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How to Choose Between Inpatient (Residential) and Outpatient Rehab

Inpatient vs. Outpatient Rehab

“Do I go for outpatient rehab?”
“Should I do residential rehab instead?”
“Wait, what’s the difference?”

Deciphering substance abuse treatment options and levels of care that might work for you can be tough. But to start investigating what would be a good “fit,” it’s important to do initial research when looking at various programs.

Let’s make that easier, with a comparison between “inpatient” and “outpatient” rehab programs.

Before we start, an important aside: If you’re interested in a particular treatment provider, make sure they’re state licensed/certified! Check the website governing treatment programs in your state (links below). Then check the admissions criteria for the treatment options that most interest you–you’ll find those on a treatment center’s website.

Once you’re set on a treatment provider, explore the treatment options they provide. The two most popular options are what we’ll cover here: Inpatient / Residential Rehab, and Outpatient Rehab.


Inpatient Rehab (Residential Rehab) – Staying at a Treatment Center

Inpatient rehab is an intensive level of care. Clients live on-site at a treatment facility, for anywhere from 30 to 90 days (on average). In order to take advantage of inpatient rehab, a person must meet these criteria:

  • The client’s primary issue must be substance use-related.
  • Client must have reasonably-good physical and mental health, with no acute injuries or conditions.
  • An assessment must deem the client suitable for residential treatment services.
  • Client is not experiencing severe withdrawal.
    • Those in withdrawal would need a medical assessment and likely detoxification, in a hospital or in a sub-acute (non-hospital) setting.

Inpatient/Residential rehab clients tend to have trouble getting or staying substance-free consistently. Many experience significant negative consequences in several aspects of their lives (e.g. work-related issues, family problems, legal issues, medical problems).

This is not a rehab option for everyone. Candidates for residential rehab must respond positively to a structured alcohol and drug-free setting. However, if they’re coping with a living environment that is dangerous doesn’t support abstinence from substances, residential structure helps immensely!

If the inpatient rehab program is state-licensed and accredited by a respected agency such as CARF (the Commission on Accreditation of Rehabilitation Facilities), then its structure will support & guide these clients toward freedom.

These aren’t just paper promises. You work with licensed, accredited treatment centers staff experts trained in SUD (Substance Use Disorder) the whole time. They know what recovery means, how to achieve it, and how to respond if a crisis occurs.


“What about COVID?”

Inpatient rehab is an essential medical need. As such, it’s safe to proceed with this treatment program.

While you are staying in relative proximity to a group of people:

  • It’s the same group.
  • Comings & goings are limited.
  • Protective equipment is on-hand.
  • Facilities are cleaned & sanitized regularly.


Outpatient Rehab – Staying at Home, or with a Loved One

Outpatient is a good choice for clients who have completed a more intensive level of care or who are somewhat stable. They can live in a safe environment, and don’t require 24-hour monitoring. During outpatient treatment, clients attend a combination of groups and individual sessions at a rehab facility several times per week, but they do not live on-site.

The client lives at their home, the home of a loved one or friend, or another safe facility. Many of Support System’s outpatient clients live in one of the company’s sober living homes and attend groups after work.

Outpatient programs are convenient for those who want to work and/or go to school, as the hours can be flexible, and groups often take place in the evening.

If outpatient sounds like the rehab choice for you, pay attention to the following admissions criteria. Most treatment centers require you to meet them before you’re admissible to an outpatient program:

  • Client must have an assessment indicating they have a substance use disorder as their primary condition.
  • Client cannot be in acute withdrawal or in need of medical stabilization.
  • Client does not have acute medical, emotional or behavioral conditions that will interfere with treatment.
  • Client has a stable drug-free living environment, or is working toward achieving a stable environment.


When Deciding on a Treatment Option (Inpatient or Outpatient), Ask These Questions

If you’re looking for treatment for yourself or a loved one, use these questions to help you identify the best fit.

  • Confirm the treatment program is, at minimum, state licensed. In California, you can do this at the Department of Health Services.
  • See if the program is accredited. This is often listed on the center’s website, but it’s always good to confirm at the source.
  • Review the admission criteria for the programs that interest you. These can often be found on the treatment program’s website, but if not, you can call to discuss this with them.
  • Inquire about the specific program structure for each level of care – hours and days of service, number of groups and individual sessions, expectations, and rules. This can vary quite a bit from program to program.
  • Does the treatment center have a clear COVID or pandemic response?
    • Do all of their facilities follow the same guidelines?
  • Ask what criteria the program uses to determine program completion.
  • Are the program’s counselors certified (or licensed professionals)? It’s important for legal reasons…and for your future!

We’ll share more about other types of rehab (such as day treatment) in future blog posts. If you’re in the San Jose area, all of our rehab services are available to you.

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