Outpatient Rehab for Drug Addiction Explained
Understanding Outpatient Drug Addiction Treatment
Substance abuse is a complex problem, potentially impacting every aspect of a person’s life, including their interpersonal relationships, health and work. At some point, the person dealing with addiction may want to reach out for outside help.
Fortunately, today, there are multiple settings and degrees of drug and alcohol addiction treatment available for recovery assistance.
A severe addiction to specific substances, like heroin or prescription painkillers, is usually best treated in an inpatient drug rehabilitation programme to help control detoxification and withdrawal symptoms.
Generally speaking, outpatient rehab is a good choice for patients who are willing to stop their substance dependence but need the flexibility of a programme that works around their daily schedules.
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What Is Outpatient Drug Rehab?
With an outpatient drug rehabilitation programme, the patient lives their life like they normally would and goes to treatment sessions when they are free. Outpatient rehab programmes provide patients with optimum flexibility while still giving them a high level of care.
Too often, persons who require alcoholism or drug rehabilitation do not get the care they need because it would require taking large amounts of time away from their family, work or school. With the flexibility of an outpatient drug rehab programme, adolescents and adults can work through addiction treatment without putting their responsibilities on hold.
The shorter and less constricting time restraints allow clients to get treatment without disrupting their daily schedules.
What Happens in Outpatient Addiction Rehab?
An outpatient drug rehab facility allows people to seek assistance at the centre during the day and go back to the comfort of their home at the end of the day. For many persons, outpatient treatment is preferable to inpatient care because they can continue to work and keep up with regular responsibilities while receiving the treatment they require.
The programmes are also more cost-effective because the clients do not need to pay for 24/7 care. Here is what you can expect in an outpatient addiction rehab programme.
Detox is usually considered the first phase of recovery from addiction. During medical detoxification, a committed team of specialists helps soothe physical distress and mental concerns.
Somebody addicted to illicit opioids, painkillers, benzodiazepines or alcohol might require medical detox to treat the withdrawal symptoms. The symptoms resulting from benzodiazepine or alcohol abuse can be life-threatening. Those of opioids are usually extremely unpleasant and hard for people to endure.
Clients who have misused other types of drugs might also require medical supervision if they risk incurring medical or psychological complications.
According to SAMHSA, there are several levels of medical detox, including ambulatory medical detox without onsite monitoring, ambulatory medical detox with onsite monitoring, medically monitored inpatient medical detox and medically managed intensive inpatient detox. (1)
Group therapy to address chemical health
Groups are an essential part of most drug rehab programmes. For a person seeking treatment for a milder addiction, group counselling can be an excellent choice. Group therapy groups may meet daily, weekly or monthly, and they give a person in recovery a chance to share their experience with substance abuse.
Group therapy is when a qualified addiction counsellor gathers several people who are dealing with similar challenges. Within the confines of a secure, controlled therapeutic setting, participants get to discuss issues that are common to the group.
The aim of group therapy is for every participant to get an in-depth understanding of their addiction while at the same time providing and receiving support to and from the others in the group.
Individual chemical health assessments and therapy
A chemical dependency health assessment is used to determine the right addiction treatment plan for an individual. Conducted by a licensed addiction counsellor, the assessment works to establish the degree of dependency on a substance for a person based on their alcohol or drug use.
The multi-step process is carried out at any certified treatment facility to determine the best action to take in treating the disorder, depending on the severity of the behaviour.
Mental health therapy groups
At first, the notion of attending group therapy may seem intimidating for some. However, group therapy in which one or multiple therapists lead a group of five to 15 persons can be very beneficial.
Mental health therapy groups help participants see they are not alone in experiencing challenges because of the support they receive from others. In addition to that, hearing how other members of the group successfully overcame a problem can be very encouraging.
In groups, clients also practice re-engaging with others, in case of drug addiction might have propelled them into being anti-social. Furthermore, every participant gets to learn about themselves through the other members.
Individual mental health assessments and therapy
In outpatient programmes, individual health assessment and counselling address the immediate issues stemming from a client’s addiction and their current efforts to attain and maintain abstinence.
During the therapy session, the counsellor might:
- Ask the client about their reactions to a recent group meeting
- Study how the client spent their time since the previous session
- Ask how the client is feeling
- Inquire about substance use
The counsellor assists the client in reviewing their reactions to recent group discussions, reviews treatment programmes and coping mechanisms, addresses fears related to the recovery process and probes sensitive matters that are hard to talk about in the group.
During the outpatient drug treatment programme, the client will need to make several medical appointments depending on the extent of the addiction. Physicians use prudence in determining which clients can undergo detox safely on an outpatient plan.
As a general rule, an outpatient treatment programme is just as effective as an inpatient plan for persons with mild to moderate symptoms of withdrawal.
The physicians and clinicians prepare the patient to enter treatment and develop a therapeutic alliance with them. That includes giving the client and their family information on the detox process and subsequent treatment sessions.
Wellness and fitness activities
Wellness programmes are essential elements of any substance abuse treatment plan. Although psychiatric therapies, skills and procedures are the basis of addiction recovery, wellness and fitness activities are critical contributors to the health of the mind and body.
Such activities promote an optimistic outlook and confidence, thus helping to maintain abstinence and general well-being. The advantages of exercise, nutrition and other concepts of wellness can’t be underestimated in the treatment of substance dependence disorders. Incorporating wellness and fitness programmes into treatment is an essential part of recovering and preventing relapse. The programmes are set to meet the client’s individual needs, depending on the problems arising from their drug or alcohol abuse history.
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Family programme participation
Counselling and therapy for substance abuse usually involve programmes for family members in addition to the individual in recovery. Through therapy, the family members learn to understand the underlying causes of the disorder, how to decrease the risk for relapse and how to correctly support their loved one during recovery.
Overall, family counselling is advantageous for family members negatively impacted by another person’s substance dependence issue. It helps every family member to know about the impact of their actions on others and also how to live and communicate effectively.
The aim of family behaviour therapy is to decrease risk factors for alcoholism or drug abuse like unemployment, conflict and performance problems. Therapy sessions involve a variety of family members including the spouse, parents and children.
A supervising doctor diagnoses the client’s nutritional deficiencies or challenges with diet and puts them into consideration when creating a wellness plan. Some of the diet and nutritional requirements that arise after long-term addiction include:
- Taking meals on a set schedule
- Maintaining a low-fat diet
- Getting adequate fibre, protein and complex carbohydrates
- Increasing the intake of vitamins (e.g., B complex, A, C and E) and minerals (e.g. calcium, potassium and zinc)
When the specific nutritional needs are known, a qualified nutritionist can come up with a meal plan that the client can follow throughout their treatment process.
Recovery from alcoholism and drug addiction can be achieved through spiritual healing. Recognising and trying to overcome substance abuse is a very trying moment for anybody. It can be distressing and unsettling to come clean to family members about substance dependence.
Each year, millions of people struggle with opiates and alcohol abuse. Nobody is exempt from substance abuse; religious or not, a person can still fall into addiction. However, the behaviour does not make one a bad person, so by taking charge, the negative habit can be defeated.
Some people have faith that a supreme being can help a person dealing with substance abuse. Many rehab centres provide spiritual care in their outpatient programmes to encourage addicts to connect more with their God.
Educational and experiential workshops
In drug rehabilitation, experiential workshops are hands-on activities that help patients in recovery process and cope with previous trauma.
At times, a recovering addict might be uncomfortable talking to psychologists in a traditional counselling atmosphere. Experiential workshops put a recovering addict in a setting where they feel comfortable, such as the outdoors or at an art or music studio.
Moreover, the recovering individual is taught life skills through practical coursework to help them gain stability and personal value. The educational courses help a client develop the self-control and discipline necessary to uphold a drug- and alcohol-free life.
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Continuing care planning
The continuing care model tackles the chronic nature of addiction by emphasising long-term treatment outcomes and concentrating on recovery.
Like other chronic ailments, continuing care and follow-up is essential in addiction recovery. The aim of a continuing care plan is to concentrate on the successes achieved during the beginning stages of care.
Continuing care might involve outpatient services offered on a weekly basis for several months up to 12 or 24 months.
The Journal of Substance Abuse Treatment detailed four components of successful continuing care techniques: extended monitoring, performance-based incentives, alternative forms of service delivery and community support. (2)
Therapy Types in Outpatient Addiction Rehab
Addiction treatment facilities use therapeutic interventions to help clients understand the root causes of their high-risk behaviour and develop skills to avoid relapse. While detoxification is an essential part of treatment as it helps people deal with withdrawal symptoms and ease cravings, it doesn’t address the variables that caused substance abuse in the first place. Modern research over the years has led to the development of evidence-based behavioural therapies for drug and alcohol dependency. The therapies have proved to be effective in curbing substance use disorders plus co-occurring psychiatric problems like anxiety, depression and OCD.
The following are the types of therapies commonly used in outpatient addiction treatment:
Acceptance and commitment therapy
Acceptance and commitment therapy (ACT) is a form of psychotherapy that helps clients accept the challenges that come with life. It is a type of mindfulness-based therapy that theorises that greater well-being is achievable by overcoming negative perceptions and feelings.
ACT looks at the client’s character traits and habits to help them decrease avoidant coping mechanisms. Additionally, the therapy also addresses the person’s dedication to making changes and how to cope when they cannot stick to their goals.
Acceptance and commitment therapy focuses on three areas:
- Accept reactions and stay present
- Pick a valued direction
- Take action
Cognitive behavioural therapy
In cognitive behavioural therapy (CBT), the client learns how to manage their problems by changing how they think and behave. CBT is based on the notion that a person’s feelings, physical sensations, actions and thoughts are interconnected and that negative perceptions and feelings can trap them in a vicious cycle.
The therapy aims to help clients deal with overwhelming issues more positively by breaking them down into tinier parts. The person learns how to change negative patterns to enhance how they feel.
Unlike some other talking therapies, CBT tackles current problems instead of concentrating on past issues. It seeks practical ways to enhance a person’s state of mind on a day-to-day basis.
Contingency management/motivational incentives
Contingency management (CM), also known as motivational incentives, is a form of behavioural therapy based on operant conditioning. The therapy gives rewards for wanted behaviours like clean drug tests.
Sometimes, disciplinary measures or removing privileges might be used when the client engages in negative behaviour. Contingency management has shown to be effective for a variety of problems, including alcoholism, drug addiction, defiance and impulsive behaviours.
Since the needs of clients vary from one person to another, CM can fit those varying needs using slight modifications. The therapy can be employed as a stand-alone treatment or together with a range of other treatment modes, including CBT, medication management and motivational interviewing.
Dialectical behaviour therapy
DBT (dialectical behaviour therapy) is an evidence-based type of psychotherapy that started with efforts to combat borderline personality disorder. However, the therapy has been proven successful in treating substance abuse, depression, eating disorders and post-traumatic stress disorder.
During DBT, the clients learn new skills to manage unpleasant emotions and reduce conflict in their relationships. The treatment specifically concentrates on giving therapeutic abilities in four key areas: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.
Skills gained through DBT are thought to have the capability of assisting those who want to enhance their ability to control emotions, tolerate negative feelings, be mindful and present in the current moment, and interact effectively with other people.
Interpersonal psychotherapy (IPT) focuses on a client’s relationships with their family members and peers and how they view themselves. The treatment explores problems in relationships with others.
All in all, the aim of interpersonal therapy is to improve the quality of a patient’s interpersonal relationships to help decrease their distress.
The therapy addresses interpersonal deficits, helps clients manage unresolved grief, helps with hard life transitions and is recommended for tackling interpersonal conflicts.
Interpersonal therapy was originally developed for the treatment of major depressive disorders, but now it’s also used successfully to treat drug and alcohol addiction, dysthymia, mood disorders and eating disorders.
MAT (medication-assisted therapies) is the use of medications in conjunction with counselling and behavioural therapies in treating substance use disorders and preventing opioid overdose.
The combination of medication and psychotherapy can effectively treat substance use disorders, and for some people dealing with addiction, MAT helps to sustain recovery.
MAT is primarily employed in treating addiction to opioids like heroin and painkillers. The prescribed medications work to normalise a client’s brain chemistry, inhibit the euphoric effects of opioids or alcohol, relieve psychiatric cravings and normalise the functions of the body without the undesired effects of the abused substance.
It is worth noting that combining the medications used in MAT with those used in the treatment of anxiety can be fatal.
Mindfulness based cognitive therapy
MBCT (mindfulness based cognitive therapy) is a combination of cognitive behavioural practices and mindfulness strategies (e.g., meditation, breathing exercises) that’s designed to help clients better understand their thoughts and feelings. (3)
Mindfulness based cognitive therapy was originally created to help people with recurring depression bouts. Nowadays it’s also used to treat a wide variety of mental and physical disorders, such as substance abuse and addiction, cancer, anxiety, fibromyalgia, diabetes, epilepsy, chronic pain and eating disorders.
In addition to being a cost-effective and readily accessible treatment, MBCT is very beneficial in an alcohol and drug rehabilitation setting because it reinforces relapse prevention, helps patients in managing anxiety and aids in recovery from trauma.
Motivational enhancement therapy
MET (motivational enhancement therapy) is a counselling technique that’s specifically designed to invoke internally driven change.
People who engage in self-destructive behaviours might often be ambivalent about changing those habits, in spite of being aware of the negative impact of such behaviours on health, social functioning and relationships with family members.
A therapist trained in motivational enhancement therapy can often help a person to view behaviours more objectively. As a result, the patient might become more motivated to start the change process.
Overall, the main aim of MET is to help clients overcome their ambivalence about behaviour change. Rather than identifying a problem and telling the client what they should do about it, a therapist encourages the person to make self-motivating statements that show a clear acknowledgement of the issue and a resolve to change.
In general, motivational interviewing is a counselling practice that aids persons to resolve ambivalent emotions and insecurities to find the self-motivation they require to modify their unhealthy habits. It’s a practical, empathetic process that considers how hard it is to make changes in life.
Motivational interviewing is commonly used to deal with addiction and in the management of physical ailments like asthma, diabetes and cardiovascular diseases. The intervention helps an individual to become motivated to alter the behaviour that is preventing them from making more positive choices.It is a short-term counselling method that needs only one or two sessions. However, it can also be incorporated as an intervention in combination with other longer-term therapies.
Group therapy comes in different forms that a client can choose from, depending on their condition and personal preferences. A common type of group therapy is psychoeducational group therapy, which is usually given to people and their support systems so they can learn how to cope and understand the problem at hand.
Psychoeducational group therapy aims to educate the client about the condition they are suffering from. It provides clients with the necessary information that could aid them in identifying roadblocks and coping with the disease.
The therapy instils self-awareness in afflicted persons. Additionally, it encourages them to look for growth by offering suggestions and resources that can assist them in their recovery.
Solution focused brief therapy/solution focused therapy
Unlike traditional therapy types that take time to assess pathology, past life events and problems, solution focused brief therapy (SFBT) focuses on identifying solutions in the current time and exploring a person’s future hopes to find faster resolution for their problems.
SFBT takes the approach that the client knows what they need to do to enhance their life and, with the correct guidance and questioning, they can find the best solutions.
The therapy can be used as a stand-alone intervention or in combination with other therapy modes. It is used to treat people of all ages and a range of problems, including addiction and family dysfunction.
Twelve-step facilitation therapy is a behavioural therapy type that promotes lasting abstinence by motivating and facilitating active engagement of a client in a 12-step recovery group.
The therapy assumes that drug and alcohol addiction is a chronic and progressive illness. It is based more on fellowship within a group support structure than on individual counselling or clinical intervention.
Although counselling and clinical intervention are part of the recovery process, it’s the 12 steps members go through that set a bridge between the past habits and an addiction-free future.
The strength of twelve-step facilitation therapy is its ability to motivate members to take responsibility for their past, present and future actions. It is an essential part of the holistic approach to addiction recovery.
For Whom and When Is Outpatient Treatment Suitable?
Most people struggling with addiction are of the opinion that they must sign up for an inpatient treatment programme in order to have the highest chance of overcoming their disease. However, the reality is that there are situations where an outpatient rehab programme might be a better option.
Without a doubt, residential treatment programmes offer some advantages to those who wish to recover from substance abuse, but it’s essential to realise that it’s not the only addiction treatment method available. Actually, outpatient treatment is in many cases a more suitable option for some people.
For anyone who has been abusing alcohol or drugs for a long time and has tried to stop in the past without any success, an outpatient treatment programme might not be the best choice. Similarly, for anybody who is near relapse, inpatient care might be more suitable.
However, for those who have been experiencing issues with alcohol or drugs for a short while, outpatient treatment might be the perfect solution for them.
Many assume that alcoholics or drug addicts will only reach out for outside assistance when they have nothing left to lose. But the truth is that some individuals do realise very early on that they have to take action to prevent their substance abuse from getting out of control. Such people are ideal candidates for outpatient care.
Factors That Play a Role in Treatment Recommendation
It is worthwhile to note that no single treatment technique is suitable for everybody. That is why it is vital for every treatment programme to have a mental health or addiction professional perform an intake assessment before developing a personalised treatment plan according to the client’s unique needs.
A person struggling with a substance use disorder can be treated effectively and continue to lead a positive life. Addiction treatments vary and can be tailored to every client’s needs. Every individual interested in recovery from substance dependence can find an option that is appropriate for them.
There are several factors that play a role in outpatient treatment recommendation as shown below.
Teenagers dealing with substance abuse should seek treatment early to avoid long-term dependence. Adolescent addiction treatment facilities know how to treat substance use disorders in younger addicts. Such centres provide a wide range of services tailored for teens and young adults. In an outpatient treatment programme, the client is able to continue care and get support after finishing a rehabilitation session.
On the other hand, adults have different needs than adolescents. Addiction treatment centres for adults use a different approach, but they still provide assistance in a supportive setting. Adult treatment may include medications, behavioural therapy, regular individual and group counselling sessions, nutritional counselling and strength training.
Addiction is an illness that can affect people of every age group. Undoubtedly, seniors have unique needs and many treatment centres provide services customised for the older generation.
Overall, drug rehab for seniors considers that:
- Older people are less likely to show aggressive behaviour.
- Seniors have different grief problems and triggers that contribute to misuse of alcohol and drugs.
- Clients of an advanced age prefer a quiet, serene atmosphere.
- Seniors usually have special medical concerns that impact their recovery.
- Illicit drug use is less seen in this age group.
When a person has both a substance use disorder and a mental health problem like depression or bipolar disorder, it is referred to as a dual diagnosis. Combating substance abuse is never easy, and it’s even harder when a person is also suffering from mental health issues.
Dual diagnosis problems are very common. According to the Journal of the American Medical Association:
- About 50% of persons with severe mental disorders struggle with substance abuse.
- 37% of alcoholics and 53% of drug addicts also suffer from at least one serious mental health disorder.
- Of all persons diagnosed as mentally ill, approximately 29% of them misuse alcohol or drugs. (4)
When a client arrives at a rehab facility, they go through an intake process. During the intake process, the client will be required to provide details about their medical history.
It is important for the client to reveal their medical history so that the medical professionals handling them know of any underlying medical problems like asthma, high blood pressure or hepatitis.
The client should be honest about their health status in order for the healthcare professionals at the centre to create an effective treatment plan.
A person with a severe addiction to a certain substance like heroin or oxycodone is better suited for an inpatient treatment plan to help manage medical detox and withdrawals. On the other hand, a mild substance abuse case detected in the early stages can usually be effectively treated using an outpatient rehab plan.
As a result, when a person goes to a rehab facility, they are usually required to reveal their drug use history so that the counsellor can determine the best treatment recommendation for them.
When recommending the most appropriate addiction treatment mode, location is an important consideration. Rehabilitation centres in luxurious settings can cost more in comparison to traditional treatment centres.
Moreover, the travel to the centre can also be factored into the overall cost, particularly if it is far from where the client lives.
The length of an outpatient rehab programme is dependent on several factors, including the severity of the substance abuse and the rate at which a client makes progress. For example, many programmes may take one or two months, but they can be extended or shortened depending on the client’s ongoing needs.
When looking for a programme, clients should ask about its average duration and the flexibility of the time length.
Advantages of an Outpatient Programme
Outpatient rehab treatment plans come with several benefits, such as:
- Affordability: Since the client is able to live at home during the treatment, they do not have to pay the costs of staying at an inpatient centre. Therefore, outpatient care is more affordable than residential treatment.
- Flexibility: In most cases, outpatient programmes work around the client’s schedule. This is advantageous for those who feel they cannot leave their occupation or family for a long period of time.
- Family involvement: Throughout the outpatient treatment programme, the client has access to support from their family, which can help them to remain on the path to sobriety.
How Much Does Outpatient Addiction Treatment Cost?
When it comes to alcohol and drug addiction, the cost of treatment varies from one user to the other. Different treatment facilities will charge differently for drug rehabilitation. Some clinical procedures are completely free, while others cost hundreds of pounds per day. For instance, an outpatient detox treatment costs £800 to £1200.
Generally, outpatient rehab is less expensive than inpatient care. A three-month outpatient programme can cost about £4000. (5)
How to Choose a Drug Outpatient Rehab
Many variables go into determining the best option for a person’s specific needs, including:
- How much does it cost?
- Can the programme treat co-occurring disorders or dual diagnosis?
- What are the credentials of the staff members?
- Does it provide individual treatment plans?
- How serious is the addiction?
- What is the schedule of the treatment programme?
- Where is the rehab programme located?
- What types of treatment does it offer?
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The Role of Counselling in Outpatient Drug Addiction Treatment and Rehab
Addiction counsellors offer support to clients throughout the treatment process and develop a personalised plan for recovery and follow-up. The role of an addiction counsellor is to:
- Offer unbiased psychiatric support for persons going through a rehabilitation programme
- Perform one-on-one therapy sessions with the client to get to the root cause of the substance use disorder
- Administer periodic drug tests
- Create a specialised treatment plan according to the client’s individual needs
- Aid the client in developing a follow-up programme based on care available in their location
- Conduct group therapy sessions
Outpatient Drug Addiction Treatment and Rehab Success Rate
All in all, outpatient rehab works for those who are committed to overcoming addiction. No rehabilitation programme, regardless of its overall quality, will work for long-term abstinence if the person in recovery is not fully dedicated to attaining and maintaining sobriety.
In a 2012 study by the National Treatment Agency for Substance Misuse, the best performing private centres in the UK had a success rate of 60%-80%. On the downside, the worst performing centres were struggling to attain 20% success. (6)
Questions to Ask Outpatient Drug Addiction Treatment Centres
As you research outpatient drug addiction treatment facilities and talk with rehabilitation providers, here are some essential topics to inquire about:
- Accreditations, licensing and certifications
- Clinical staff credentials and licensing
- Use of evidence-based practices
- Mental health services
- Treatment success rates or outcomes
- Types of detox offered
- Rehab programme length
- After-care support
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