valuable treatment option, it may not always be the most appropriate level of care for certain individuals, such as those with relatively more severe AUD and/or significant acute alcohol withdrawal risks. Undergoing a thorough assessment by a doctor or other substance abuse treatment professional can help you determine if outpatient treatment is right for you.
What Is Outpatient Rehab?
Outpatient treatment is a form of treatment for drug and alcohol use disorders in which a person regularly attends treatment at an outpatient center but is able to return to their home or other outside living arrangements outside of program hours.1 Several types of outpatient programs are available, with a varying number of treatment hours per week and intensity of oversight.2 Some programs offer daily sessions and others only meet 1 to 3 times per week.3
Types of Outpatient Alcohol Rehab
Some outpatient alcohol rehab programs are relatively time-intensive and structured and are known as either partial hospitalization programs (PHPs) or intensive outpatient programs (IOPs). Both provide a full range of assessment, ongoing support, and linkages to more intensive levels of care if needed.2
Successful outpatient alcohol treatment participation is contingent upon a person’s home environment being alcohol-free and further benefits from the presence of a safe support system. These types of programs are also sometimes utilized after completion of an inpatient program (i.e., step-down treatment after residential rehab) as a way of easing the transition back to an individual’s everyday life. However, this isn’t always the case, as all types of outpatient programs may serve as a person’s initial point of rehabilitation care, when appropriate.
Intensive Outpatient Program
Intensive Outpatient Programs (IOPs) are a type of addiction treatment designed for those who may not necessarily need medical supervision or hands-on treatment, but prefer to be in close contact with medical professionals. Generally speaking, IOPs will have patients meet with staff members several hours a week, placing it in a middle ground in terms of intensity between outpatient programs and partial hospitalization programs (PHPs).
Partial Hospitalization Programs
Partial Hospitalization Programs (PHPs) are a type of alcohol rehab that is more intensive that standard outpatient treatment, but isn’t quite as intensive as inpatient, residential, or hospital care. Whereas inpatient programs will see patients living onsite at a facility, PHPs allow patients to remain living at home and participating in daily life.
Types of Therapy in Outpatient Rehab
Many outpatient alcohol treatment centers will utilize a combination of medical and behavioral treatment interventions, though these approaches may vary from one program to the next as well as based on the type of substance use disorder being treated. Some of the more commonly used therapy programs may include:
- Cognitive-behavioral therapy (CBT): This approach teaches people to identify certain types of maladaptive thoughts so that they can adjust the resultant behaviors associated with them, such as using and/or abusing alcohol. The underlying idea is that thoughts and behaviors are learned, and thus can be unlearned.4 CBT teaches people to cope with triggers that lead to drinking and to learn new ways to cope and avoid relapse.4
- The Matrix Model: This approach was developed to treat people who used stimulants, though variations of the original treatment protocol have been used to help people with substance use issues involving opioids and alcohol. The Matrix Model incorporates numerous approaches and treats the whole person, including relationships, behavior, and emotions. 4 This approach emphasizes the counselor-client relationship and teaches patients how to structure and manage their daily schedules and free time.4
- Contingency management: This approach is based on the idea that individual recovery may be promoted when some of the rewarding aspects of using drugs or alcohol are replaced with other types of rewards to encourage abstinence. Clients are often given vouchers for submitting negative urine drug screens, for example, or attending certain groups. These vouchers can be traded for a variety of items.4
- Motivational interviewing: This approach focuses on meeting a client where they are and not forcing a person to see that he or she has a problem with drugs or alcohol. Instead, the therapist works on “rolling with resistance,” an approach in which the counselor helps the person determine his or her own definition of the problem, as well as the solution, which minimizes power struggles and resistance, as the person isn’t being told what to do. Other techniques are designed to motivate change.5
- 12-step facilitation: Patients are introduced to the concept of 12-step groups for recovery and relapse prevention. The principles of 12-step groups are used as a foundation of the program and attendance at 12-step groups, such as AA is encouraged and promoted as a tool for aftercare.4
- Family therapy: Family therapy incorporates the family into treatment by including them in sessions and encourages members to set up family rules that reinforce abstinence and discourage substance use. This approach includes contracting for positive behaviors and sometimes incorporates elements of contingency management.6
- Medication for addiction treatment (MAT): This type of treatment involves FDA-approved medications, in combination with counseling and behavioral therapies, to treat certain types of substance use disorders.7 Often used in treating opioid use disorders, certain types of MAT can help people control cravings and decrease continued drug use. Some drugs are also used to treat people with an AUD, as discussed in the following section.
Benefits of Outpatient Rehab
Outpatient treatment can offer a number of benefits, providing that you are ready and willing to participate in the recovery process. These benefits include:13,14
- Recovering from your addiction and taking back control of your mental and physical health.
- Being able to live at home and go to work (depending on your circumstances) while attending treatment.
- Being able to keep your weekends free for activities, hobbies, and time spent with friends or family.
- If you are attending treatment during the day, you can have time with your children or other family members and spend evenings together. If you are attending an evening program, you can take care of your responsibilities during the day.
- Potentially less financial burden. The cost of outpatient treatment is often less than inpatient care.
- Counselors, treatment staff, and recovering peers can help patients start applying the skills they’ve learned in treatment to their home settings or other living environments.
Outpatient treatment services are often used as a follow-up to inpatient or residential rehab. They are also an effective option for people who have already been to rehab before but are looking for additional professional support and guidance to continue their recovery process, particularly after a relapse.5
Medication Used in Outpatient Alcohol Rehab
Numerous medications may be used in outpatient alcohol treatment to aid with withdrawal management and help prevent relapse. These medications are used in conjunction with counseling. The long-term use of drugs such as methadone and buprenorphine is often incorporated into treatment to aid in managing symptoms of withdrawal from opioids and in controlling cravings and preventing relapse.8
The following 3 medications are most commonly used to treat an AUD:8
- Disulfiram is given only after a person has undergone detoxification and is abstinent from alcohol. Disulfiram’s side effects may include nausea, vomiting, chest pains, and headaches if even a small amount of alcohol is ingested.
- Acamprosate does not prevent withdrawal symptoms, but aids in helping a person continue in abstinence from alcohol once they’ve stopped drinking. It is typically started on the 5th day of abstinence from alcohol.
- Naltrexone prevents a person from feeling some of the rewarding euphoria associated with alcohol use, thereby facilitating a decrease in ongoing drinking behavior. Naltrexone can be given by injection, including formulas that work for several weeks at a time. Naltrexone can be administered even if a person is actively drinking. Naltrexone also controls cravings for opioids, which is helpful if a person struggles with opioid misuse in addition to alcohol issues.
When Is Medication Used in Outpatient Rehab?
Again, it is important to note that medication is only one element of AUD treatment. Comprehensive rehabilitation efforts combine medications with counseling and behavioral therapies.8
Several factors are involved in determining whether a patient is a candidate for MAT. These factors include:9
- The person’s motivation to stop drinking.
- The person’s readiness to change his or her drinking.
- Underlying psychiatric or medical issues.
- Ability to tolerate the medication.
- Potential for relapse.
- Whether or not the person is pregnant.
How to Choose Outpatient Rehab for Alcohol
It’s important to thoroughly research treatment facilities to ensure that you will receive the best care possible and that the program will be able to meet your specific needs. It could be helpful to write down your questions before calling and think about practical considerations such as cost, location, and duration of treatment. Some additional questions you may wish to ask include:15
- Does the program use evidence-based treatments? This means that the treatments have research evidence that supports their effectiveness and continued use for addiction treatment.
- Are you accredited or certified by state or national organizations? Programs that are accredited or certified by reputable independent organizations have been shown to offer high-quality care and are focused on maintaining the standards required by the accrediting or certifying organization.
- Is the staff at your facility licensed and credentialed? Just like visiting a properly licensed and credentialed medical doctor, you want your mental health care team to be properly licensed and credentialed. This means that they are legally operating per state and local government rules that define their scope of practice, as well other state-determined standards.
- What is your success rate? How is the success of treatment measured? This may help you to learn how effective the program’s treatment is. Find out how the facility measures that effectiveness (for example, short-term vs. long-term sobriety) and examine the data they give you.
- Is the length of treatment adequate for my needs? Longer treatment duration (e.g., 3 months or more) is associated with improved treatment outcomes.
- Is treatment personalized to the unique needs of each patient? Effective treatment often involves tailoring the program to each person, and a person’s needs may change or progress more slowly or more quickly during treatment. Treatment programs should adjust personalized treatment regularly according to your changing needs and individual progress.
- Do you offer aftercare when I finish the treatment program? If so, what type of ongoing support is offered? The need for support and services doesn’t end when treatment does, and many people find aftercare helpful for ongoing recovery.
How Effective is Outpatient Alcohol Treatment?
Are you thinking to yourself “is outpatient alcohol rehab for me” and is it an effective form of treatment? Outpatient alcohol treatment has been demonstrated to be effective for an AUD; however, some people tend to do better overall in this type of setting than others. Outpatient treatment may not be right for you if:9
- You have a risk of acute withdrawal (i.e., experiencing uncomfortable and potentially severe symptoms when you stop drinking).
- You have chronic medical conditions or complications. This does not preclude you from attending outpatient treatment; as long as your condition is stable and your problems will not interfere with treatment, you may be eligible for outpatient rehab.
- You have co-occurring emotional, behavioral, or cognitive issues, in addition to alcohol use disorder. You can still be treated in an outpatient setting, but the facility must be geared toward the treatment of dual diagnosis patients (i.e. people with both a substance use disorder and a mental health condition).
- You aren’t willing to change and engage with treatment. If you’re not ready, you may need a more motivating and supportive form of treatment.
- You have experienced a relapse or if your problems are worsening with less intensive levels of care. In these cases, you may require a relatively more intensive form of outpatient care or possibly an inpatient stay.
- You have less support at home or have limited contact with people who do not abuse substances.
Although people in these groups may not do as well as others overall, many participants in these groups still benefit from outpatient treatment. A recent study indicated that outpatient treatment may be just as effective as inpatient treatment for treating AUDs.11
Other studies show that 50% to 70% of people who attended an IOP were abstinent from alcohol during follow-ups.12 Another review of numerous research studies show that overall, outpatient treatment was just as effective as inpatient treatment for the majority of participants.12
How to Find Outpatient Treatment for Alcohol Addiction Near Me
If you’re ready to take the next step and start treatment, we can help. American Addiction Centers (AAC) is a nationwide provider of addiction treatment facilities. We offer a complete continuum of care starting with detox and continuing through aftercare that is uniquely tailored to meet every patient’s specific needs; we know there’s no one-size-fits-all approach to treatment.
Call to ask about your alcohol treatment options and start your recovery journey.
Does My Insurance Cover Outpatient Alcohol Rehab?
If you’re ready to seek treatment for alcoholism with AAC call our hotline to speak with an admissions navigator who can answer any questions you may have about treatment and your options close to home or throughout the country. All calls are 100% confidential. You can also easily and quickly check if your insurance is in-network by filling out the form below.