Of the people who need assistance with an addiction issue, the vast majority get help on an outpatient basis. In the 2000 National Survey of Substance Abuse Treatment Services, for example, 89 percent of those enrolled in addiction care were in outpatient programs. This form of care can be attractive to some people, as they’re allowed to continue to live at home and attend to their responsibilities in programs like this, and the assistance they get in a program like this can help them to turn their lives around for good. Even so, this isn’t the right kind of treatment for everyone who has an addiction issue or a mental health issue. In fact, some people are best treated in inpatient programs. Read on to find out more.
Freedom of Movement
Many of the services provided in an outpatient program are similar to those given to clients in inpatient programs. For example, an outpatient addiction program provides clients with:
- Individual education
- Private psychotherapy
- Group therapy
- Family therapy
- Medication management
- Relapse prevention therapy
The main difference between inpatient and outpatient care involves where the client lives when the program isn’t in session. In an inpatient program, the person lives on the premises as the program moves forward. In an outpatient program, the person lives at home with the family. This can be helpful for some people, as they’ll have the opportunity to stay connected with their children and friends when they’re in an outpatient program, and they might even be able to continue to work or go to school, but it can have some risks for some people.
Fostering Lifelong Change
In an outpatient program, people may still have access to the dealers who once sold them drugs, and they may still be faced with the same pressures and the same challenges they faced before they chose to tackle their addictions. People with mental illnesses might still be under stress, and the medications used to control these issues might not yet be working at optimal levels. It can be all too easy, when faced with this kind of pressure, to simply drop out of care. According to the Treatment Episode Data Set, about 28 percent of people who enroll in outpatient care do just that. Instead of staying in their programs and continuing to learn about their addictions or mental illnesses, they drop out of care altogether, and quite possibly, they return to their addictions or disordered behaviors. Some studies suggest that people who enroll in outpatient care are more likely to drop out of their programs, due to the difficulties of healing while living at home. For example, in a study in the journal Psychiatric Quarterly, researchers found that people enrolled in outpatient care were four times more likely to fail out of their programs, compared to people who were in inpatient programs. Studies like this seem to suggest that living at home isn’t ideal, especially for people with very real mental health issues. However, facilities that offer outpatient care may know all too well that clients might be tempted, and they might tailor their treatments to help clients resist the pull of their former lives.
Motivational enhancement therapy is one such technique that can help program directors to keep their clients engaged and involved. This form of therapy proceeds on the basis that people make a choice to change their lives after following a predictable set of stages, including:
According to an article in Relapse to Substance Abuse: Recent Findings from Basic and Clinical Research, therapists can help clients by determining where they are on this continuum and then using motivational enhancement therapy in order to help clients transition from one phase to another. Clients who enter treatment programs at the precontemplation phase, by this theory, might not really want to get better, and they may only be thinking about sobriety in a vague or abstract way. With therapy, however, these clients might be ready to make a big leap and change their lives for the better. It’s the kind of program that can help to reduce the risk of dropouts. Contingent reinforcement therapy might also be helpful in an outpatient program. In an addiction program, for example, clients are asked to provide a urine test on a regular basis, and if that test is clear of drugs, they are provided with a small prize or reward. This kind of therapy can allow people to stay sober, so they can participate in their therapies and resist the lure of drugs. It’s a difficult program to utilize with mental illness concerns, however, as the disordered behaviors that stem from mental illnesses don’t always appear in a blood or urine test.
In the past, outpatient care was reserved for people who had relatively uncomplicated cases of addiction or mental illnesses, and strong family ties that could help to shield them as they healed. Now, the Substance Abuse and Mental Health Services Administration reports that more and more serious cases are being treated on an outpatient basis. People with addictions and mental illnesses are sometimes treated on an outpatient basis, for example, as are people with very serious medical conditions running alongside their mental health concerns. Even people with eating disorders and addictions are sometimes treated on an outpatient basis now, where they likely would have been treated exclusively in inpatient programs in the past. The key is that people stay engaged in their programs, going to all of their appointments as directed and learning all they can about the conditions they’re struggling with. If this kind of care and attention is paid, this kind of program can be quite helpful for almost anyone who has a mental health concern. If the will to get well is low, however, it might be best for care to be provided on an inpatient basis. People who aren’t motivated to succeed may struggle with the openness of an outpatient program, and they might be willing to take shortcuts, skip sessions and otherwise shortchange their recovery. Their therapists may try hard to reach them when they are attending their appointments, but frequent abandonment of appointments could lead people like this to miss out on the recovery that waits for them after an effective treatment program. That’s why, at Futures of Palm Beach, we focus on providing inpatient care. Our residential program is designed to help people with addictions and co-occurring disorders, and many of our clients come to us with very serious problems and a low motivation to succeed. Outpatient care could quickly lead to failure for people like this, and as a result, we find that inpatient care really is the best way to help reach our clients and help them to succeed. If this sounds like this right kind of care for you, please call us. We’re ready to help you.
Some services listed may not be included in our core program. An admissions counselor will be able to provide you a complete list of core services. Information provided for educational purposes. Premium services or programs may be arranged through your therapist or case manager.