Addiction Treatment: Residential or Outpatient Care?

Key considerations to help in making your decision

Several factors, including duration and severity of addiction as well as recovery environment and relapse potential, influence decisions about the most effective treatment option for a particular patient. While recommendations are typically determined through an in-person diagnostic assessment, a general overview of key considerations is provided below.

What's the typical structure of an inpatient, or residential, addiction treatment program?

Traditionally, a residential program requires that patients stay on-site at a treatment facility for a certain period of time. Medically supervised detoxification and stabilization services are often provided at the site. At the Hazelden Betty Ford Foundation, we don't prescribe a set number of days for length of stay, as each person is unique. Through education, group therapy, one-to-one counseling, and peer interaction, patients learn about the disease of addiction and the process of recovery in a safe, supportive environment. In a residential setting, patients are removed from influences in their home, work, or social environment that could impede treatment or jeopardize recovery. They also have 24/7 support as they go through those early ups and downs of post-acute withdrawal and are provided tools to cope with emotions in early recovery.

When is an outpatient treatment program more appropriate?

Generally speaking, candidates for outpatient addiction treatment programs do not require medically supervised detoxification, have stable mental and physical health, and have a supportive home and/or work environment. The flexible scheduling of outpatient programming allows for individuals to fully experience treatment and incorporate it into their daily lives, whether working, volunteering, or caring for family.

How is the appropriate level of care determined?

An in-person diagnostic assessment by an addiction professional provides the most accurate recommendations for patient placement and care. This assessment process typically draws upon criteria set forth by the American Society of Addiction Medicine:

  • Acuity and complexity of addiction, including withdrawal needs
  • Biomedical considerations or complications
  • Emotional and behavioral factors
  • Motivation to change
  • Relapse potential
  • Recovery environment

Because the patient is often unable to provide the full picture of his or her addiction, a good assessment also includes collateral information from professionals and people who have witnessed the patient's addictive behaviors, such as family and friends.

What are some hallmarks of effective addiction treatment, whether residential or outpatient?

Look for treatment programs that specialize in evidence-based practices, such as Twelve Step facilitation therapy, cognitive-behavioral therapy, and motivational interviewing. Look also for programming that is individualized and flexible enough to meet the patient where he or she is in terms of readiness to change and that guides the patient through the stages of change. Education, therapy, and peer interaction are important areas of activity for the patient. At the Hazelden Betty Ford Foundation, we also believe that integrating patients into the recovery community while in treatment smooths the path to ongoing recovery.

How important are continuing care and recovery support?

In a word, crucial. Research shows that the first 18 months following treatment are critical in building lasting sobriety. Remember, addiction is a chronic health condition, like diabetes, that needs to be managed over one's lifetime. Effective treatment programs equip the patient with a continuing care plan and a relapse prevention plan that take into account the patient's specific issues and challenges, such as chronic pain, medication management, grief and loss, and co-occurring mental health conditions. Building a strong support system is integral to sustaining recovery. Hazelden Betty Ford Foundation patients have access to multiple recovery tools that range from recovery coaching and web-based tools to mobile apps and recovery retreats. In addition, prior to discharge, all patients are set up with a professional follow-up appointment to support their ongoing recovery in their home community.

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