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When Is Intensive Outpatient Program (IOP) Needed
Everyone experiences times in their lives when it may be helpful to reach out for assistance from a mental health professional. Many are able to receive help and guidance on an outpatient basis by their primary care physicians, psychiatrists, nurse practitioners, psychologists and mental health therapists. When the symptoms become more debilitating, however, it will be important to consider a higher level of care.

Levels of Care In Mental Health

  • Outpatient Individual Therapy/Medication Management
  • Intensive Outpatient Therapy
  • Partial Hospitalization
  • Inpatient Hospitalization

Outpatient therapy is for those who are not in any danger to self, others or property and are more resilient as they seek to work on treatment goals. Frequency is typically weekly and is adjusted eventually to an as needed basis.  Partial hospitalization is for those who experience more serious signs and symptoms and need ongoing assessment, diagnostic and treatment services typically at a minimum of 20 hours/ five days per week and return home at night.   Inpatient hospitalization requires admission into a hospital 24/7 which includes ongoing nursing, medical, medication, assessment, diagnostic and treatment services for those in very serious need of avoiding jeopardy of health to self or others.

What I would like to emphasize is the Intensive Outpatient Program (IOP).     Intensive Outpatient Programs have been of tremendous assistance in helping its members return to a productive and rewarding lifestyle both on the job and in general.  It is a 7 week, 3 day per week, 3 hour per day program.  The main goal is to teach individuals healthy coping skills which will increase health and wellness rather than continue to struggle with daily functioning or to be placed on leave from work/school with no guidance or skills.   The latter often results in relapse of symptoms or minimal existence.  


Those Appropriate For IOP include

  • Visits  with  individual  outpatient  providers  exceeds  once  per  week  or  is  not currently effective
  • Multiple phone calls to outpatient providers
  • Stepping down from/needing to avoid partial or inpatient hospitalization
  • On leave or disability from work/school
  • Missing significant work or school days due to mental health/pain issues
  • Needing to have short or long term disability or FMLA forms completed
  • Need help coping with acute/chronic medical issues
  • Frequent anxiety/panic attacks
  • Moderate to severe depression
  • Social withdrawal/isolation
  • Inability to maintain healthy relationships
  • Significantly  decreased  activities  of  daily  living,  such  as  hygiene/cooking/ sleeping/ daily accomplishments, etc.
  • Self-harming/self-defeating behaviors
  • Suicide attempts or frequent suicidal ideation
  • Lacking  effective  coping  skills  to  regulate  emotions,  tolerate  distress  or  be effective interpersonally
  • Inability  to  maintain  sobriety  or  other  substance  related  legal  issues  (OVI, possession of drugs, trafficking drugs)

Be an Advocate for Appropriate Levels of Care

  • Seek consultation from a licensed mental health professional
  • Be diligent about complying with medication and therapy recommendations
  • Consider  short  term  disability  from  work/school  if  symptoms  are  seriously affecting performance
  • Don’t retreat to home, often under the covers, waiting and hoping to get better
  • Be proactive and discuss possible higher levels of care with healthcare or mental health professionals
  • Consider Intensive Outpatient Programs (IOP)

In conclusion, know the signs that you or someone you care about is struggling beyond that which can be effectively managed at the routine outpatient level of care. . Reach out and don’t suffer or watch others struggle in silence.  Know the effective levels of care in mental health. Know that there is effective help. There is hope!            

John A. Glovan, Psy.D.
Director, Health and Wellness Program

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The Behavioral Wellness Group is a counseling center providing therapy and behavioral health services and assessment including chemical dependency/drug addiction treatment, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and other therapies. We also provide mental health or psychological assessments, and psychological,educational and bariatric testing. Providing services to the following communities in Ashtabula, Cuyahoga, Geauga and Lake County: Cleveland, Ashtabula, Beachwood, Chardon, Concord, Eastlake, Euclid, Fairport, Geneva, Grand River, Highland Heights, Kirtland, Leroy, Lyndhurst, Madison, Mayfield, Mayfield Heights, Painesville, Pepper Pike, Perry, Russell, Solon, South Euclid, Thompson, Wickliffe, Willoughby, Willoughby Hills, and Willowick, from our offices in Mentor, Ohio.