Intensive Outpatient Program – Mental Health Disorder

Millions of people in the U.S. and worldwide suffer from various mental health disorders, such as mood disorders and personality disorders. In addition, mental health disorders such as depression and anxiety have increased at alarming levels in recent years, especially since the emergence of Covid-19. According to the Centers for Disease Control and Prevention (CDC), symptoms of anxiety and depression have increased significantly in the United States from April to June 2020, compared to 2019. 

The prevalence of psychiatric conditions and increased understanding and acceptance of the disease have paved the way for developing efficient treatment programs. One such treatment approach that has shown significant success is the intensive outpatient program (IOP). 

An IOP is a treatment program that helps address mental health disorders and substance use disorders that do not need detoxification and round-the-clock supervision. Instead, it provides treatment on a part-time basis to allow patients the flexibility to continue their regular life with minimal interruptions. 

Intensive outpatient programs for mental health disorders combine the rigorous structure of residential treatment and the flexibility of standard outpatient programs to help patients improve social functioning. 

Mental Health Disorders Treated by IOPs

Intensive outpatient programs help treat a variety of mental health disorders, such as: 

• Eating disorders – This refers to a set of complex mental health disorders that can severely impair health and social functioning. Eating disorders are formally classified as “feeding and eating disorders” and are characterized by abnormal eating behaviors and related thoughts and emotions. Some of the common types of eating disorders are binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN).
• Depression – This is a medical condition that negatively affects how a person thinks, acts, and feels. Depression causes feelings of sadness, hopelessness, and a loss of interest in activities once enjoyed. It can lead to various physical and emotional problems and greatly interfere with daily functioning. 
• Bipolar disorder – This mental condition causes unusual changes in mood, energy, concentration, activity levels, and the ability to perform day-to-day activities. Bipolar disorder was previously referred to as manic-depressive illness or manic depression and is classified into three types, namely bipolar I disorder, bipolar II disorder, and cyclothymic disorder. 
• Anxiety disorders – This refers to a set of mental health diagnoses that cause excessive feelings of nervousness, worry, fear, and apprehension. Anxiety disorders can significantly change how a person behaves and processes thoughts that manifest into certain physical symptoms. Some common types of anxiety disorders are generalized anxiety disorder, panic disorder, and specific phobia. 
• Post-traumatic stress disorder (PTSD) – This psychiatric disorder occurs in people who have witnessed or experienced a traumatic event. PTSD is characterized by flashbacks, nightmares, severe anxiety, and disturbing thoughts about the event. This psychiatric condition can have a crippling effect on an individual’s life if left untreated.
• Personality disorders – This refers to a mental illness characterized by long patterns of unhealthy and inflexible thought processes, behaviors, and feelings. These internal emotions and behaviors often deviate from cultural expectations and cause serious troubles in relationships and work. Some common personality disorders are paranoid personality disorder, schizoid personality disorder, and antisocial personality disorder. 
• Co-occurring disorders – Also known as dual diagnosis or comorbidity disorder, are conditions in which a person simultaneously has a substance use disorder and a mental health disorder. 

IOP Treatments for Mental Health Disorders 

IOP treatment mainly revolves around individual and group counseling to help patients resolve immediate problem areas and develop skills to sustain long-term recovery. Some of the other treatment services provided by IOPs are: 

• Cognitive-behavioral therapy (CBT) 
• Dialectical behavioral therapy (DBT)
• Motivational interviewing (MI)
• Group processing 
• Skill-building exercises
• Family therapy
• Psychotherapy
• Medication management 

IOP treatments require a great deal of commitment and a willingness to participate in treatment services. Hence it may not be an ideal approach for individuals with a severe mental health disorder requiring constant supervision and support.

What to Expect During Intensive Outpatient Treatment?

Most IOPs require patients to undergo an initial assessment, including a physical and psychological background evaluation, to determine the severity of their mental health conditions. The evaluation will also determine a person’s eligibility for treatment and where they are in the recovery process. Once the assessment is complete and the person is deemed eligible for treatment, clinical professionals will work closely with the patient and their loved ones to plan and develop a viable treatment plan. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), IOP requires a minimum of nine to 20 hours of participation each week. And most programs usually meet between nine to 15 hours per week in three-hour sessions. Patients spend the agreed number of hours engaging in various group and individual therapies and educational workshops centered around their mental health disorders. They may also be encouraged to participate in 12-step programs to ensure long-term recovery. The overall goals of IOPs are to help patients:

• Manage mental health disorders effectively 
• Develop positive-coping skills and problem-solving skills
• Improve self-esteem and self-awareness
• Regulate emotions and control impulses 

How Long Do IOPs Last?

According to the National Center for Biotechnology Information (NCBI), the length of time a person stays in an IOP treatment may vary depending on the individual requirements of each patient. The length of IOP treatment may be determined by factors such as the severity of a patient’s condition, their support system at home, and their treatment progress. Most IOPs last anywhere from one to six months. During this time, the majority of patients complete 30 to 60 treatment sessions. However,  IOPs can also potentially linger up to a year in some cases.

Who Benefits from Intensive Outpatient Programs? 

Although IOPs offer a flexible treatment option, they may not be the best solution for everyone suffering from a mental illness. Patients who benefit the most from IOPs are those who:

• Do not require round-the-clock supervision or care but still need access to intensive therapeutic modalities. 
• Have unavoidable daily commitments that preclude them from enrolling in full-time treatment. 
• Need a “step down” program to transition from a residential program or a partial hospitalization program (PHP).
• Have a history of frequent hospitalizations due to mental health issues and suicidal behaviors.
• Require specialized support for stabilization, symptom reduction, and relapse prevention. 

Before engaging the services of an IOP, patients should seek advice from a physician who specializes in mental health disorders. The doctor will assess each patient’s situation to determine if IOP is the best option for them.