In-patient or Out-patient?

Choosing a treatment facility

When choosing a facility, In-patient or Out-patient, for your loved one, especially if you have limited knowledge about rehabilitation and addiction, may prove to be a difficult task. The first question is always “Are they going to be okay?”. Trusting a team of people you don’t know and a program that you don’t understand is a difficult thing to do. Entrusting the well being of a person you care about to a facility is daunting, because the second question is always “are they capable of handling this?”. It is important to research and evaluate whether a facility will meet the needs required.

If it is the first time you are choosing a treatment facility, looking into what different centres and programs have to offer is a good place to start. Always remember that asking questions is a good thing, if it helps ensure your piece of mind. Many facilities may talk about treatment modalities and different types of therapies and programs and it can be so easy to get caught up and confused by the jargon.  If you are unsure of what this means, researching and inquiring further is always an option before you sign on for something that you are uncertain about.

Critical Differences

Though many of the facilities you have seen look more or less the same from the outside there is always one big decision that needs to be made before entering a program. Is outpatient or inpatient the better option. This choice will help you narrow down facilities that are being considered and give you more options in terms of programs available, because often a person will consider one but not the other. Of course, each has strong selling points, but they also come with their weaknesses. The following breakdown may help in explaining the critical differences.

Out-Patient

The main appeal of an outpatient program is that for the duration of treatment, a client does not have to be a resident of the facility. They are required to attend counselling sessions and group therapy according to a schedule, but it is not a full-time commitment, giving them an opportunity to continue giving other priorities, such as work or school, the time needed. This is a large part of the appeal of an outpatient program, along with the fact that it is often the cheaper option. The recommended period of this type of treatment program is 76 days, it may however be extended depending on the progression of the client and this is usually up to the discretion of the counselors.

Although this form of treatment may seem convenient, the seriousness of the condition a person is in should be taken into consideration. A person who is at a high risk of relapse should not be considered for this type of program. Because it offers much less structure and accountability compared to an inpatient program, people who fall into this category may take advantage of the freedom an outpatient program affords them.

Convenience

This type of treatment is however very beneficial to a person who is in the beginning stages of substance abuse or for people who have spent a significant time in a treatment facility and perhaps had a small slip up. Outpatient is also a viable option for secondary care. This means that upon leaving an inpatient program they move to an outpatient program as a form of transition between rehab and the real world.

It is also important to note that for the most part a medical detox is not part of this type of program. If a person is experiencing any sort of withdrawal, medical intervention is needed before entering an outpatient program.

In-patient

An inpatient program offers much more in the way of structure compared to an outpatient program. Clients live on the premises of the facility for the duration of their treatment. This can be a period of 21 days up to a year, if the facility is geared toward long term treatment. As with outpatient the length of stay is usually advised by a counselling team involved with that patient. It has been proven that client who stay at a facility longer have a much higher chance of achieving long term sobriety.

Structure

An inpatient treatment plan involves a fair amount more counselling and groups than an outpatient program. The extra time a client spends at a facility also enables them to attend mandatory support group meeting as well as building connections and fellowship with other people undergoing the same struggles. This type of program involves much of the same elements as outpatient treatment, just more of it. Working with a one on one counselor and attending a variety of therapeutic groups should both be cornerstones of any treatment program.

At an inpatient facility the clients are closely monitored, this decreases the risk of a person relapsing while in this type of program. It also keeps them safe as drugs and alcohol are not on the premises and people who may pose a risk to them, such as friends and family members who are using drugs, are often barred from the property. Patients are not given the opportunity to put themselves at risk. This is very beneficial for people who are at a high risk of returning to their addiction.

Benefits

The other benefit, which should always be considered, is that with an inpatient program, recovery is the clients sole priority. This dedicated time gives a person the opportunity to get more work done and learn more about themselves and their disease. The same amount of time in an outpatient program may not achieve the same results.

Most inpatient facilities will also offer a medically supervised detox period. This is incredibly important as withdrawals can have serious health consequences if not handled appropriately. The value of working with a doctor and a nurse under these circumstances should not be underestimated. If a person displays withdrawal symptoms a medical detox should also be considered as a priority.

Making a choice

Given the differences in an outpatient and inpatient program the best way to assess which choice is the correct one is to be critical of just how much support a person needs. Each option is designed to address a specific need. Just because one seems easier or more convenient does not mean it is the correct choice to make. Make no mistake, these are not two solutions to the same problem. The ultimate decision should be based on which option will best meet the needs of the person in question. Most rehabilitation centers will offer an assessment prior to the admission process. If there is any uncertainty as to which option should be chosen, consulting with a professional is a great way to receive guidance and direction.

M Mojapelo (BACC)

C Van de Erve (BACC)

Johannesburg & Pretoria