This TIP, titled Intensive Outpatient Treatment for Alcohol and Other Drug Abuse, describes the level of care that is provided by intensive outpatient treatment (IOT) programs and the range of services and service components that are included in such programs. Practical information for staffing IOT programs and for addressing clinical challenges that arise in the IOT setting is provided. The treatment needs of special groups, such as women and ethnic and cultural minorities are addressed. Improving the quality of services in IOT programs is discussed and suggestions for obtaining public and private funding are presented. A separate chapter addresses legal issues.

Contents

• What Is a TIP?
• Consensus Panel
• Foreword
• Chapter 1—Introduction
  • The Purpose of This TIP
  • Advantages of IOT Programs
  • Underlying Principles Of the TIP
  • Summary
• Chapter 2—Placement Criteria and Expected Treatment Outcomes
  • Description of IOT
  • Assessment and Placement Issues
  • Dimensions for Assessment
  • Patient Transition From One Level to Another
  • Treatment Goals
  • A Final Thought
• Chapter 3—Components of an Effective IOT Program
  • Rationale
  • Advantages
  • Problems and Challenges
  • Treatment Components
  • Clinical Challenges and Responses
  • Summary
• Chapter 4—Staffing Issues and Guidelines
  • Staff Member Roles
  • Shared Knowledge and Beliefs
  • Clinical Competency Guidelines
  • Ethical Guidelines
  • Staffing Level Guidelines
  • Staff Stressors
  • Recommended Staff Supports
  • Certification and Credentialing
  • Recommendations
• Chapter 5—The Treatment Needs Of Special Groups
  • A Note About the Family
  • Women
  • Minority Ethnic and Cultural Groups
  • Patients With Dual Disorders
  • Homeless People
  • People With HIV or AIDS
  • Gay Men and Lesbian Patients
  • Elderly Patients
  • People in the Criminal Justice System
  • Patients From Other Special Groups
  • Summary
• Chapter 6—Special Fiscal and Administrative Issues
  • Quality Improvement
  • Public Funding
  • Private Funding
  • Managed Care
  • Program Costs
• Chapter 7—Legal Issues for IOT Programs¹
  • Federal Confidentiality Laws
  • Sharing Confidential Information
  • Communication With Others
  • Duty to Warn
  • Reporting Patients' Criminal Activity
  • Reporting Child Abuse And Neglect
  • More Exceptions to the General Rule
  • Other Requirements
  • A Final Note
  • Endnote
• Appendix A -- References
• Appendix B—Sample IOT Program Schedules
• Appendix C—Federal Resource Panel
• Appendix D—Field Reviewers

This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number ADM 270-91-0007 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA). Anna Marsh, PhD, and Sandra Clunies, MS, served as the CSAT Government project officers. Randi Henderson, Mim Landry, Christopher Phillips, and Deborah Shuman served as writers.

This publication describes just one approach to, or model of, intensive outpatient treatment. Research and evaluation of this approach are needed, particularly with respect to its application in the public sector.

The opinions expressed herein are the views of the consensus panel members and do not reflect the official position of CSAT or any other part of the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT or DHHS is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized patient care and treatment decisions.