When a client commits to an alcohol or substance use rehabilitation program for the first time, the choices might seem a bit bewildering. Popular movies and media, like 28 Days, typically feature only one type of rehab as a cure-all for every single chemical dependency. But while basic models like 12 Steps Programs have helped millions of people, clients actually have many modes of treatment to choose from. Depending on their needs, clients can have 24/7 supervision or visit a counselor as few as once a week.

If you’re not sure about which treatment program is the perfect fit for your needs, the best way is to do a little research on rehab models. Each program varies, but they all follow the same guidelines laid out by experts in the American Society of Addiction Medicine (ASAM). ASAM has created categories for different levels of care, which helps clients and their healthcare providers track their continuum of care throughout their recovery.

The ASAM Criteria for Continuum of Care has several stages, depending on the severity of the client’s addiction. Each level further divides into subcategories. Not everyone will fall into the same levels; adults’ levels of care might vary from adolescents or seniors. But the basic structure for all clients remains the same.

Level 0.5: Interventions

The lowest level of care consists of interventions. If a client is at risk of developing an addiction but has not yet been formally diagnosed, an intervention can serve as a “wake-up” call to prevent the client from falling deeper into dependency.

An intervention can take place in a variety of ways. Professional counselors and interventionists can intercede with the client at their home, a clinic, the workplace, or at neutral public or private spaces. Interventions usually consist of education/awareness programs and motivational interviews. Family members may also be present to lend support and even suggest alternatives to curb the client’s substance use disorder.

Level 1: Outpatient Rehab

Outpatient rehab is the least intense level for clients who have a formal diagnosis of chemical dependency. Clients in outpatient care do not require 24/7 supervision, and their dependency on alcohol or drugs might be stable. Nevertheless, these clients need formal monitoring, such as from a counselor or a structured peer support program. Treatment generally lasts up to 9 hours per week. Counseling can take many forms, from individual and family therapy to more holistic treatments, such as outdoor exercises, yoga and acupuncture, and light medication.

Clients in outpatient care have a stable home environment, where the risks of relapse are low. Family members offer support and clients generally do not face overwhelming pressure from their personal or professional lives.

Level 2: Intensive Outpatient and Partial Hospitalization

The next stage in terms of care includes intensive outpatient and partial hospitalization. As its name suggests, intensive outpatient programs require a stronger commitment from clients to participate in therapy. Their treatment can range from 9 to 19 hours per week and can include night and weekend sessions. Counseling sessions might also have a greater focus on clients’ addictions, motives, and underlying mental and behavioral health.

Partial Hospitalization Programs

Partial hospitalization is a transitionary care between outpatient programs and inpatient hospitalization. The National Library of Medicine defines partial hospitalization as an outpatient program that offers hospital-level services for clients who do not need overnight supervision. Clients attend day programs in a hospital setting, receive services such as medication, lab work, and other benefits, but leave after several hours of treatment. Program lengths generally consist of more than 20 hours per week.

Intensive Outpatient

Intensive outpatient programs and partial hospitalization include more structure than general outpatient care due to the severity of their disorder. However, like general outpatient programs, clients have stable home environments and support to reduce the chances of relapse. For partial hospitalization, clients can even save costs by not having an overnight stay; however, clients with financial concerns should not prefer partial hospitalization as a money-saving program. The client’s case management team determines whether a client is eligible for partial hospitalization or inpatient care.

Level 3: Inpatient or Residential Rehab

Clients who have a severe dependence on alcohol or substance use or have a high risk of relapse outside their treatment programs may warrant the third level of care. Inpatient rehab programs, also called residential housing, offer clients 24/7 supervision and monitor their health and wellness during recovery. Clients become full-time residents of their programs and may share living spaces with a roommate, receive meals, and participate in group activities throughout the day, in evenings, and on weekends.

Clinically Managed Low-Intensity Residential Services

The lowest level of inpatient care, Level 3.1, consists of Clinically Managed Low-Intensity Residential Services. Clients at this level require a low level of management and do not have a high risk of relapse. Rather, these clients tend to lack a stable home environment, which necessitates an inpatient stay. These residents tend to have an interdisciplinary team, including counselors, nurses, social workers, and recovery specialists. Counseling may focus on coping mechanisms to develop resilience from the pressures of everyday life. Life management skills, career coaching, and education courses may be included to wean the client away from substance use as a crutch.

Clinically Managed Population-Specific High-Intensity Residential Services

The mid-level tier, Level 3.5, is called Clinically Managed Population-Specific High-Intensity Residential Services. Clients in this stage require a more hands on approach for the case management team, which may include private consultations with physicians and clients at this level have a deeper addiction, which may be due to co-occurring mental and behavioral health disorders. Counseling sessions tend to have a greater range of services, such as arts and music therapy, to address psychological trauma.

Clinically Managed High-Intensity Residential Services

The highest tier, Level 3.7, includes clients who qualify for Clinically Managed High-Intensity Residential Services. This means that clients may have acute addictions that have severely impacted their cognitive and behavioral functions. These clients may require active 24/7 monitoring, regular medication-assisted treatments, and a rigid structure to promote their sobriety.

Level 4: Medical Detox

The highest level of care consists of medical detox. At this stage, clients require 24/7 medical and nursing care to fulfill basic activities of daily living. Clients at level 4 often need to undergo medical or social detox in an acute psychiatric hospital setting to safely remove all substances from their body systems to begin recovery. The case management team provides care, such as medication management, to reduce cravings and withdrawal pains. As clients experience detox, nurses and staff address any cognitive, emotional, physical, and behavioral distress.

In addition to detox, level 4 clients also begin joint counseling and recovery programs. The Department of Drug and Alcohol Programs lists intensive individual and group therapy, health education programs, and motivation enhancement initiatives as good starting points for a level-4 recovery. Once clients have stabilized, they can transition into an inpatient program.

No matter the program you select, remember: you’re not alone. The Substance Abuse and Mental Health Services Administration (SAMHSA) has reported that of the 29 million adults who admitted to having or once had a substance use disorder, over 72% consider themselves to be fully recovered or are currently recovering from their dependency. Treatment is not easy, but millions of individuals have successfully beaten their dependencies.