The Intensive Outpatient Programme Option

The Intensive Outpatient Programme Option

IOP or “dayhab” as it is colloquially known is similar to its counterpart ‘rehab’ or Intensive Inpatient Treatment Programme – and features more similarities than differences these days.

Hello again

In this month’s newsletter I am going to talk about outpatient treatment for addiction. This is especially relevant as The Cabin have just opened our first IOP or Intensive Outpatient Programme in Hong Kong, and so far it has been very well received.

So let me explain a little bit about IOPs and outpatient treatment generally. IOP or ‘dayhab’ as it is colloquially known is similar to its counterpart ‘rehab’ or Intensive Inpatient Treatment Programme. What are the differences or should I say, what are the benefits of dayhab as opposed to rehab.

  1. They are conveniently located in your community or city. (In the case of Hong Kong), we are in the central business district
  2. They allow you to continue on with your life or career relatively uninterrupted.
  3. They provide confidence. Perhaps for family or employers who might be asking you to deal with your issues but also, of course, for yourself – because you will be monitored for your drug and alcohol use when you are going through the programme.

All the evidences suggest the bio-psycho-social approach to treatment is the most effective one. Bio/psycho/social treatment is a combination of medical, psychological and social models and methods of treatment. It requires an interdisciplinary approach; i.e. different professions doing different things. So, for example, doctors and nurses are required to do the medical supervision and interventions, (that is the bio part of the model).  Psychologists and counsellors are required to do the psychological part of the programme (i.e. the counseling),  and 12 Step support groups and other entities in the community are required to create social recovery (this social aspect of the illness and its treatment should not be underestimated).

The IOP  is appropriate for a different subset of the addicted population to those who require residential treatment, because it offers a different level of care to an intensive inpatient unit like our centre in Chiang Mai.  The IOP usually works best for clients with lower support needs in terms of medical monitoring and care. For example, most of the clients in our Hong Kong centre are quite high functioning and usually do not require a lot of medical intervention.  On assessment, most of  them can be oriented straight into the Hong Kong programme and begin the counselling aspect of treatment, while receiving a lighter level of medical supervision from our consulting psychiatrist. He also provides provide a comprehensive psychological evaluation and general health screening.

Those who are severely dependent on drug and alcohol are referred on to Chiang Mai where we can give them the proper medical support required, say, during detox and/or ongoing.

Like most intensive outpatient programmes, the majority of the therapeutic work that is conducted in The Cabin Hong Kong, is done in evening group therapy sessions. We also conduct one-on-one counselling. Every client has a one-on-one counselling session every week to go through their assignment work or their case work with their counsellor. There will be a lot of other issues on top of addiction, such as martial problems and confidential issues that clients may want to talk about, and so it is important to have that one-on-one time as well, as part of their support.

As we all know working with family is an extremely effective and necessary part of treating addictions. IOPs should also have a family programme because addiction is a family illness, and so we provide this service in Hong Kong as well. Many family members:

a) require help themselves in coming to terms with their relative’s addiction b) need to understand the illness better

Effective treatment for addiction is not just about stopping drinking and drugging. It is a chronic illness and the symptoms aren’t just going to go away of their own accord, you are going to have to work at it. My experience has been, if you can embrace the need for a full recovery and do the things that are necessary, you get psychically stronger, you have greater mental clarity, more manageable emotions; and a vastly improved life situation – including career, relationships etc.

 

Alastair Mordey

Programme Director The Cabin adiction service group