Intensive Outpatient Treatment, also known as IOP, is a primary treatment program recommended in certain instances by a clinical and medical assessment. These types of programs help provide additional structure and level of care than a typical outpatient program while still accommodating the patient’s personal and professional life.
Behavioral health conditions are quite common in American society. These conditions do not discriminate and can strike regardless of age, race, gender, or socio-economic status. They effect your thoughts, feelings, moods, and behavior. They may occur once, occasionally, or chronically and can impact your ability to relate to others and function on a daily basis. These conditions include depression, various types of anxiety, bipolar disorder, panic disorder, phobias, obsessive-compulsive disorders, post-traumatic stress disorder, disordered eating, substance use disorders, and psychotic disorders.
Behavioral health conditions are as, or even sometimes more, prevalent than common chronic health conditions such as cancer, diabetes, hypertension, or obesity. Consider that behavioral health conditions affect nearly 18.2% Americans each year while cancer affects .05%, diabetes 9.4%, 29.0% for hypertension, and about 30% of Americans are morbidly obese.
Consider these facts:
- Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.
- The annual U.S. suicide rate increased 24% between 1999 and 2014, from 10.5 to 13.0 suicides per 100,000 people, the highest rate recorded in 28 years.
- In 2014, 20- to 24-year-olds in Georgia had the highest suicide rates of any age group — 12.94 per 100,000. Also, according to the Georgia Bureau of Investigation’s child fatality review unit, 51 children ages 5 to 17 killed themselves in 2016.
There is truth in the numbers and behavioral health conditions are just as treatable as any medical condition. However, sometimes people delay getting the help they need, which allows these conditions to worsen, thereby causing a greater impact on their lives and those around them. With the similarities between medical and behavioral health conditions in mind, shouldn’t we be just as proactive in treating them?
Why some people develop behavioral health conditions and others don’t is based on a combination of factors, which may include:
- Genetic predisposition
- Alterations to brain chemistry
- Changes in the brain circuitry and structure
- Impacts from drug use, physical or psychological trauma, or injury during normal brain development
- Gene-by-environment interactions
- Environmental exposures
- Gender differences
- Co-occurring conditions
- Characteristics of personality
Our formative years as a child and our family systems also influence how we see the world and interact and form relationships with others. We are all different and how we respond to or rebound from adverse events depends on a range of variables.
We all encounter adversity during life’s journey, such as the death or loss of a family member (or other significant support person), loss of a spouse or significant other, loss of a job, a geographic move, divorce – a wide range of life’s events will have an impact on us. Adversity can also have a cumulative effect on us, making us more susceptible to developing a behavioral health condition. It is not a sign of weakness to be depressed or anxious; having the courage to address it is a sign of strength. Pyramid Family Behavioral Healthcare is here to help.
What’s an IOP?
In an Intensive Outpatient Program, or IOP, the degree of the client’s dysfunction is not so great that they cannot function in their home, work, or school environment. The client doesn’t require containment at higher levels-of-care (such as inpatient), or need daily medical monitoring, but impairment exists in several life domains (family, social, school/work, etc.) and is beyond the scope of effective outpatient counseling.
IOP is defined as a program that offers:
- At least 9 hours of structured programming per week
- Provides group based, non-residential, intensive interventions
- Consists primarily of counseling and education
- Improves the level of functioning in various life dimensions, such as family, social, occupational or educational, etc.
The advantages of this level of care are real world application of newly learned skills in a familiar environment (home) while clients still have the opportunity to process experiences of distress in a supportive treatment environment. These programs usually last 6-12 weeks, resulting in more time to solidify skill development. IOP is the lowest level of care for a structured program, has the broadest application, and is the least restrictive measure used to address behavioral health conditions.
IOPs are effective:
- As an early intervention measure to prevent the need for a higher level-of-care
- For clients who have not responded to outpatient counseling or their interventions, such as behavior contracts.
- As a transitional level of care from a higher intensity of services (such as Inpatient, Residential Treatment, or Day Programs)
IOPs are a recognized level-of-care by the American Psychiatric Association (APA), American Academy of Child & Adolescent Psychiatry (AACAP), and the American Society of Addiction Medicine (ASAM) and is an industry standard level-of-care. All insurance carriers provide benefits for this level-of-care, is a standard by the National Committee on Quality Assurance (NCQA), and accreditation is offered by both The Joint Commission (TJC) and the Commission on Accreditation of Rehabilitation Facilities (CARF), among others.
Our program focuses on mood and anxiety disorders and other co-occurring conditions such as substance use disorders and eating disorders that are secondary to the primary mental health conditions for which the client has sought help.
The program is insight oriented, with an emphasis on helping clients understand their own inner workings and motivations ultimately helping clients to internalize any changes. As a result, our program is not optimal for those clients who have thought disorders, conduct disorders, organic disorders, or other behavioral health conditions that dominate a client’s problems, such as a primary substance use disorder or an eating disorder. The first two weeks are considered an assessment period to assure clinical and program fit.
We believe treatment should be person-centered, self-directed, and individually paced to ensure the client is fully engaged in the treatment process. This keeps the individual at the center of care and accounts for their needs, wishes and preferences so they remain engaged in treatment.
We provide intensive outpatient psychiatric services to help patients identify and manage behavioral or emotional concerns. At Pyramid Family Behavioral Healthcare, behavioral health psychiatrist services for an IOP level-of-care is a best practice and not a requirement.
Our philosophy includes the following guiding principles:
- Whole Person – an approach encompassing the bio-psycho-social-spiritual components that function as a system.
- Strength Based – to acknowledge that every individual has a unique set of strengths and abilities that they can rely on to overcome problems.
- Trauma / Adverse Experience Informed – an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma or adverse experiences, when present.
- Family Systems – the family as an emotional unit and uses systems thinking to describe the complex interactions in the unit. It is the nature of a family that its members are intensely connected emotionally and that changes in behavior of one family member are likely to have an influence on the way the family functions over time.
The outpatient behavioral and mental health program will target the following areas:
- Mood – This program component consists of learning to identify and express feelings, finding safe and appropriate outlets for avoided feelings, and improved distress tolerance.
- Cognitions – The cognitive component of the program assists in developing problem-solving skills, assertiveness training, and anxiety and anger management through identifying effective coping skills and strategies to overcome perceptual errors, negative self-talk, and disputing distorted thought patterns.
- Relational Dynamics – Relational dynamics are addressed through identifying consistent maladaptive themes within relationships with others that impact the ability to form meaningful connections and communicate effectively.
- Psychophysiological Symptoms – The psychophysiological element of the program focuses on the mind-body response to distress and helps the client develop ways to manage these manifestations that may otherwise exacerbate their distress.
The program will utilize a variety of modalities with a framework consisting of the following:
- Cognitive Behavior Therapy
- Cognitive Distortions & Restructuring
- Distress Tolerance and Emotional Regulation
- Resilience Training
- Interpersonal Skills Role Play
- Interpersonal Process Groups
Group sizes and targeted caseload are about 8 clients with one therapist as the Primary Therapist for the individual client and the other therapist working with the family. Clients will have weekly individual and family sessions with their assigned treatment team or they may coordinate some of these services with an existing provider on a case by case basis. Treatment planning occurs every two weeks for each client and continuing care planning begins within the first couple of weeks of treatment. As a client improves based on achieving treatment goals and objectives, the frequency of attending IOP will begin to taper down to allow the client to practice new skills while still having the safety of the program to process any issues that may have been encountered. The final two weeks may be reduced to attending one time per week, which would be during a Family Workshop IOP session day.
Pyramid Family Behavioral Healthcare is committed to ongoing program development, refining the content and structure of our program. We evaluate response to treatment through symptom reduction scales and through client, family, and referral source/community partner reports. Understanding what elements of our program are effective allows us to improve performance, efficacy, and treatment outcomes. In summary, Pyramid Family Behavioral Healthcare believes in an integrative approach, both in terms of the outpatient treatment program and in relation to the community.