Substance Use Disorder Treatment Outpatient Treatment and Intensive Outpatient Treatment
Integrated SUD/MH for Adults

Outpatient Treatment and Intensive Outpatient Treatment focus on individuals with co-occurring disorders at every level of care. Some clients have serious and persistent mental illness and others have relatively stable disorders of mild to moderate severity. The service utilizes procedures for screening, assessing, enrolling clients and referring clients to external services. If the screening and assessment process establishes a substance abuse or mental illness beyond the agency’s capacity or resources, referrals are made to suitable residential or mental health facilities or other community resources. Staffing includes two linked teams, one specializing in mental illness and the other in substance abuse. Both teams are clinically supervised by a single supervisor who holds both LISW-S and LICDC licenses. While pharmacological management for mental illness is available within the agency, currently addictions pharmacotherapy lies outside the agency’s capacity and appropriate referrals are made as needed.

Groups are central to both Outpatient Treatment and Intensive Outpatient Treatment with Individualized Psychotherapy as an important, supportive adjunct to group sessions. The services support clients by: Providing opportunities for clients to develop communication skills and participate in socialization experiences; Creating a group atmosphere where clients help, support and when necessary, confront one another; Providing structure and discipline into the often chaotic lives of clients; Providing norms that reinforce healthful ways of interacting and a safe and supportive therapeutic milieu that is crucial for recovery; and Providing a venue for group leaders to transmit new information, teach new skills, and guide clients as they practice new behaviors.

Clients experience several different types of groups during the course of treatment, psychoeducational, skills-development, support, and interpersonal process groups. These classifications are not rigid and each type of group borrows ideas and techniques from others. Groups are both heterogeneous and homogeneous. Open-ended heterogeneous groups provide clinicians the flexibility of assigning new clients to ongoing groups and homogeneous groups allow clinicians to address therapeutically relevant issues for a subset of clients such as a co-occurring mental health disorder.

Psychoeducational groups typically focus on the signs and symptoms of mental
disorders, medication, and the effects of mental disorders on substance abuse problems. These groups increase client awareness of their specific problems and do so in a safe and positive context. Interrelated Relapse Prevention groups help clients become aware of cues or “triggers” that make them more likely to abuse substances and help them develop alternative coping responses to those cues. Additionally, these groups focus on recognizing cues for the return of psychiatric symptoms and for affect or emotion management, including how to identify, contain, and express feelings appropriately. These groups provide a forum for discussion of the interrelated problems of mental illness and substance abuse, helping participants to identify triggers for relapse through discussion rather than acting upon impulses.

The main difference between outpatient treatment and intensive outpatient treatment lies in the amount of treatment hours received by the client. The other difference is that intensive outpatient treatment might be more appropriate for someone who is unable to attend an inpatient facility, while outpatient treatment may be more appropriate for someone who has completed previous treatment. For both, groups range between 6 and 15 clients. Intensive Outpatient Treatment includes at least 9 hours (up to 12) of therapeutic contact per week and is scheduled for 3 hours of treatment on 3 days within a week. This might entail 2 evenings of back-to-back 90-minute groups and a third evening might include 30 minutes of individual counseling, a 90-minute family session, and an hour-long skills training group.