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Perhaps you’ve been seeing your therapist regularly, but your depression, bipolar disorder or anxiety disorder symptoms are becoming more severe. Or you’ve just been discharged from the hospital, but you’ve still got issues that make transitioning to work and home challenging. An intensive outpatient program (IOP), which is a step in between, might be what you need.

An Intensive Outpatient Program allows you to get comprehensive mental health treatment for part of the day while living at home. You may attend the program two, three, or five half days or evenings a week for two to eight weeks, depending upon your needs. You might go to work for at least part of the day.

What are the advantages of an IOP? 

• You’re at home for part of the day and at night.
• You may be able to go to work, at least part of the day.
• The program is tailored to your individual needs.
• It combines individual and group therapies.
• It provides more intensive treatment than traditional psychotherapy, but with more freedom than hospitalization.
• You’ll have consistent monitoring of your mood changes.
• A multi-disciplinary team will be involved in your treatment.
• Treatment addresses the issues you’re dealing with now  

What happens in an IOP?
In an intensive out-patient program, you’ll have opportunities to work on life, relationship and work issues with other people who have similar issues. You’ll learn about your illness, how to manage your medications and how to prevent relapse. You may participate in family therapy. You will work with a team of licensed professionals, including psychiatrists, psychologists, nurses, clinical social workers, and other therapists or clinical specialists.

You will participate in facilitated groups that teach wellness and coping skills, on such topics as anger management, nutrition, communication skills and relaxation techniques. There will be handouts and you may have homework. You’ll also take part in groups where you will discuss with other participants the issues you’re dealing with in your life. There may be art and fitness activities led by specialists. “In psychotherapy groups you talk about the problems you’re struggling with and identify and explore related concerns. In educational groups, you learn coping skills to manage your life, relationships, and everyday functioning.” says Juliet Douglas, Clinical Coordinator, Princeton Healthcare System, Princeton, New Jersey.

“It can be tremendously supportive to be with others who share your experiences and who are in varying levels of recovery,” she says. “You find out you’re not the only one; that others have faced similar difficulties. Some have been able to address them successfully, and can share what works.”

Your may see your psychiatrist in the program once each week, and your medications will be monitored. Your spouse or family members may participate. “We encourage everyone to have at least one family meeting,” says Douglas, “so that we can explore family dynamics, and understand and support the patient in that context.”

“The program provides structure for those who struggle with maintaining a daily routine and getting through the day,” she says.

Will my insurance company cover an IOP?
Many health plans offer an Intensive Outpatient benefit. You can find out if yours does by calling the number on your membership card. Participation in the program begins with an evaluation by a psychiatrist, who determines if this level of care is needed. If the doctor determines an IOP is appropriate, he or she will need to advise your health plan of the medical necessity of participation in the program. The insurer will then authorize a certain number of days of coverage, authorizing additional days as it deems necessary, based on communication with the program staff.  Medicaid may also provide coverage for intensive outpatient treatment in some settings and instances.

How can I find an IOP?
Ask your primary care physician, psychiatrist, psychotherapist or other healthcare professional to refer you. Or, you may refer yourself to this type of program, if you know of one in your area.

Related articles
So you're going into the hospital
Group therapy
How to get your health plan to pay
HMOs and PPOs  

Sources
Juliet Douglas, LCSW, Clinical Coordinator, Princeton House Behavioral Health, Princeton Healthcare System, Princeton, New Jersey.
Psychiatric Solutions, Inc. ,Fremont Hospital
The Acadia Hospital, Bangor ME
Princeton HealthCare System. Princeton, NJ

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