History of Outpatient Treatment
Early American History of Outpatient Treatment
In the earliest days of the United States, around the year 1812, a hospital founded by Benjamin Franklin, called Pennsylvania Hospital, had treatment records for people who excessively used “ardent spirits” that were the cause of one-third of the hospital’s admissions.
This large segment is significant because at that time American society wanted to secretly treat people who had addiction problems and keep them separate from other patients. The United States kept people with addictions to substances segregated in private residential programs, often called asylums or sanitariums, for the first 100 years of our history.2
20th Century Growth and Expansion of Outpatient Treatment
People with alcohol and drug addictions were first treated on an outpatient basis early in the 20th century. The Emmanuel Church in Boston launched a clinic in 1906 that provided outpatient treatment for “weakness or defect of character” disorders. This program was a milestone because it was the first to hire people in recovery as counselors. 2
By 1923, the Yale Center for Alcohol Studies was created to study and treat alcoholism. Its efforts were high-reaching as the program included research, publications, training and treatment. It’s considered the first practice and research collaboration in the United States.
In 1944, the Yale Center for Alcohol Studies hired psychiatrists and former alcohol abusers who teamed up to encourage others to join Alcoholics Anonymous, while providing human behavioral therapy.
By 1957, treatment clinics that were based on the Yale model were established in 34 states. By the late 1950s, outpatient treatment programs of different designs and levels of treatment had been established across the United States, which included many day treatment programs created for mostly working people.
By the 1970s, detoxification on an outpatient basis and treatment programs that look like what we know today became available. By the 1980s, many day treatment programs had been established that provided detoxification combined with rehab services.
By the mid-1990s, government funding started to turn to OT programs to treat Medicaid recipients, and treatment program managers began adapting program designs to accommodate the needs of people experiencing homelessness and individuals who had serious co-occurring psychiatric and other psychosocial issues.
What Outpatient Drug Rehab Looks Like Today
Today, outpatient drug rehab offers services from medical detox through all the psychosocial therapies individuals need to make recovery from substances a success.
Clients receiving outpatient detoxification treatment travel to the facility daily for treatment sessions. The sessions can be conducted in the day or evening. The first step involves an initial assessment, physical exam, lab tests and the first detox treatment. Additional sessions can range from over a period of three days to two weeks. One research study reported the average duration of treatment was six and one-half days, which is significantly less than the average duration for inpatient detoxification. 3
Outpatient medical detoxification has several advantages:
- For people experiencing mild to moderate substance abuse withdrawal symptoms, outpatient detox is considered as safe and effective as inpatient detox, but it’s much less costly and time consuming.
- Individuals who enter an outpatient rehab treatment facility following outpatient detox can benefit by going to the same treatment facility for both phases of treatment.
- Nearly all people in outpatient treatment enjoy a higher level of social support compared to those in inpatient treatment. The exception is those outpatients who have exceptionally adverse family or job situations.
- Outpatients can keep functioning in everyday life, continue to work and can maintain family and social relationships.
Types of Outpatient Addiction Treatment Services
There are different types of outpatient programs that a person completing detox can enter. The difference is the setting and level of care offered.4
- Partial hospitalization and day treatment programs use a combination of medical professionals and addiction treatment therapists to deliver a highly intense level of counseling services during daytime hours. Clients return home at the end of the day.
- Intensive outpatient programs are typically run by addiction treatment therapists (non-medical) within a clinic setting. Clients attend six to nine hours of counseling services weekly at a frequency of two to three days a week.
- Traditional outpatient services are provided by addiction counselors in a clinic or office environment. Clients attend for less time compared to intensive outpatient programs.
- Recovery maintenance programs aren’t considered treatment but are put into place to help maintain sobriety. These include 12-step meetings and other support groups that have a focus of maintaining the gains in living substance-free that were made during treatment. Sober living environments (SLEs) are also an option for clients that can be included in recovery maintenance.
How Outpatient Treatment Is Different from Inpatient Treatment
Drug and alcohol treatment generally falls into two broad levels of care: inpatient and outpatient. Both types of rehabilitation can be effective in helping clients live sober and substance-free lives. 5
Inpatient rehab is an intensive program that treats serious, long-term addictions in a residential setting where the client resides at the facility. Outpatient rehab is part-time treatment that permits the client to live at home (or a sober house) while continuing to work or attend school during the day.
The goal of both inpatient and outpatient rehab is for clients to achieve sobriety. Both types of care use the same methods to do so: detox, therapy, and family and peer support during and after treatment. The main difference between outpatient and inpatient is where these services are provided.
Inpatient treatment in a residential setting can vary in length from a few weeks to a few months or longer. Participants then transition into some form of outpatient treatment. Outpatient programs also vary in the lengths and intensity of treatment. There is more flexibility in OT because the number of weekly sessions can fluctuate to accommodate a person’s schedule. This makes OT more suitable for those who can’t be away from work or other responsibilities for extended periods of time.
What to Consider When Entering Rehab
When you’re deciding whether inpatient or outpatient treatment is best for you or a loved one, you may have other considerations about the decision process besides the clinical ones.
Here’s a checklist of questions to ask yourself when you’re deciding what level of care is best to meet your goal of long-lasting sobriety:
- Does your current living situation support sobriety? Is your home life stable, or will you be exposed to alcohol or drugs at home?
- Does your current family situation at home provide a strong support network that will help you stay sober?
- Can you set aside your work, school, or home responsibilities for an extended period of time?
- Do you have a co-occurring disorder that requires treatment besides your substance abuse problems?
- If you decide on outpatient treatment, can you dependably travel from your home to the treatment center several times a week?
Identifying your own unique and distinct needs is the first step in making the right choice for the level of care that works for you. The next step, after you’ve chosen between inpatient vs outpatient care, is to decide which facility or provider to put your trust in.
Where Can I Find Outpatient Drug Rehab?
The Silvermist staff is dedicated to providing you with the best possible opportunities for long-lasting recovery by using a highly personalized and progressive process for substance abuse treatment. We understand how important it is to assess all aspects of your recovery journey and use cutting-edge, integrated treatment models to help you achieve your recovery goals.
Silvermist’s treatment plans include evidence-based drug and alcohol counseling methods, medical interventions, holistic and experiential therapy and life skills training.
The recovery journey is different for each person, so our private drug and alcohol rehab treatment program includes many different aspects that, when personalized for your situation, provides an effective and individualized drug and alcohol rehab plan that maximizes your chances for success.
Our admissions specialists are here to handle your call 24/7. Call us today at (724) 268-4858 or fill out our online contact form if you’d like to learn more about how we can help you achieve a sober, renewed and rewarding life.