How To Find the Right Level Of Treatment

By Erin O’Brien, Office Manager, Cast Centers

When seeking treatment for mental illness and/or substance abuse, it can often be difficult to determine what level of care is needed. The first step is looking at what the options are. The main treatment options include: standard outpatient, intensive outpatient, residential treatment, and inpatient hospitalization. The main difference between them is the frequency of care and amount of structure.

Outpatient

  • Standard outpatient therapy
  • Often in a private practice
  • Generally 1-2 hours per week or less

 Intensive Outpatient (IOP)

  • Live off-site
  • Often a combination of group and individual therapy
  • At least 3 hours/day, at least 3 days/week

 Residential

  • Live on-site
  • Can often check self in and out
  • 24-hour care

Inpatient Hospitalization

  • For stabilization
  • Must be discharged by hospital
  • Typically 3-7 days of 24-hour care and behavioral observation

Even knowing these differences, it can be difficult to gauge which will be the most beneficial for the client. How do you know if someone needs a higher level of care? The rule of thumb is we always aim for the least restrictive care possible. Ideally someone can get what they need with standard outpatient, but sometimes the least restrictive care suitable for a particular person is hospitalization, because they’re a danger to themselves or others.

So how do you know which is the best fit? There’s a lot of gray area, but it’s largely based on how much support the person needs in order to function in their day-to-day life. Since hospitalization and outpatient therapy are fairly straightforward, we’ll focus on the two in between: intensive outpatient and residential.

Signs you are best suited for intensive outpatient treatment:

  • You need more support than standard outpatient therapy offers
  • You are able to drive yourself or arrange transportation for yourself
  • You can motivate yourself to make most appointments on time
  • You have a supportive home environment
  • You don’t require behavioral observation outside of treatment hours

Residential treatment may be a better place to start if you:

  • Are discharging from inpatient hospitalization
  • Require detoxification
  • Have active suicidal ideation
  • Are experiencing psychosis
  • Don’t have a strong support system
  • Require 24-hour support and regular behavioral observations

A good follow up to this information would be to have a discussion with a medical or counseling professional who can likely offer more individualized insight and offer referrals for the kind of treatment you’re seeking. There is a lot of nuance involved in this decision, but this overview should help jumpstart the process of determining the most suitable level of treatment for you or your loved one.


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