So What’s An IOP Anyway?

An Intensive Outpatient Program (IOP) is a treatment option that serves as a step-down from a residential or partial hospitalization program or a step-up from standard outpatient therapy. IOP is an opportunity for individuals to engage in their daily lives (i.e. participate in work, school or community and social activities) while working toward treatment goals in a supportive and structured environment. For those who are phasing back into their everyday lives after a residential stay or partial hospitalization program, IOP is an opportunity to restore independence. For those who are seeking a higher level of care than a traditional outpatient program, IOP provides more points of contact with a treatment team and peers while enabling participants to participate in the activities of daily life, as appropriate.

What is the time commitment for IOP?

Traditional IOP programs will require between 6-15 hours of treatment per week over the course of 3-5 days. The intensity (i.e. 3 vs 5 days) depends on the individual needs of the client.  Some programs run IOP in the evening hours (5-8pm or 6-9pm) while other programs may offer more flexibility with daytime options for those whose schedules allow.

What does treatment look like on a day-to-day basis?

IOP is an opportunity for many to “jump start” treatment. In other words, in a short amount of time, programs work to redirect and shape behaviors, change long-standing patterns and support new strategies for stable eating. Typical expectations for an IOP suggest a 50% reduction in symptoms within 8 weeks.  For those who are stepping down from more intensive settings, IOP may be structured differently…. to slowly expose the individual to more and more independence until the client feels confident to move on.  IOP hours typically include group therapy, supported meals, individual therapy and family work (if indicated).  Intervention strategies and objectives vary by disorder. For example, for AN clients, it’s important to see movement toward more varied and balanced eating along with a clear trajectory of weight restoration. With bulimia, an ideal program will focus in on food exposure, variety and skills for managing/coping with urges to binge or purge. For binge eating disorder,  an IOP program would be geared around skill building, developing self-awareness, mindfulness, distress tolerance, and emotion regulation.To determine if an individual is appropriate for an IOP program, clinics will typically utilize standards established by the American Psychiatric Association.  Below is a basic chart – based on the APA standards - that we use at our Columbus Park IOP.  It represents some factors we consider when establishing the appropriate level of care for individuals coming into our program.

Standard Outpatient Criteria Intensive Outpatient Program  Criteria Partial Hospital/Residential/Inpatient Criteria
Medically stable/cleared by Medical Doctor Medically stable/cleared by MD/ frequent follow up required Medical instability
With guidance, pt is capable of creating one’s own meal structure External structure needed to eat or gain weight Supervision required during/after meals
Fair to good motivation to recover At least fair motivation to recover Poor motivation to recover
Co-morbidities  (i.e. depression, anxiety) may have some limited impact on functioning Co-morbidities (i.e. depression, anxiety) have high impact on functioning Psychiatric condition requiring hospitalization
Suicidality, if present, is passive (no active plan or intent to take one’s life) Suicidality, if present, is active and more structure/points of contact needed.  Possible suicide attempts in past. Suicidality is active w/intent and plan and unable to contract for safety
Some ability to control exercise Some ability to modulate exercise Structure needed to prevent compulsive exercise
Some social support Limited social support No support available to add structure outside of treatment
Weight: safe range Weight: significantly compromised range Weight: severe compromise

Could you or a loved one benefit from an IOP program?  Columbus Park offers a number of flexible treatment options (day or evening) to ensure individuals with varied schedules, obligations, and availability are able to access quality treatment. While our IOP program is grounded in evidence-based treatments such as CBT and DBT, each individual’s treatment track (Meal Intensive, DBT Intensive, and CBT-E intensive) is selected and individualized to their unique needs. Interested in learning more about our programs? Contact us today! 

MELISSA GERSON, LCSW

Melissa Gerson is the founder of Columbus Park Center for Eating Disorders in New York City. Over the last 20-plus years, she has trained in just about every evidence-based eating disorder treatment available to individuals with eating disorders: a dizzying list of acronyms including CBT-E, CBT-AR, DBT, FBT, IPT, SSCM, FBI and more.

Among Melissa’s most important achievements has been a certification as a Family-Based Treatment provider; with her mastery of this potent and life-changing (and life-saving!) modality, she’s treated hundreds of young people successfully and continues to maintain a small caseload of FBT clients as she also focuses on leadership and management roles at Columbus Park.

Since founding Columbus Park in 2008, Melissa has trained multiple generations of eating disorder professionals and has dedicated her time to a combination of clinical practice, writing, and presenting.

https://www.columbuspark.com
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