FAQ’s (Frequently Asked Questions) About Addiction Recovery Services’ IOP Program

An Intensive Outpatient Program (also known as IOP) is a structured treatment program that provides group therapy, education, and skill-building. Our program offers the psychiatric care, professional counseling, and peer support of a residential or inpatient program condensed into three-hour sessions four days per week.  Our New Hampshire IOP allows people to maintain their normal routine and comfortably live at home.

The Intensive Outpatient Program (IOP) is for anyone who wants to change or stop their use of alcohol or substances.

Eligibility for the IOP is determined by a one-hour clinical assessment conducted by our clinicians as part of the admissions process. Most people are eligible for our IOP unless they have life-threatening withdrawal or medical conditions, a living environment that would prevent successful treatment or a mental health condition that would prevent effectual participation in a group setting. Our clinicians will help to determine someone’s appropriateness for our program through a phone screening and in person assessment, so if you’re uncertain, give us a call at 978-748-6293.

The intake/application process is simple. We just need someone’s full name, address, date of birth, phone number, and insurance plan information. Pictures of the front and back of the card are the easiest to use. We can then confirm coverage with your insurance company and schedule someone for the next available appointment. We schedule most intakes at 9:15 am or between 2:00 pm and 4:00 pm. If someone can’t make those times work, we will work to accommodate them. The intake appointment usually lasts about an hour. It involves reviewing some program information, signing consents, and collecting a brief history from the person to better understand their circumstances and goals.

Enrollment in our IOP occurs on a rolling basis so, someone can begin the program at any time and usually within a day or two of initial contact.

Our IOP program usually runs for a period of five weeks, four nights or days per week, for a total of twenty sessions. Some people may do more than twenty sessions if indicated. We offer daytime (10:00 am-1:00 pm) and evening (4:00 pm-7:00 pm) programs to accommodate different schedules at our main offices in Greenland (Portsmouth Area) of New Hampshire. Someone can switch attendance between the day and evening programs. If possible, this should be avoided in order to maintain group cohesion, but it can be accommodated if necessary for people who have changing work schedules or other conflicts.

Research has shown that individuals whose families are involved in treatment have higher rates of success in their recovery. We are very supportive of family involvement and include family members in treatment when possible.  The goal of our program is to provide both you and your family members with information and support that will assist in your recovery. Family involvement can happen through phone support, family meetings led by a clinician, or participation in some of the educational topics offered in the group.

Following completion of the intensive outpatient group, our alumni engagement staff will check in with people by phone, text, and email weekly for the first month, biweekly for months 2 and 3, and then monthly up to 12 months after completion. We put an emphasis on supporting the progress of all of our group participants, including those who did not finish the group. If you don’t wish to be contacted, you can easily opt out of follow-up calls. We strongly encourage continued contact since it is linked to positive improvements in recovery and overall health and wellness.

Our staff will assist you in creating an aftercare plan. We offer an ongoing and unlimited alumni support group.

Participants are encouraged to participate in community-based support group meetings and will be given information on wellness groups, and/or peer recovery coaching as continued aftercare.

We will also assist with referrals to individual counseling, psychiatric care, and family and couples counseling as appropriate in order to strengthen a foundation for long-term recovery. Our staff are knowledgeable about effective and trustworthy resources in the areas we serve.

Most insurance plans now include coverage for substance use disorder treatment, and many plans cover much of the cost. We will determine the out-of-pocket cost for you once we have a person’s plan information. If there is a large deductible or insurance doesn’t cover the service, we can arrange flexible payment plans with our clients.

Absolutely not! We see many folks from northern Massachusetts from towns like Lowell, Haverhill, Lawrence, Newburyport, and Andover, MA, quite frequently. Essentially, anyone on the North Shore of Boston can easily access our location in Greenland, NH – just outside of Portsmouth. We also find that many people with private insurance will travel to our IOP to receive a higher level of client-centered care. It doesn’t matter where you are from, provided you can access our location regularly for sessions. Telehealth options are also available, so please inquire.

In an Intensive Outpatient Program, you generally receive services through group therapy. The groups rarely exceed twelve people to allow for a safe learning and healing environment. Small groups are a tremendously powerful vehicle for positive change. The benefits include the opportunity to practice social skills and communication, receive social support and form healthy connections with others, reduce shame and other difficult emotions associated with addiction, and learn from the experiences of others.

Using the shared experiences and conversations among our participants, questionnaires, brief video clips, lectures, and handouts, we cover such topics as Managing urges and cravings, managing post-acute withdrawal symptoms and co-occurring mental health symptoms; how our brains work and neurobiology of behaviors; regulating our emotions; anger; grief; shame; forgiveness; communication skills and relationships; getting our needs met; saying ‘no’ or setting boundaries effectively; perceptions of success and failure; humility and self-esteem; acceptance; empowerment; gratitude; mindfulness; and having fun in life and recovery.

Each session is usually split into two halves. The first half of each session is more conversational. There are some questions written on the board that prompt insight into our lives and how to manage thoughts, feelings, and behaviors related to the topics at hand. Once everyone has considered the questions and contributed, there is a fifteen-minute break, followed by a presentation that further enriches understanding of the topic or an activity that allows the group to put into practice the skills discussed.

Our program provides access to psychiatry as an included service, not an additional charge or appointment. Everyone can speak to a Medical Doctor or a Nurse Practitioner for a medication management conversation as often as once per week, depending on need.

The sessions are led by either two or three counselors (three when we have interns). The two counselors will always include at least one person who is an NH Board of Mental Health Practice licensed clinician – either a Licensed Independent Clinical Social Worker, a Licensed Clinical Mental Health Counselor, and/or a Master Licensed Alcohol and Drug Counselor. Other staff leading a group may also have a license, be working toward licensure while supervised by a licensed staff person, be an intern in a clinical mental health or master of a social work program, or be a New Hampshire certified recovery support worker (CRSW).

Because our group is four days per week and lasts about five weeks, we do not offer weekly individual therapy sessions. Individual counseling should occur for longer than five weeks, and space and time constraints keep us from offering both IOP and individual counseling. We often refer to effective and trusted providers in the community. Several of our group leaders have private practices in addition to their roles with our program; at times, when it’s a good fit, a group participant will decide to see one of them for individual counseling. Individual attention is given to the medical doctor and nurse practitioner for briefer medication consultations, which occur on a weekly or biweekly basis. Because of our higher staff-to-client ratios, if someone is in crisis, we are also able to give them as much individual attention as necessary to help them resolve the crisis or come up with a plan for resolving the crisis.

We recommend attendance at various types of community and professional support and services as a way to explore various options for recovery. However, people need to find what works for them, and what works may change over time. People are also more likely to forge a healthy pathway when motivated to do so internally and without an external mandate. With that in mind, we will discuss the pros and cons of different support groups and practices, troubleshoot the pros and cons, and help people find the support systems most beneficial to their recovery. Ultimately, it’s up to the individual what they decide to do.

While the activities performed in our group sessions strongly complement many tenets and exercises of a 12-step model, we are not a 12-step program or culture.  In recognition of the predominance of 12-step culture in recovery styles and supports, we aim to make sure that those who are not attracted to 12-step programs and cultures feel welcome and at home in our program.

We integrate some education about the 12 steps by showing their common ground with other clinical approaches. For example, a Rational Emotive Behavioral Therapy group about anger can help someone to identify how their thinking about a situation may cause some of their feelings and behaviors. This practice closely aligns with the ‘Step 4’ activities of making a moral inventory, which involves writing resentment lists and ‘turnarounds’ to better understand the role that our thinking and motives played in the resentment. Our group on forgiveness covers the concept of making amends and repairing relationships while withholding expectations of outcomes similar to step 9. Our group about self-esteem examines the concept of humility, which is central to all 12 steps. Sessions focused on change, and acceptance helps people gain the wisdom to know the difference between what they can change and what they cannot or should not try to change – familiar concepts in 12-step programs and fellowships and vital to the first three steps.  Mindfulness practices in the group are akin to practicing Step 11. Approaching the relationship between treatment and the 12 steps in this complementary fashion, but without mandates, keeps the door open both to people who do and those who do not wish to follow a formal 12-step recovery program. This approach also creates an open and accepting environment in which a person may more readily change their mind and become interested in the 12 steps without a power struggle. If someone is more interested in pursuing step work, we will help them connect to the appropriate 12-step group and contacts.

We do provide urine drug screens and breathalyzers once per week on alternating days. We will provide additional screens if there is a concern that someone has used them. The results of the screens are meant to promote positive change and conversations about progress and are not used punitively. People are not discharged for returning to use, but we make changes to the interventions provided and, in some cases, recommend a transfer to a higher level of care. We aim to support people and not promote further shame, which usually intensifies substance use.

People are asked not to attend the program impaired and are assisted in finding safe transportation home if impaired. An emergency contact will be contacted if someone is impaired or suspected to be impaired. Sometimes, we cannot detect impairment. If there is concern about a fellow group member, we ask program participants to please share their concerns privately with a staff person so that we can assess the situation and intervene appropriately. Sometimes, the side effects of medications can look like impairment. In those cases, we may make changes to medications, doses, or directions of when to take medications. 

The underlying causes of addiction, and therefore the tools and solutions to change addictive behaviors, are similar to many addictive behaviors. That said, there are some differences in symptoms and circumstances around different substances and behaviors. All of our staff are skilled in addressing those subtleties. Insurance does not cover treatment for process addictions like sex, gambling, technology, or shopping. However, the group will help with those problems if they are present.

The groups are usually diverse, comprising a mixture of people with alcohol and other substance use problems and varying ages. When someone can see past their uniqueness and find commonality with other people, regardless of their differences, powerful healing can occur among all parties. We wake up appreciative every day for that part of our jobs.

Yes, someone can withdraw from treatment at any time, though we hope to discuss any discomforts and to help people to push through the ones that they can. Pushing through that discomfort can greatly enhance your recovery. If someone has decided that they want to try a different source or type of support, we will enthusiastically help them to find it.

There is no consequence for missed sessions from us. Part of our philosophy is to be more flexible and understand that people have lives and competing priorities, and to assist them in making changes and managing time in a way that helps their recovery. At a certain number of absences or tardiness, we would have to discuss whether or not it’s feasible or beneficial for someone to continue participation. Insurance can also deny payment for services if someone is absent too often. Some of the drawbacks to missing groups are the content that is missed and the disruption they may cause to the group by their absence or late arrival. We can still provide missed information to people to review on their own. We ask that people who miss or are late explain to the group the circumstances when it is their turn to participate in order to minimize the impact on others.

Success rates for abstinence from intoxicating substances are impossible to measure accurately. Research suggests that only about one out of every ten people who complete any type of treatment program for substance use disorder remain abstinent for at least a year after completion of their first treatment program.

That answer often leads people to question, “What’s the point of your profession?” And our answer is that recovery is a process with many more variables and indicators of success than the sudden cessation of substance use. Outcomes improve with successive attempts at change. The vast majority of people who complete a treatment program are going to change for the better to some degree. In some cases, the positive outcome may include the realization that they need more help than they thought. At that point, we can assist someone to get into a more structured program. Other positive outcomes can include improved relationships, employment, reduction in health and psychiatric problems, and new educational pursuits, all of which may or may not be accompanied by abstinence from all drugs and alcohol. When someone uses the tools presented to them and commits to changing their thinking and engaging in new habits/behaviors, they gain new levels of recovery. When people engage in the process of recovery, their lives improve – whether they drink or take drugs again someday or not. Changing a behavior, just like any other kind of learning process, often involves trial and error and some level of experimentation with changes.