WORKSHOP: Intensive Outpatient Treatment (IOP) for Mental Health and Substance Use Disorders: Evidence and Clinical Implications

Evaluate the session

Presenting Author(s): Dr. Avi Aulakh, MD, FRCPC, DABAM, DRCPSC, Dr. Lovneet Hayer, MD FRCPC, DRCPSC , Dr. Mohit Singh, MD, FRCPC, DABAM

Date and time: 20 Mar 2026 from 14:30 to 15:15

Location: Mount Temple Ballroom A/B  

Learning Objectives:

1. Summarize the evidence base supporting IOPs for substance use disorders and co-occurring mental health conditions; including relative effectiveness compared with inpatient/residential treatment; 
2. Identify key clinical and system-level advantages and limitations of IOPS (e.g., flexibility, community- integration, resource use, patient suitability, need for standardization); and
3. Outline a practical framework for implementing IOP services, including patient selection, program structure (intensity, modalities, aftercare), and integration with pharmacotherapy (when indicated) to optimize outcomes. 

Abstract

Intensive Outpatient Programs (IOPs) provide structured, non-residential treatment for individuals with mental health and substance use disorders (SUDs), typically delivering multiple therapeutic sessions per week while patients live in the community. IOPs occupy a critical intermediate level of care between standard outpatient services and inpatient/residential treatment, yet remain under-utilized in many systems. 

Evidence suggests that IOPS can produce clinically meaningful reductions in substance use and psychiatric symptoms, with outcomes comparable to inpatient/residential treatment for many patients who are medically and psychiatrically stable. A review by McCarty et al. (2014) found equivalent reductions in substance use between IOPs and inpatient/residential modalities, noting a high level of evidence in support of IOP models. More recently, Watkins et al. (2022) demonstrated significant reductions in substance use, PTSD, and depression symptoms in an integrated IOP for comorbid mental health and SUD populations. Virtual and hybrid IOPs have also shown promising outcomes and engagement rates in post-pandemic delivery models (Contreras-Schwartz et al., 2024). 

Advantages of IOPS include lower cost, reduced disruption to employment and family life, opportunities to practice coping skills in naturalistic environments, and utility as both step-up and step-down care in a stepped-care continuum. Key limitations include heterogeneity in program design, variable access to pharmacotherapy, and limited implementation in publicly funded systems. 

Given rising demand for addiction and mental health services in Alberta and constrained residential capacity, IOPs offer an evidence-supported modality that may enhance access, continuity of care, and recovery outcomes. Further work is needed to standardize models, identify optimal patient selection, and integrate IOPs within system planning frameworks. 

Literature References

1. Contreras-Schwartz J, O'Neill C, Threlkeld A, O'Callaghan E, Winsberg M. Patient Engagement in Providing Telehealth SUD IOP Treatment: A Retrospective Cohort Study. Healthcare (Basel). 2024 Dec 18;12(24):2554. doi: 10.3390/healthcare12242554. PMID: 39765981; PMCID: PMC11675410. 
2. Watkins, L. E., Patton, S. C., Drexler, K., Rauch, S. A. M., & Rothbaum, B. O. (2022). Clinical effectiveness of an intensive outpatient program for integrated treatment of comorbid substance abuse and mental health disorders. Cognitive and Behavioral Practice, 30(3), 354-366. https://doi.org/10.1016/j.cbpra.2022.05.005 
3. McCarty D, Braude L, Lyman DR, Dougherty RH, Daniels AS, Ghose SS, Delphin-Rittmon ME. Substance abuse intensive outpatient programs: assessing the evidence. Psychiatr Serv. 2014 Jun 1;65(6):718-26. doi: 10.1176/appi.ps.201300249. PMID: 24445620; PMCID: PMC4152944.