Key Components for Intensive Outpatient Program Retention

Behavioral health providers are needed more than ever today and are continually looking for treatment options to support their patients. Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) are being considered more often as these programs bridge the gap between outpatient services and inpatient care, many times working well for individuals who don’t require around-the-clock support. Participants can continue their daily life and live at home, yet still receive intensive therapy. 

Typical IOPs provide between 9 to 12 hours of therapy per week and often include a mix of group, individual and family therapy. PHPs provide more intense daily care (25 to 30 hours per week), medication management and educational support and patients also return home at night.  Individuals might join an IOP or PHP due to difficulty coping with a life crisis or difficulty with self-care and daily life activities due to depression or anxiety. These programs can also be beneficial for patients transitioning back to their communities after inpatient behavioral health care. 

Treatment models like these offer more access to mental health support, but have some nuances for providers to consider related to maintaining engagement and helping patients reach treatment completion.

The importance of patient retention

Patient retention and engagement is key to making these programs successful. Dropout rates can be high, with national averages ranging from 30-50% in the first three weeks. For adolescents, that number is even higher, with 70% leaving treatment early. Encouraging consistent participation is another core element to reaching positive clinical outcomes. On the patient side, completing treatment lowers the risk of relapse. On the provider side, strong retention translates to more consistent caseloads, better allocation of resources and stronger financial results. 

Key factors contributing to dropout 

Individuals often leave treatment before completing programs for various reasons. In some cases, people leave due to treatment-related challenges. Examples of this are misalignments between the program and the patient’s expectations.

The inability to take time off work or school is another factor that can impact retention rates.  Because these programs allow individuals to continue their daily lives while in treatment, it requires significant upfront planning to take time off from work or school. Having family and friends to help is invaluable for short-and long-term success during intensive outpatient programs.

And while mental health has made great strides, a stigma remains. According to the American Psychological Association, 85% of adults still think the term “mental health”carries a stigma. 35% admit they’d think differently of someone who has a mental health condition. 

To build IOP/PHP programs that succeed, below are practical strategies that address these challenges.

Build a strong engagement foundation

Providing a welcoming environment during the intake and onboarding process is critical for patient retention. It sets the tone for the program and offers a supportive environment for those seeking treatment. 

Some best practices to sustain engagement throughout these programs is to outline clear goals, structure and expectations from the outset. Introducing staff and peers right away will build trust and foster comfort and belonging. When patients understand what to expect and how the program works, they’re more likely to feel invested. It’s important that providers prioritize informing patients of available resources and the elements of the IOP/PHP support systems. A strong start with clear communication from the beginning will enhance buy-in and motivation to complete the program.

Emphasize integrated, personalized care

Because individuals all have different goals for their success, providers must work with patients to create individual plans highly tailored to their needs. Everyone needs a different mix of therapy, and IOPs/PHPs offer family, individual, peer support, and more that can help lead them to positive outcomes. Ensuring the plan tracks specific, measurable goals will provide accountability and empower patients to take part in their recovery. With nothing to work towards, patients can lose sight of the end goal and drop out.

Supporting ongoing engagement with consistency and predictability 

Even entering IOP/PHP programs can be difficult for many, and consistent schedules and routines are critical components to helping patients integrate therapy into their lives. Holding sessions at the same time throughout the entire treatment period helps individuals organize their days to meet the required program elements. This is especially important with IOPs/PHPs since patients are incorporating them into their daily lives on top of their routine responsibilities.  

Integrate technology 

Streamlining and automating program components with an EHR can positively enhance the overall experience. EHR functionality helps patients stay organized with automated appointment reminders and a portal with care dashboards that provide clear feedback on improvement and progress tracking. All of these strengthen engagement and build confidence.

Providers that leverage the data an EHR generates identify disengaged patients, alerting them to connect and provide proactive support. Combining technology with the human element helps set up patients in IOP and PHP programs for positive outcomes.

Patient engagement is the key to achieving real, lasting improvement and success. Building strong relationships that foster trust encourages meaningful progress that leads to better outcomes. Combining these protocols with the efficiency of technology can create a more stable environment that greatly enhances the chance for a patient to complete treatment.

Photo: z_wei, Getty Images

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