Outpatient Treatment for Substance Use
Outpatient treatment for substance use is a common option, particularly for those who have not progressed to the most severe stages of addiction. Outpatient services are also often the first step toward rehab as well as the follow up after rehab. For example, many go to outpatient sessions before seeking any other help when having substance problems. Also, after rehab, outpatient services are typically suggested for aftercare and support in early sobriety.
Outpatient therapy is also a valuable intervention for many related and underlying issues of addiction that need long-term work to resolve. Among such common, longer term issues are trauma reactions such as from childhood abuse, neglect, and abandonment. Additionally, longer-term issues commonly addressed in outpatient therapy are relationship difficulties, depression and anxiety. However, not all outpatient treatment is long term. For people with substances issues, such co-occurring problems are common. Once abstinence is obtained, these issues are more easily addressed in outpatient therapy.
Outpatient is Not for Everyone
Outpatient treatment is certainly not for everyone who has a Substance Use Disorder but can be the first step. Particularly, outpatient help can identify the issue and need for more intensive help in a rehab setting. Also, outpatient help can resolve some of the barriers and obstacles to rehab. Some of the things that postpone rehab for people who would most benefit from it are:
- Lack of willingness to take action to become sober
- Shame and stigma of having a substance problem and going to rehab
Most particularly, those who need a rehab stay for substance problems are those in need of a closely supervised medical withdrawal and detox. While some can be safely monitored in outpatient appointments as they withdraw, others cannot. A medical healthcare giver can best determine the most appropriate withdrawal method. However, among those who should withdraw with around the clock medical supervision are those who have taken opioids, benzodiazepines and alcohol heavily or for a prolonged time, and those who have compromised physical or mental health. In any event, consultation with medical personnel who understand the degree of one’s use, and the full medical history is strongly recommended before any withdrawal method is begun.
Apart from withdrawal and detox, there are many with Substance Use Disorders that need the immersive, structured and supportive environment of a rehab stay to successfully transition from detox to early sobriety. People who already have a sobriety support group of friends and/or family can fare better in an outpatient only. They also need a substance-free environment at home and the ability to engage in a healthy daily structure in sobriety. Many have been successful in overcoming an addiction without rehab by using outpatient services. Typically, supplementing outpatient services with the support of 12 Step groups helps many successfully enter sobriety and maintain it. However, one should always be aware that the triggers of substance use are usually embedded in one’s daily life at home when there is an addiction to contend with.
Keep in mind that there is not a one-size-fits-all approach to substance treatment. People are individuals with unique circumstances. Some of the most important things to keep in mind when choosing a treatment modality are:
- Accessibility—can you get prompt help?
- Cost—can you afford help, and what resources do you have? Insurance? Ability to pay as you go?
- Is the provider educated and credentialed to provide the specialized help you need?
- Can you commit to a course of treatment and stay in treatment long enough to benefit?
- Will the treatment service adequately monitor your physical and mental health?
- Is the provider educated, experienced and well-informed about the substance(s) you abuse?
Court-Ordered Outpatient Treatment for Substance Use
Fortunately, these days many people in the judicial system see the illness and not the need to incarcerate people suffering from addictions. However, this often results in people being court-ordered to treatment, either rehab itself or outpatient treatment. Naturally, no one wants to be told what to do, but often this type of situation can be a ‘blessing in disguise’.
There is no wrong reason to go to treatment if you are addicted. You may go for yourself, your partner, your children, or because a judge gives you a choice between treatment and jail. However you get to addiction treatment, if you tackle it as an opportunity, you will find benefit. Your open-mindedness, honesty and willingness to participate make all the difference. If you find yourself somewhat ‘coerced’ into treatment—by the court or even a mandate from a spouse, you can choose rebellion, resentment, and resistance, or you can take what you need from the treatment you have.
Many people in 12 Step meetings will weave such ‘coercion’ into their stories, but find great gratitude in having had ‘no choice’ at a particularly out of control time in their lives. Of course, it is not always the case, but there are countless people who have found gratitude in retrospect, and the help they couldn’t ‘willingly’ seek out themselves.
What an Effective Outpatient Treatment Program Will Do for You
It is too difficult a task to completely enumerate in detail what a good outpatient program will do for you, but overall there are universals you can expect from a good outpatient service. Some of these are:
- Ongoing assessment of progress, needs, the effectiveness of treatment strategies.
- A treatment plan that you and your provider formulate together, and review often to amend as progress occurs and needs change.
- Medical supervision and monitoring of the physical aspects of withdrawal, and other healthcare concerns related to addiction such as testing for HIV and hepatitis, and substance use during pregnancy.
- Continuous monitoring of substance use during treatment.
- Prompt referrals to services outside the scope of the provider’s practice as needs arise.
Most outpatient services will offer a combination of individual and group services. Also, there may be family involvement in sessions if you are comfortable with that. Among the types of methods typically used in therapy are:
- Cognitive-Behavior Therapy (CBT)—this is a method that helps identify thoughts and beliefs that contribute to problematic behavior. Replacing such thoughts and beliefs with more helpful ones is the goal. Problematic behavior is better able to change as these replacements take place.
- Motivational Interviewing—this method is designed to help people move along a continuum of change. It is applicable to wherever a person is when dealing with a problem and is geared toward increasing awareness, mobilizing hope for change and behavior that will bring about change. A key ingredient in motivational interviewing is the relationship between the counselor and the client in which resistance and ambivalence about taking action to solve problems are resolved.
- Supportive Counseling—supportive counseling is a common method used in outpatient therapy. It typically involves an emphasis on identifying and mobilizing a client’s strengths and resources to address problems. Supportive counseling also typically involves collaboration to establish reasonable and achievable goals as well as coping strategies.
Outpatient treatment commonly fluctuates in intensity. For example, at the onset, appointments may be more frequent or involve multiple activities such as individual, group and education. As one improves, it is usual for fewer services to be offered, and less frequent appointments to be scheduled.
How to Choose the Right Treatment for You or a Loved One
Finding the right treatment for you or a loved one who has a substance problem can be overwhelming. However, this is not because the right treatment isn’t out there. Typically, the emotionality and fatigue of living with an addiction (for the addicted and loved ones) is the cause of difficulty finding the right program. There is simply a great deal of information out there, and any search can unlock an avalanche of possibility. However, not every treatment option is the right option for you or a loved one at a particular time. There are many factors to consider. For example:
- How severe is the problem? Is daily functioning seriously compromised, or can necessary activities and routine still be done?
- What level of commitment can be made to treatment at this time?
- Can staying at home when withdrawing from substance use be done safely?
- Do you or your loved one need help deciding to stop substance use?
- Are you unsure if you or a loved one is addicted? Would discussion and education help?
We can help you sort out these kinds of issues, and we will do so free of charge. We have an extensive knowledge of available treatment resources and can help you or your loved one find those that will suit your clinical needs as well as your financial situation. We offer an in-depth phone consultation that can efficiently cut through the confusion involved in seeking treatment.
Substance treatment is not a static thing; you change, and your situation changes, so does a Substance Use Disorder. As you address your issues, you will discover the next steps that you need to take to get to the life you want, and with effective help, you can make those transitions far more easily than on your own.
Recovery from addiction is truly a process. In fact, becoming addicted is a process that sometimes progresses unnoticed. Effective treatment in any setting, at any time during your struggle with substance use will carry you to the next stage of healing that needs to occur.
If you or your loved one is struggling with substance use in any way, reach out for help today. Recovery happens. It is possible, and countless people have overcome problems like yours. They have gone on to lead substance-free lives. You or your loved one can, too.