IOP (Intensive Outpatient Program): What You Should Know (2023)

What Is an IOP?

An IOP (intensive outpatient program) is a type of mental healthcare that is considered one step up from traditional outpatient therapy where you see a therapist once or maybe twice a week in their office. An IOP is a program where you will likely be in therapy (both group and individual) somewhere between two to three hours a day, three to five days a week.

IOPs are considered a higher level of care on a spectrum that also includes:

  • Outpatient therapy: This is the type of therapy most people are familiar with or attend. It is generally held in a therapist's office, and most people go once a week.
  • Partial Hospitalization (PHP): A partial hospitalization program, often confused with an IOP, is typically about five hours of therapy a day (including both group therapies and individual therapy), for five days a week.
  • Inpatient Acute Care: When someone is in a crisis or psychiatric emergency situation, they may be placed in inpatient acute care, which may either be at a psychiatric hospital or in the psych ward of a general hospital.
  • Inpatient Residential: Someone who is placed in an inpatient residential treatment facility is typically there for a month or more. They receive the same therapies as those in an IOP program, except they also stay at the facility.

There are two ways that IOPs are used. One is when a person is potentially at risk for hospitalization and regular outpatient therapy doesn’t seem to be enough.

The other way is what’s known as a step-down from a higher level of care, such as inpatient acute care or inpatient residential. IOPs are used as a step-down to help someone transition from inpatient treatment back to their regular lives.

History Of Intensive Outpatient Programs

IOPs rose to popularity in the 1980s, as many White, middle-class working professionals were dealing with cocaine addiction and did not want to have to take time off of work. IOPs, which sometimes take place in the mornings or the evenings, may allow individuals to still keep up with their professional responsibilities and maintain income.

In the 1990s, as managed care (healthcare designed to keep costs low) grew, so did IOPs. More than just White businesspeople, the populations served expanded to include everyone from those with moderate mental health or substance issues to unhoused individuals to adolescents and those with dual diagnoses.

Data from the latest National Survey of Substance Abuse Treatment services shows a dramatic increase in the number of IOPs from 2010 through 2020, with nearly 3,000 more facilities (16,000 in total) eligible for inclusion. The number of clients served also rose from 1.2 million per year in 2010 to 1.4 million per year in 2019.

Types of IOPs

Though IOPs originated as a treatment for substance use disorders, they are now used for several different kinds of conditions that may require more attention than is possible in once-weekly therapy. Some different kinds of IOPs may include:

  • Depression/Mental health
  • Dual diagnosis
  • Substance use
  • Eating disorder

How to Find an IOP

While you can search online for IOP centers in your area, it's best to get a personal recommendation if you can. You may also be able to get a recommendation from your therapist or psychiatrist if you see one or perhaps your primary care doctor or other healthcare provider.

The United States Substance Abuse and Mental Health Administration (SAMSHA) also hosts a behavioral health care service locator on their website. As these programs are a significant investment of time and money, you should take your time to do your research and talk to several different programs. Most programs will do an intake call with you for each of you to see if this is a good fit.

Here's some questions you might want to ask:

(Video) Intensive Outpatient Program (IOP) Virtual Tour

  • How long are people usually in your program?
  • Do you take my insurance?
  • Have you worked with clients with issues/diagnoses like mine before?
  • Have you worked with clients who identify like me? (This may include race or sexuality.)
  • How will you prepare me for the transition back to my "regular" life?
  • What age range are the people in your program, typically?
  • What is the structure of the program?
  • What is the treatment philosophy?
  • What modalities do your therapists practice?

What to Expect in an IOP

Intensive outpatient programs are called that because they are, well, intensive. Treatment typically involves three to four hours of treatment per day for three to five days a week, for a duration of about four to six weeks.

The sessions will usually consist of a combination of individual and group therapy helping individuals better cope with any emotional or behavioral issue they may be facing. If you are on any psychiatric medications, you will likely be meeting with a psychiatrist for medication management and assessment.

Some IOPs may help you connect with adjunct or alternative therapies, such as Transcranial Magnetic Stimulation, ketamine infusions or EMDR. Other therapies that may be used include equine therapy or yoga therapy.

What Is Group Therapy?


Depending on what brings you to an IOP, or the individual IOP, the type or modality of treatment may vary, but what follows are some of the most common ones.

12-Step Facilitation

Though the 12-step model was originally developed for Alcoholics Anonymous, the approach is also used for people with drug misuse, eating disorders, and other compulsive disorders. When the 12-step model is used in an IOP or similar setting, people will begin working through the steps under therapeutic supervision.

A major advantage to these types of programs is the ease of ongoing support for individuals through their ability to attend AA meetings in the community afterward, continuing their work from the IOP.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is based on the idea of giving people skills to deal with when confronted with triggers, as well as helping reframe cognitive distortions that lead to those behaviors that are maladaptive. CBT is a particularly good match for intensive outpatient programs because people are still in their normal situations and so can test out the new skills right away.

Motivational Approaches

Approaches such as Motivational Interviewing or Motivational Enhancement Therapy are designed to discover someone's ambivalence towards treatment and changing their behaviors.

The therapy is kind—acknowledging that substances or behaviors had served some purpose for the client—but also directive by strong encouragement to confront one's behaviors that are not aligned with their desired outcomes or values.

(Video) Mental Health Partial Hospitalization and Intensive Outpatient Programs in the Continuum of Care

Therapeutic Community

The idea of a therapeutic community is derived from residential substance use treatment. However, some programs also use them for IOPs, especially as a step down from residential. Their approach is "community as method," using any social interaction as a way to guide change and help people find better skills once they are back in their original community.

Matrix Model

The Matrix Model was founded in the 1980s to address the widespread cocaine and stimulant problems at the time. It integrates several different approaches, including CBT, 12-step and motivational enhancement to target change. The full program is 16 weeks and combines individual sessions with psychoeducational sessions, relapse prevention sessions and family and social support groups.

Symptoms of Stimulant Use Disorder

Community Reinforcement and Contingency Management Approaches

Those methodologies are based on the idea that future behavior is influenced by positive or negative consequences from past behaviors. The approaches, in an IOP setting, use a points/reward system to reinforce the desired behaviors. This could look like someone being able to "buy" (have a staff member buy them) a small reward once they have saved enough points.

A Word From Verywell

If you think you or a loved one could benefit from an IOP-style treatment program, talk to your healthcare provider about the available options and how to get started.

2 Sources

(Video) What is IOP? 4 Benefits Of An Intensive Outpatient Program For Substance Use and Mental Health

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

IOP (Intensive Outpatient Program): What You Should Know (1)

By Theodora Blanchfield, AMFT
Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer.

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What is the IOP process? ›

IOP therapy is centered around about 10-12 hours of group and individual therapy each week, as well as encouraging participation in a 12-step program. Patients in intensive outpatient programs (IOP) typically visit a facility three to four times per week, often for three hours at a time.

What is the success rate of IOP? ›

IOP Effectiveness and Success Rates

As previously mentioned, there are many factors when determining the success rate. However, on average more than 70% of IOP participants have favorable outcomes, which is actually higher than some inpatient treatment options.

How do I get the most out of my IOP? ›

Prioritize Your Recovery

IOP should not be viewed as any less important or time intensive as residential treatment. The most surefire way of making the most of your time in IOP is to prioritize your recovery above everything else and to not minimize the importance of putting effort into it.

Is IOP the same as day treatment? ›

Day treatment and IOP are very similar. The only difference between the two levels of care is the number of hours spent in therapy each week. Day treatment requires a greater time commitment, but patients can still work late afternoon or evening jobs, take care of their children, or manage schoolwork.

What is the point of IOP? ›

Intensive outpatient programs (IOP) can help you if you need a step down from inpatient care, partial hospitalizations, residential treatment, or another higher level of care. You might begin recovery at an IOP program, depending on the severity of your addiction and the quality of your natural support system.

What time of day is IOP highest? ›

Blood pressure tends to downregulate during sleep hours in the early morning, which is also the time of day where IOP tends to be the highest. These two opposing factors can have a duplicative effect in reducing OPP during nocturnal hours, which may allow increased damage to the ocular nerve head.

Can lack of sleep increase IOP? ›

Failing to sleep for enough hours can contribute to increased pressure in the eye. This is because the eyes do not get enough time to rehydrate and recover. This can lead to straining of the eyes, which in turn triggers glaucoma.

Does exercise increase IOP? ›

Exercise is known to result in changes in IOP. In fact, IOP is decreased following aerobic exercise. Moreover, the decrease in IOP is reportedly correlated with the intensity and duration of exercise—accordingly, an increase in exercise intensity and duration results in a greater reduction of IOP.

Does drinking water raise IOP? ›

Results: In both series, mean IOP increased significantly 15 minutes after water ingestion and remained elevated above baseline for 45 minutes. In contrast, colloid osmotic pressure and hematocrit were unaltered by water drinking, and neither these variables nor total plasma osmolality correlated with IOP.

Does caffeine increase IOP? ›

Studies on the pathophysiological effects of caffeine in the eye are still very limited. However, coffee drinking has been suggested to cause a transient elevation of intraocular pressure (IOP) in patients with glaucoma. The magnitude of such pressure elevation ranges from 1 to 2 mmHg, an hour after drinking coffee.

Does anxiety affect IOP? ›

The results indicated that people with a high anxiety-state and/or a high trait anxiety showed increases in intraocular pressure and heart rate.

Is high IOP painful? ›

A mildly high eye pressure does not cause any noticeable symptoms or pain, but a very high pressure (likely 35 or higher) can cause pain in and around the eye and nausea or vomiting. That's one reason for you to see an ophthalmologist or optometrist regularly.

How often should IOP be checked? ›

If there is a low risk of glaucomatous damage, then the test may be performed only once a year. If there is a high risk of glaucomatous damage, then the test may be performed as frequently as every 2 months.

What is the best time to check IOP? ›

Based on our study we believe that more cases of glaucoma could be identified by early morning measurement of IOP during phasing.

Does stress affect IOP? ›

IOP increases with stress have also been demonstrated in humans. Brody et al. measured IOP before and after psychological stress with the mental arithmetic test as a stressor. IOP was increased about 1.3 mmHg following the stressor9.

Do eye exercises reduce IOP? ›

Exercising reduces eye pressure as long as you continue to exercise regularly. Find activities that you enjoy and develop the habit of exercising 3-4 times a week. It only takes a few weeks of inactivity for IOP levels to rise.

What is an acceptable IOP? ›

Normal intraocular pressures average from 12-21 mm Hg. The “mm Hg” refers to millimeters of mercury, a scale for recording eye pressure.

Does caffeine affect eye pressure? ›

Consuming large amounts of daily caffeine may increase the risk of glaucoma more than three-fold for those with a genetic predisposition to higher eye pressure according to an international, multi-center study.

What is dangerously high IOP? ›

Your eye pressure is measured in millimeters of mercury, expressed as mm Hg. Normal eye pressure is between 10 to 21 mm Hg. High intraocular pressure is greater than 21 mm Hg.

How should you sleep to lower eye pressure? ›

With the knowledge that IOP rises at night or whenever a person is prone, many doctors have advised their patients to sleep in an upright position. One study found that turning the head into a pillow in a simulated sleep position is associated with a clinically significant increase in estimated IOP.

What does high IOP feel like? ›

A normal eye should feel a bit like a tomato that is just ripe: not solid, nor very soft. It is important to compare the two eyes with one other. An eye with very high IOP will feel abnormally hard and solid.

What happens if high IOP is left untreated? ›

High eye pressure, if left untreated, may damage the optic nerve and could result in vision loss or blindness, a condition known as glaucoma. Monitoring IOP is essential to the early detection of glaucoma which is the leading cause of blindness in the United States.

What is the normal eye pressure by age? ›

Age-related change in IOP

In the cross-sectional analysis, average IOP increased from 12.7 mm Hg in subjects in their 20s to 14.0 mm Hg in those in their 40s. Then IOP decreased from 13.9 mm Hg in those in their 60s to 13.1 mm Hg in those in their 70s.

What should glaucoma patients avoid? ›

High trans fats have been proven to cause damage to the optic nerve. Time to cut out fried foods, baked goods and any product with an ingredient list that includes hydrogenated or partially hydrogenated oils. Saturated foods that include red meat, beef, lard, shortening and oils can also worsen glaucoma.

What activities worsen glaucoma? ›

People who engage in anaerobic exercise may hold their breath temporarily while they're straining, and this too can raise eye pressure and further increase the risk of developing glaucoma or worsening vision loss in people who have the disease. Examples of anaerobic exercise can include: Situps and pullups.

Does walking increase eye pressure? ›

Walking, for example, was found to be associated with a significant fall in IOP. After running a 42 km marathon, IOP was found to have dropped by a mean of 2.25 mmHg with greater reduction occurring for subjects with higher baseline readings.

What is the best vitamin to take for glaucoma? ›

Treating it may ultimately involve addressing both pressure issues and neuroprotective issues. Vitamin supplements that have been posited to have an effect on glaucoma include B1, B3, B12, C, A and E.

Does weight affect IOP? ›

CONCLUSION: A higher BMI was associated with increased IOP in ground-based studies. IOP also decreased with weight loss. These data support the idea that alterations in body weight affect intraocular pressures.

Does bending over increase IOP? ›

Conclusions: Significant elevations in intraocular pressure occur when bending over and, contrary to previous reports, when performing a valsalva maneuver, but do not when lifting a 15 kg weight.

Why does IOP go up at night? ›

Recent findings: Peak intraocular pressure (IOP) likely occurs at night because of the head and body positions assumed during sleep. Sleeping in a 30° head-up position leads to IOP lowering during this time period.

Does CBD lower IOP? ›

CBD administration did not reduce the IOP at any time. However, the higher dose of CBD (40 mg) produced a transient elevation of IOP at 4 hours after administration, from 23.2 to 25.9 mm Hg (P=0.028). Vital signs and visual acuity were not significantly changed.

Does Rubbing eyes increase IOP? ›

While acute rubbing of the eye can cause elevated intraocular pressure (IOP), chronic rubbing has been associated with the progression or development of keratoconus, keratoglobus, pellucid marginal degeneration, glaucoma, corneal astigmatism, and corneal hydrops 1.

Does IOP increase with age? ›

Results: Mean intraocular pressure increases progressively with age until 60 years. When one age group is compared with its preceding, the increase is non-significant until 40 years but highly significant (P < 0.001) in the age groups of 41-50 and 51-60 years.

Does age affect IOP? ›

The IOP was estimated with either Schiøtz or noncontact tonometers, which consistently showed a decreasing tendency of IOP with age in both sexes.

Is chocolate good for glaucoma? ›

Even if your Dove bar doesn't sharpen your vision, the flavonoids found in dark chocolate may help improve vision in people with glaucoma as well as reduce the risk for macular degeneration.

What age does glaucoma start? ›

Glaucoma can occur at any age but is more common in older adults. It is one of the leading causes of blindness for people over the age of 60. Many forms of glaucoma have no warning signs. The effect is so gradual that you may not notice a change in vision until the condition is in its later stages.

Is there a cure for high eye pressure? ›

Prescription eye drops are the most common treatment. They lower the pressure in your eye and prevent damage to your optic nerve. Laser treatment. To lower your eye pressure, doctors can use lasers to help the fluid drain out of your eye.

Can I check my IOP at home? ›

With recent advances, IOP measurements are now possible at home, with an FDA approved prescription device called the iCare® HOME. Current in-office diagnostic techniques provide sufficient information to treat most glaucoma patients but in rare cases, monitoring IOP at home may be helpful.

Can you test IOP at home? ›

iCare HOME tonometer is the first device available to patients for measuring intraocular pressure at home. iCare HOME provides an extensive and accurate view to the patient's diurnal IOPs for the eye doctor adding value to glaucoma management.

Is eye pressure higher in morning or night? ›

“Pressure is highest typically in the morning, when you're just waking up, and lowest in the afternoon,” says Johnson.

How long does an eye pressure test take? ›

Your Expectations. A complete eye exam should take a little more than an hour, but the tonometry test during that full exam lasts no longer than one minute once everything is set up.

Can stress cause high eye pressure? ›

Psychological stress can significantly elevate intraocular pressure (IOP), even in healthy individuals, according to a report published in Ophthalmology Glaucoma.

What procedure is done to check IOP? ›

Tonometry is a diagnostic test that measures your intraocular pressure (IOP), or the pressure inside your eye. Tonometry can help your healthcare provider determine if you're at risk for glaucoma.

What does IOP stand for in substance abuse? ›

Service definition. Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision.

What does IOP mean in psychiatry? ›

Intensive Outpatient Programs offer a number of benefits to patients who need behavioral healthcare but do not need a residential program. Our IOP gives patients that freedom to come and go to each session, and to return home every evening.

What is IOP in medical billing? ›

An intensive outpatient program, or IOP, in which outpatient behavioral health services are provided for between 9 and 19 hours per week.

What is IOP in investment? ›

An initial public offering (IPO) refers to the process of offering shares of a private corporation to the public in a new stock issuance.

Are IOPS effective? ›

IOP programs are just as effective as inpatient and residential programs for most individuals who have a lower risk of withdrawal and less symptom severity, and who do not require a 24-hour structured setting.

What is the meaning of outpatient treatment? ›

Also called ambulatory care, this term defines any service or treatment that doesn't require hospitalization. An annual exam with your primary care physician is an example of outpatient care, but so are emergent cases where the patient leaves the emergency department the same day they arrive.

What is IOP for OCD? ›

The UCLA Adult OCD Intensive Outpatient Program (IOP) was the first of its kind in California and one of the first in the country. It has been providing the highest quality of care to the OCD community since 1990 and has been a model for other treatment programs around the world.

How long do PHP programs last? ›

Average Length of a PHP

The majority of PHPs expect clients to attend sessions anywhere from three to five days per week, and sessions are usually about six hours in length. Data from the Center of Medicare & Medicaid Services states that most people stay at a PHP for an average of three to four weeks.

What is an ASAM assessment? ›

The ASAM Criteria's strength-based multidimensional assessment takes into account a patient's needs, obstacles and liabilities, as well as their strengths, assets, resources, and support structure. This information is used to determine the appropriate level of care across a continuum.

What does RTC stand for in rehab? ›

Residential Treatment Centers (RTCs)

What are IOP devices? ›

Device: Icare Tonometer. Detailed Description: Intraocular pressure measurement (IOP) is a vital part of the routine eye examination. High and low eye pressure may be associated with various ocular pathologies, including glaucoma. The current gold standard for IOP measurement is Goldmann Applanation Tonometry (GAT).

What IOP is an emergency? ›

This is considered a medical emergency because the intraocular pressure spikes suddenly to anywhere from 30-70 mm or higher. This causes extremely sharp pain, nausea and vomiting, and cloudy vision. The IOP needs to be lowered within hours to prevent permanent vision loss.

When a company goes public who gets the money? ›

When a company lists its securities on a public exchange, the money paid by the investing public for the newly issued shares goes directly to the company (primary offering) as well as to any early private investors who opt to sell all or a portion of their holdings (secondary offerings) as part of the larger IPO.

What happens when a company goes public? ›

Going public typically refers to when a company undertakes its initial public offering, or IPO, by selling shares of stock to the public, usually to raise additional capital. Going public is a significant step for any company and you should consider the reasons companies decide to go public.


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