Residential vs. Outpatient Treatment
Substance abuse rehabilitation centers offer specialized programs on both an outpatient and inpatient basis. The appropriate treatment plan is selected based on individual circumstances.
Residential treatment programs offer 24-hour supervision and care. While participating in an inpatient program, the individual remains at the treatment facility for several weeks or months and lives there around the clock.
In this type of setting, the individual’s full focus is on recovery. Days are filled with therapy sessions, in both individual and group settings; alternative therapies, such as equine-assisted therapy, art therapy, or music therapy; fitness activities like yoga and group exercise classes; and meals. Clients may reside in private or shared rooms, depending on the specific facility. With this 24-hour approach to recovery, clients are immersed in the recovery process, allowing them to fully focus on addressing their addiction issues.
The length of stay in a residential treatment program will depend on various factors, such as the severity of the individual’s addiction, the length of time the person has been abusing substances, any co-occurring mental health issues, as well as any co-occurring medical issues. In most instances, particularly for cases of long-term or severe addiction, long-term treatment has been shown to be more effective. According to NIDA, treatment is most effective when it lasts for at least 90 days. While some individuals remain in residential treatment for three months or more, others begin with inpatient care for a month or so, and then transition to outpatient care for the remainder of their treatment regime.
Many different models of outpatient treatment exist, varying in length and intensity. Outpatient programs can offer certain advantages over inpatient treatment. Some individuals may have families or jobs that they are unable to leave for an extended period of time to seek inpatient treatment. Outpatient treatment can more easily fit around their existing lives, allowing them to schedule treatment around work, familial responsibilities, or social commitments.
Generally, those with less severe or more short-term addictions, can benefit most from outpatient treatment. Those with severe addictions often need the intensive supervision offered with residential treatment. With outpatient care, the risk of relapse is higher since individuals have greater access to substance of abuse as well as more triggers to use as they navigate life in the outside world.
Intensive day treatment, also referred to as partial hospitalization programs, allows clients to continue living at home while spending a majority of their time in treatment, usually several hours every day. Treatment in these intensive programs is comparable to the level of treatment and support found in residential programs, but they are usually far less expensive since clients don’t reside onsite. This might be a good option for those who need intensive care but still want to live at home.
Other outpatient programs are less involved, ranging from a couple hours of treatment per day to therapy sessions a few times per week.
Both inpatient and outpatient treatment can be very effective in treating addiction and substance use disorders. However, inpatient treatment may offer certain advantages to some individuals. A study published by the U.S. National Library of Medicine found that people who attended outpatient treatment were four times more likely to relapse during the course of treatment than individuals enrolled in inpatient programs.
Oftentimes, the treatments offered in residential and outpatient treatment may be similar, including individual therapy, group therapy, and alternative therapies. Since clients in residential treatment are onsite 24/7, additional time may be spent participating in recreational activities, eating meals with other clients, and meditating. This total immersion in treatment allows clients to form greater friendships with other clients, which can often serve as the foundation of a strong support system post rehab.
In addition, most residential facilities tend to offer a greater variety of therapy offerings than outpatient programs. Specific therapies like wilderness therapy, equine-assisted therapy, or adventure therapy may only be offered at specialty programs; however, some individuals may find great benefit from participating in more niche therapy offerings.
Generally, residential care is more expensive than outpatient treatment due to the costs associated with lodging and feeding clients as well as the additional costs of 24-hour staffing. Insurance coverage does vary between outpatient and inpatient treatment, but the specifics depend on the individual’s policy as well as prior attempts at treatment. If a person has attempted outpatient treatment in the past and subsequently relapsed, the insurance company may cover the cost of inpatient care, at least partially, at this juncture.