What is Outpatient Drug Rehab?

Outpatient drug rehab is a non-residential option for individuals seeking substance abuse treatment. It involves attending scheduled sessions during daytime hours, with no overnight stays at a facility required.

How Does Outpatient Rehab Compare to Inpatient Rehab?

Unlike inpatient addiction treatment, where clients live at a facility 24/7 during treatment, with outpatient rehab, clients can work, attend school, or meet other outside obligations while they’re receiving treatment. However, this means that they will not be totally removed from the temptations and distractions faced in their outside environments, as would be the case with inpatient treatment.

For these reasons, outpatient treatment is often a good choice for clients with mild to moderate addiction, and those who are not in danger of experiencing severe withdrawal symptoms. In severe cases, inpatient treatment, that provides 24/7 care and monitoring, might be needed. Typically, inpatient treatment programs run from 28 days to 6 months, but they can last longer. Most outpatient treatment programs run for 3 months to a year or more. So, while inpatient treatment is more intensive and immersive, outpatient treatment gives the client more time to make changes and adjust to sobriety.

Is Outpatient Rehab Effective?

A meta-analysis study, comparing the effectiveness of inpatient vs. outpatient treatment, that was reported in an NIH Library of Medicine review, found that in the short term–one month post treatment–inpatient treatment was more likely to lead to greater abstinence than outpatient treatment. However, 6 months after treatment, the differences were negligible.1 In addition, another study, reviewed on an American Psychological Association’s online web page, concluded that “a growing body of evidence supports the concept that improved quality of care during treatment can improve treatment outcomes.” They suggest that identifying and using evidence-based therapies (in both inpatient and outpatient treatment) can positively affect both the treatment experience itself and the outcomes as well.2

Types of Outpatient Addiction Treatment

Outpatient rehab treatment programs include partial hospitalization programs (PHP), intensive outpatient programs (IOP), general outpatient treatment (OP), and outpatient telehealth treatment. Outpatient treatment usually involves a combination of group and individual therapy.

PHP, or “day treatment,” as it is also known, offers the most intensive treatment that does not require overnight stays. Partial hospitalization programs do not necessarily take place in a hospital; many freestanding rehab clinics also offer PHP. The main designation for PHP is the number of hours per week spent in treatment. Typically, PHP programs require 20 hours or more per week of treatment, and sessions are often held 4-5 days per week for several weeks, depending on the clinic and the needs of the client.

IOP, intensive outpatient treatment, requires fewer hours than PHP, with programs often offering sessions 2-3 days per week, and totaling 9-20 hours each week. It also may last several weeks to several months, depending on the program and client needs.

Regular outpatient treatment (OP) is usually scheduled 1-2 times per week and may involve one hour to 1.5 hours per session. However, traditional outpatient treatment usually lasts longer than PHP or IOP and may take place over several months to a year or more.

Outpatient telehealth treatment is best for clients who are relatively stable and don’t require intensive treatment or monitoring. It is also useful for clients who live in rural areas, where rehab clinics are difficult to access, and for clients who may not be able to travel. Telehealth treatment can take place by telephone or over the internet, through video conferencing.

How Much Does Outpatient Drug Rehab Cost?

According to the National Center for Drug Abuse Statistics (NCDAS), the average cost of general outpatient treatment (in 2022 dollars) was about $5,700 per month; but many clinics offer a 3-month discounted program price for around $5,000 total. Intensive outpatient programs cost about $15-20,000 for a 3-month program, and partial hospitalization programs cost, on average, $12,000 per month.3 Telehealth outpatient therapy is less costly than in-person therapy, but costs vary.

Fortunately, most private insurances cover some, or most, of these costs. With insurance, the cost of drug rehab can often be reduced by 80% for the client. Telehealth drug rehab typically costs about half as much as in-person rehab, and when covered by insurance, the cost can be minimal (less than $20 per session). Benefits for all insurances will vary according to an individual’s plan. In addition to private insurance companies, government insurance (Medicare and Medicaid) also pay some of the costs of drug rehab for patients who are diagnosed with a substance abuse disorder. Co-pays may be applicable, and coverage varies according to individual plans.

There are also federal, state, and local grants available from various organizations that can help pay for drug rehab. The Substance Abuse and Mental Health Services Association (SAMHSA) provides block grants to all states to help nonprofit organizations assist uninsured or underinsured clients pay for addiction treatment services.4 Often, nonprofit associations that are associated with minority or underserved populations (such as tribal organizations, LGBTQ organizations, etc.) have their own substance abuse programs that may provide free or low-cost rehab treatment to individuals in need. Many clinics will assist prospective clients in finding supplemental funding options. Some may even have their own reduced fee or free service plans. It’s always a good idea to ask if the clinic itself offers discount programs.

Types of Therapies Used in Outpatient Rehab

The kinds of therapies used at outpatient drug rehab facilities vary according to the facility. But with the current interest in using evidence-based practices, most outpatient rehabs utilize at least one or more of these research-backed therapies.

Cognitive Behavioral Therapy

The most used evidence-based therapy is cognitive behavioral therapy (CBT). CBT focuses on gaining an understanding of the relationship between thought, emotions, and behaviors. Clients are taught how to address each of these factors in ways that lead to the elimination or reduction of maladaptive behaviors, which are then replaced with healthy, positive behaviors.

Motivational Interviewing

Motivational interviewing (MI) is another commonly used evidence-based therapy. Client and therapist share a collaborative, explorative type of communication that seeks to discover and enhance the client’s motivations for addressing their drug misuse, as well as their personal beliefs about their capacity to change. The therapist’s role is to gently guide, but not direct, the conversation so that the client draws out his/her own meaning and gains confidence in the possibility of success.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT), developed in the 1980s, is a specialty type of CBT. It focuses on the behavioral aspects of CBT and teaches clients how to achieve emotional regulation, distress tolerance, and mindfulness, so that they can reduce the number of maladaptive behaviors, such as substance use, self-harm, passive-aggressiveness, anger, and inappropriate interpersonal personal interactions that they engage in. Individual, group, and family therapy are also considered evidence-based therapies and are hallmarks of drug rehab treatment as well as other psychological treatment programs.

Experiential Therapy

In addition to evidence-based therapies, many drug rehabs utilize experiential therapies that engage emotions that the client may be reluctant to talk about or be unable to verbally articulate. Such experiential therapies include art therapy, music therapy, outdoor/adventure therapy (hiking, swimming, ropes courses, etc.), creative writing, or psychodrama/role playing therapy.

Holistic Therapy

Holistic, or mind/body therapies are also used in many drug rehabs. Meditation and mindfulness have become commonly used. Yoga, Tai Chi, acupuncture, nutritional counseling, and spiritual techniques such as drumming, dancing, and sound and vibrational medicine techniques are sometimes offered, especially at luxury clinics or rehabs that feature holistic practices as a part of their rehab identity.

Factors to Consider When Choosing a Drug Rehab Program

While cost is often a major factor in choosing a drug rehab treatment facility, there are also other considerations to keep in mind. First, consider the quality of the facility. If the facility has accreditation with one or more of the major accreditation organizations (JACO – The Joint Commission on the Accreditation of Healthcare Organizations, aka “The Joint Commission,” or CARF – Commission on Accreditation of Healthcare Organizations), you have assurance thatthe facility meets or exceeds expected standards.

Convenience of the facility location and access to public transportation, if needed, is another factor to consider, especially if you have work or other obligations to take care of. You’ll also want to check out the types of therapy modalities used, to see if they are agreeable or desirable for you.

Finally, consider whether the facility offers aftercare programming, such as follow-up groups/meetings, community 12 Step meetings, or continued access to individual therapy, should it become needed. By spending some time investigating different facility options, you can choose the drug rehab facility that best fits your needs and interests.

Sources

1. National Library of Medicine (2017). Inpatient and Outpatient Treatment Programs for Substance Use Disorder: A Review of Clinical Effectiveness and Guidelines. Online Summary at: https://www.ncbi.nlm.nih.gov/books/NBK507689/
2. American Psychological Association / Psychiatry Online (2004) Relationship Between Drug Treatment Services, Retention, and Outcomes. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.55.7.767
3. National Center for Drug Abuse Statistics (NCDAS) 2022. https://drugabusestatistics.org/cost-of-rehab
4. SAMHSA.gov Substance Use and Mental Health Block Grants. https://www.samhsa.gov/grants/block-grants