Choosing between Inpatient and Outpatient Rehab

Guest Post by Christine Hill

Embarking on the journey of addiction recovery can be bewildering. The stakes are high, and it might feel like one wrong choice may throw your whole life back into disarray. Choosing a recovery facility, or program, will make a big impact on how your recovery goes. However, before you even choose a place, you need to decide on one question: should you (or your family member) go the outpatient route, or opt for a residential facility?

The purpose of this post is not to argue one route over the other. Each person is different, and so their needs during addiction recovery will also be different. Both inpatient rehabilitation and outpatient recovery options have the power to create lasting change and healing in those who participate. However, understanding some of the pros and cons of each can help you determine which one is best for your situation.

It is highly recommended that you consider lower cost programs, or programs provided by your province or state before you choose programs that cost you your own money. If you are not certain what options are available in your area, talk to your doctor or a specialist in addiction treatment.

Inpatient

Inpatient addiction recovery is also referred to as a residential rehabilitation program. An inpatient program means that you will essentially pack up your bags and live at the treatment center during the duration of your enrollment. There, you’ll eat, sleep, participate in counseling, activities and recreation, and sometimes chores that contribute to the structure of your treatment.

Pros:

  • 24/7 supervision: This can be an especially appealing factor when a patient has erratic behavior, or co-occurring disorders like severe depression.
  • Close companionship with other patients: Many participants in residential programs thrive on the feeling of community that comes as individuals work to help each other.
  • Distance from an unhealthy environment: Completely removing someone from the environment that enabled their addiction can be an important step in the recovery process, especially if there are persistent unhealthy relationships.
  • Relaxing environment focused on your mental health: Regular life comes with many stressors that shift our focus away from recovery and feed anxiety levels that can make it harder to stay sober. This aspect of residential recovery can be especially helpful, for example, for mothers who need some time to focus on their own mental health needs.
  • More personal interactions with therapists and counselors: As clinicians at your residential rehab facility are able to observe and evaluate your behavior and progress, they can give more insights and help to enable you to achieve your recovery goals.

Cons:

  • Expense: Of course, residential recovery programs are usually more expensive than outpatient programs. In Canada and other countries, recovery programs are often provided by health care. In the US, costs are the responsibility of the person attending treatment (and often their families). Many families and individuals find themselves struggling to manage the expenses without outside financial aid. 
  • Interrupts school and work: While school and work can sometimes be stressors that jeopardize our sober lifestyle, other times, these regular routines support a normal lifestyle, keep us busy, and give us much-needed purpose.
  • Distance from the familiar: Admittedly, this can be both a pro and a con, but for those of us who get stressed in unfamiliar situations, inpatient treatment can add to an already-overwhelming situation. You’ll be away from your usual home and your bed, habits, foods, people, and settings. In fact, depending on the facility, the only familiar thing around you will be what you’re allowed to pack.
  • Removes you from family support: Sometimes, there are family patterns that make recovery harder. Other times, family support is the biggest asset someone has in their recovery, and participants do better when they’re consistently surrounded by people who love and care for them.
  • The challenges of reintegration: One of the biggest worries with residential treatment is that it’s too isolated from a patient’s normal life, and so it’s hard for patients to translate what they’ve learned in treatment into day-to-day life back home. Some people find a better chance of success in outpatient programs for this very reason.  

Outpatient

Outpatient programs for addiction recovery vary widely. They can include anything from two hours/week in group and individual counseling, to an intensive outpatient program (IOP) that amounts to a full-time job, with 40 hours a week (or more) spent participating in individual and group therapeutic activities. You might also see options for a partial hospitalization program (or PHP) which are similar to an IOP. But in all cases, an outpatient program sends you home at the end of the day.

Pros:

  • Practice: Those who attend outpatient treatment are able to put therapeutic concepts, tools, techniques into practice right away as they interact with their family and home environment. This allows them and their counselors to constantly check on progress and adjust therapy according to needs as they come up.
  • Price: Outpatient programs are almost always cheaper because you don’t have to worry about the cost of sleeping arrangements and constant supervision. Check with your province, or state, regarding the costs of each program. 
  • Family support: One of the most essential ingredients to a healthy recovery is a solid support group of family and friends. In an outpatient program, you’re able to spend time with your family in a more normal routine.
  • Independent motivation: Because you’re not under constant supervision by a trained staff, participants are required to be somewhat self-motivated in an outpatient program. This can mean that they take more responsibility and ownership of their process.
  • Additional experiential therapy opportunities: Experiential therapy is an ever-increasing feature of inpatient treatment, with many facilities offering immersive work therapy, equine therapy, and other unconventional formats that can shake us free of our patterns and reach important breakthroughs in recovery. This can be a major draw for inpatient treatment, but it’s important to note that many outpatient programs have similar offerings.
  • Continue school and work: If you know that you need professional help for addiction recovery, but you don’t see a way to step away from your obligations at home, work, or school, outpatient treatment can be the perfect solution for you. However, it’s important to recognize that your recovery must be a priority, and will sometimes demand that your other obligations work around the program schedule.

Cons:

  • Less clinical supervision: You won’t have the same level of observation, care, and responsiveness in an outpatient setting.
  • Stuck in unhealthy patterns and environments: The biggest drawback of an outpatient program is if the home environment is actually an unhealthy place for the patient to be in order to continue with recovery. In this case, it’s often best for the person in recovery to be removed from the situation until they’re empowered to identify and solve problems at home.
  • Distraction: As mentioned above, it’s important for recovery to be your priority during this time, and sometimes other demands on your effort compromise this.
  • Less medical management: Many participants, as they move away from dependence on a substance, have a regime of medical management prescribed to deal with withdrawal and any continued health issues caused by drugs. Sometimes it’s helpful to be in an environment where medical professionals can administer and monitor the effects of these medications.

Determining What You Need

As I mentioned before, each person’s recovery is different. What you need might not be the same as what someone else does. In order to determine which treatment option is right for you, here are some tips:

  • Talk it out with a counselor and/or medical professional. Most people dealing with addiction usually have a form of intervention through a medical professional. These individuals have insights into your own life, along with professional experience about what programs are available and how they can serve you.
  • Weigh your responsibilities at home. Figuring out the practicalities of making time for addiction recovery is harder than we usually think at first. Often, it’s best to talk with your family members to determine what’s the best choice for all of you. That being said, remember to ensure that you’re taking your recovery seriously. As difficult as it may be, taking time to decide what you will do is the best choice. Deciding whether or not to invest your time and your money in expensive treatment can help prevent adding to the burdens you are living with. 
  • Talk to your insurance company (where necessary). If finances are a concern, the program you choose might be largely determined by what insurance will help cover. Talk directly to your insurance company beforehand in order to see how they can help, rather than relying solely on the claims of a recovery center.

Research the different forms available. This article covers inpatient and outpatient options, but there are many levels in-between. There are intensive outpatient programs (IOP) and partial hospitalization programs (PHP) that still give you very intensive care while you’re still able to come home at night. Do your research before limiting yourself. In addition, you want to research the individual programs themselves and perhaps conduct some tours of the facilities. It could be that the counselors you meet and the environment at the recovery center will be the biggest factor in your decision.

Christine Hill is a professional writer and an avid reader who’s passionate about storytelling in any form. At any given moment, she’s in the middle of at least three books on anything from psychology to ninjas. Although she’s a marathon swimmer and enjoys camping in the mountains, she believes there’s nothing better than a carton of ice cream and a Dawson’s Creek marathon. She blogs about marketing here. Follow more of her writing on Twitter @readwritechill.

All photos courtesy of the author.


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