The Difference Between
OP and IOP

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If you’re one of the nearly 10 percent of Americans with an addiction to drugs or alcohol, you’ve probably tried quitting on your own, only to find it very challenging to do alone. That’s because addiction is very complex, involving changes in brain function and shifts thought and behavior patterns. Addiction almost always has underlying causes, and it causes problems in your life. All of these issues must be addressed for successful recovery. According to the National Institute on Drug Abuse, addiction almost always requires professional help.1 A high quality addiction treatment program addresses a wide range of issues and gives individuals the strategies, skills and tools they need to recover for the long-term. Addiction treatment takes place in a variety of settings, depending on an individual’s needs. Both outpatient programs (OP) and intensive outpatient programs (IOP) enable you to live at home while in rehab. Here, we take a closer look at what these are and how they work.

Outpatient Program vs. Intensive Outpatient Program

The primary difference between an outpatient program and an intensive outpatient programs is the number of hours an individual attends programming each week. Clients in both outpatient and intensive outpatient programs engage in therapy, psychoeducational classes and other services and interventions, depending on their unique needs.

Holistic Treatment

A high quality outpatient program or intensive outpatient program will take a holistic approach to treatment that addresses issues of body, mind and spirit for whole-person healing. This approach typically involves a variety of traditional and complementary therapies that treat a wide range of issues and problems.

Traditional Therapies

Traditional therapies are those that have been shown through research to successfully treat addiction. These include:
  • Cognitive-behavioral therapy, which is the most commonly used therapy in addiction treatment programs and helps people identify self-destructive thought and behavior patterns and develop new, healthier ways of thinking and behaving.
  • Family therapy, which helps repair damaged relationships and restore function to the family system.
  • Trauma-focused therapies like acceptance and commitment therapy, which instills a sense of safety in trauma survivors.
  • Pharmacotherapy, or the use of medications, which may be used to treat a co-occurring mental illness or, in the case of medication-assisted treatment, the addiction.

Complementary Therapies

Complementary therapies are those that have been shown through research to successfully treat addiction when they’re used along with traditional therapies. These include:
  • Art or music therapy, which helps individuals express difficult emotions, heal emotional wounds, decrease denial and increase motivation and self-awareness.
  • Biofeedback therapy, which helps individuals learn to reduce their body’s stress response and become more aware of how stress affects the body.
  • Meditation, which improves mindfulness, reduces stress and increases self-awareness.

Psychoeducational Classes

Psychoeducational classes are a combination of therapy and education and help individuals better understand addiction, treatment and recovery. Other interventions are used as needed during treatment and may include legal, vocational or educational assistance or help with finding safe housing or other resources.


Once an outpatient program or intensive outpatient program is completed, an aftercare plan is developed to ease you into solo recovery. The aftercare plan will often include ongoing therapy, participation in a support group and other components as needed. According to the Butler Center for Research, the likelihood of long-term recovery increases by 20 percent for each consecutive month you engage in an aftercare plan.5
  • 20% Increase of Long-Term Recovery for Each Consecutive Month of Aftercare 20% 20%

The Continuum of Care for Addiction Treatment

The continuum of care for addiction treatment is designed to help ensure that individuals are placed in a treatment setting where treatment will be the most effective. The American Society of Addiction Medicine has identified four levels of care for treating addiction.2

Level 1: Outpatient

The first level of the continuum of care is outpatient treatment, which involves living at home while receiving services during the day or in the evenings at a treatment facility. Clients in this level of care attend programming for nine or fewer hours each week.

Level 2: IOP & PHP

The second level of care is divided into two sub-levels. Level 2.1 is an intensive outpatient program, which is similar to outpatient treatment except that it consists of nine or more hours of programming each week. Level 2.2 is partial hospitalization services, which involves 20 or more hours of outpatient services each week.

Level 3: Residential

Level three is divided into four sub-levels of residential care. The first three are clinically managed residential programs, which involve living at the treatment center while in rehab. The higher the sub-level, the more intensive the services. The fourth sub-level is medically monitored inpatient treatment for those who require medication or medical supervision.

Level 4: Intensive Inpatient

The fourth and highest level of care is medically managed intensive inpatient services, which involves 24-hour nursing care and daily care under the guidance of a physician. This level is for people who are unstable, have severe problems or who are experiencing severe withdrawal during detox.

Four Stages of Treatment

Regardless of where you enter the continuum of care, you’ll progress through four stages over the duration of treatment, according to the Substance Abuse and Mental Health Services Administration:3

Engagement in Treatment

Engagement in treatment, which is essential for the best possible outcomes. The engagement process often includes therapies like motivational interviewing, which help individuals identify their own personal reasons for wanting to overcome an addiction.

Early recovery

Early recovery, during which clients are engaged in a routine that supports abstinence. During early recovery, individuals work to change faulty thought and behavior patterns, resolve personal problems and make essential lifestyle changes that support long-term recovery.


Maintenance, which involves practicing relapse prevention skills, developing a sober network, improving emotional functioning and continuing to address personal problems.

Community Support

Clients begin to develop independence from the treatment program, continue to create a strong support network in the community and develop hobbies and new interests that support recovery.

Recovery Starts with Detox to End Dependence

Recovery begins in detox, which is the process of allowing all traces of drugs and alcohol to leave the body so that brain function can begin to return to normal and treatment for the addiction can begin. Detox treats dependence, which is characterized by withdrawal symptoms that set in when you suddenly stop using drugs or alcohol. Dependence is a physical reliance on drugs or alcohol, caused by changes in neurotransmitter function resulting from heavy substance abuse. Dependence is different from addiction, which is characterized by compulsive drug abuse despite negative consequences, driven by intense cravings and dysfunctional thought and behavior patterns.

How Long Does Detox Take?

Medical detox is supervised by medical and mental health professionals who can provide medication as needed to reduce the severity of withdrawal symptoms and shorten the length of time it takes to detox. In general, detox can last anywhere from a few days to a few weeks or longer. How long it takes to detox depends on a number of factors, including:
  • The drug of dependence
  • The length and severity of dependence
  • The amount of drugs or alcohol in the body at the time detox starts
  • An individual’s age and general state of physical and mental health
  • An individual’s unique biology

How is My Program Determined?

During medical detox, a variety of assessments guide the team of care providers in developing a highly individualized treatment plan for addressing the addiction. The assessments identify the issues and problems that need to be addressed in treatment. They also help determine where an individual is placed on the continuum of care, depending on:
  • The length and severity of the addiction
  • Whether a mental illness co-occurs with the addiction
  • How safe and stable an individual’s living environment is
  • The extent and severity of an individual’s personal problems
  • How motivated a person is to recover
Motivation is an important factor for determining where on the continuum of care someone will enter treatment. Those who have little intrinsic motivation to recover will likely start treatment in an inpatient program. People with a higher level of intrinsic motivation will likely start in an outpatient program or an intensive outpatient program.

High Quality Outpatient and Intensive Outpatient Programs Work

Treatment works for most people who fully engage with their treatment plan and stay in treatment for an adequate period of time. Proper placement on the continuum of care is essential for the best possible outcomes, and high quality, holistic treatment programs give people in recovery the skills and tools they need to enjoy successful recovery for the long-term. If you’re struggling with a drug or alcohol addiction, an outpatient program or intensive outpatient program may be right for you. You’ll be able to continue living at home and working or caring for the family while undergoing treatment, and you’ll be able to put into practice right away, in the real world, the skills and strategies you’re learning in therapy. Treatment can help you end an addiction once and for all, and it can improve your quality of life and lead to authentic happiness in a life of sobriety.