Help advice for intensive outpatient program?

[orangecrush]

well, i finally worked up the courage to call the hospital and book myself in to an intensive outpatient program. the person who helped me was so sweet, i feel bad because as soon as she asked about my suicidal ideation i broke down crying and was basically incomprehensible, she had to ask me so many times to repeat what i was saying

up until this point i was so scared about it and doubting it, but now that it's all scheduled i feel like a weight has been lifted off my shoulders. unfortunately i couldn't get in anytime soon but i'll start before my ctb date. at least i'm trying to get better.

the program is 4 weeks, 5 days a week, for 8 hours a day. which sounds very overwhelming to me.

does anyone have any advice/stories about going through a program like this? how can i make the most of it?

 

[gattara]

recently when i went to intensive outpatient i usually made my own food because mine was at a hospital and the hospital food sucked really bad. getting to have a nice homemade lunch every day really took the edge off. even if it's just a sandwich. i would just find some easy things to make it easier. at the beginning i brought a big blanket with me because it was cold or even a stuffed animal. overall i didnt find the program helpful beyond giving me some much-needed socialization. at the beginning my outpatient group was mostly women which i found more comfortable than when a large influx of men started coming in. they began monopolizing group therapy sessions. most men there were respectful of me, but as a younger women i felt uncomfortable with the way one of the older men there was staring at me and once he sat next to me in an open room where there were plenty of other spots he could sit in, i became really uncomfortable with the program. i didnt feel comfortable speaking freely about my problems anymore. i talked about this with my therapist and they said they would talk to him and make boundaries clear but ultimately i stopped attending the group. i guess im sensitive to these things because ive been harassed before and felt like it was starting. i didnt feel like my therapist was taking me seriously even though she was also a younger woman. one of my acquitances there also told me that a clique was beginning to form while i was absent. idk all sorts of weird dynamics can occur in these groups. the only one i ever attended that i found actually helpful was when i went to eating disorder outpatient. i really enjoyed playing trivia games there though. i think if going to outpatient even has a shot of helping you, its worth trying. ive been to good ones and bad ones and ones that are just okay.

 

[bagel12]

it's huge that you worked up the courage to call and get help! :)

i havent done an iop but a few of my friends have. there's a lot of variation when it comes to iops, so it's hard to give specific advice. from my perspective, iops helped my friends deal with things better. like there were things that made them really upset before, but after the program, they dealt with these stressors better. overall i'd say iops helped them be more functional and "get their shit together" if that makes sense.

to feel more prepared, it might help to learn more about the modalities they'll use or the populations the program is intended for.

it is important to start out with an open mind, practice the skills you learn, be open to listening to others in the group, and sharing if you feel comfortable doing so. if you feel like something isn't working well for you, or if you want to adjust something, please communciate this the therapists (or the psychiatrist if your program has one). i remember one of my friends was transferred from one iop program to another because they had issues with the first one, but the second one seemed to help a lot.

 

[amnesia999]

Wow, 5 days a week, 8 hours per day really is intensive! I went to one of these during the summer of 2024, but it was only 3 days/week, 7 hours/day. They had me fill out reams of paperwork to get in the program. It was all lectures about various modes of treatment, i.e. CBT, DBT, art therapy, etc. as well as weekly visits with a psychiatrist and with a therapist. I took lots of notes. They gauged progress with these forms you had to fill out every week about how you were doing. Insurance paid for it all. Some of the people there had been hospitalized before being released to the outpatient program. Some were court-ordered to be there.

My main issue is bad anxiety, so talking about my problems to the group as a whole was difficult. On the other hand, they wanted you to sleep at night (insomnia was a common problem), so that's mainly what the psychiatrist was doing - prescribing medication to make people sleep.

Good luck, in my case it was mostly a bunch of lectures every day.

 

[orangecrush]

recently when i went to intensive outpatient i usually made my own food because mine was at a hospital and the hospital food sucked really bad. getting to have a nice homemade lunch every day really took the edge off. even if it's just a sandwich. i would just find some easy things to make it easier. at the beginning i brought a big blanket with me because it was cold or even a stuffed animal. overall i didnt find the program helpful beyond giving me some much-needed socialization. at the beginning my outpatient group was mostly women which i found more comfortable than when a large influx of men started coming in. they began monopolizing group therapy sessions. most men there were respectful of me, but as a younger women i felt uncomfortable with the way one of the older men there was staring at me and once he sat next to me in an open room where there were plenty of other spots he could sit in, i became really uncomfortable with the program. i didnt feel comfortable speaking freely about my problems anymore. i talked about this with my therapist and they said they would talk to him and make boundaries clear but ultimately i stopped attending the group. i guess im sensitive to these things because ive been harassed before and felt like it was starting. i didnt feel like my therapist was taking me seriously even though she was also a younger woman. one of my acquitances there also told me that a clique was beginning to form while i was absent. idk all sorts of weird dynamics can occur in these groups. the only one i ever attended that i found actually helpful was when i went to eating disorder outpatient. i really enjoyed playing trivia games there though. i think if going to outpatient even has a shot of helping you, its worth trying. ive been to good ones and bad ones and ones that are just okay.

thank you for taking the time to write and share your experience. i'm sorry that you went through that and that nobody took you seriously. i'm scared of that situation with older men happening to me too, and if it did i'd quit for sure. i'm already very distrustful of most people and so the second i start to feel uncomfortable i know i'd bail. the cliques and social aspect is something i didn't really think about but i already feel like a complete outcast in the rest of my life so i doubt it would effect me too bad

i'll be sure to bring my own food because it's also at the hospital. and i'll bring blankets and i have a little stuff animal to bring with me too. thanks for the advice!

i just want to believe that this can be a good thing for me because i'm so close to giving up. that phone call with the receptionist shook me into realizing i care more about living than i thought i did. just that one person listening to me and offering sympathy was enough to convince me to actually do something to take care of myself.

if you feel like something isn't working well for you, or if you want to adjust something, please communciate this the therapists (or the psychiatrist if your program has one). i remember one of my friends was transferred from one iop program to another because they had issues with the first one, but the second one seemed to help a lot.

that's a good thing to keep in mind! i thankfully have some other places near me so i could switch easily if i needed to.

My main issue is bad anxiety, so talking about my problems to the group as a whole was difficult. On the other hand, they wanted you to sleep at night (insomnia was a common problem), so that's mainly what the psychiatrist was doing - prescribing medication to make people sleep.

Good luck, in my case it was mostly a bunch of lectures every day.

i'd say my main issue is anxiety too, so i am pretty worried about group therapy, but they said they won't force me to participate so i feel okay. and yeah they said it's basically like being in a school environment which is kind of scary tbh. but at this point im just glad i have the opportunity to get help even if its scary.

 

[dragonofenvy]

the program is 4 weeks, 5 days a week, for 8 hours a day. which sounds very overwhelming to me.

Wow. The IOP where I'm at is 5 weeks, 4 days per week, for 3 hours. I'm currently attending PHP which is 3 weeks for 6.5 hours per day.

You will want to quit. Multiple patients at my PHP wanted to quit at many points. I've wanted to quit a few times, and have talked about it with the lead therapist. It is a natural feeling. If you ever feel that way, or anything makes you feel uncomfortable, make sure you talk to one of the program facilitators about it. If your needs are continuing to be unmet, talk to them again and see what your options are.

A lot of things in PHP I don't like. I don't like art as recreation, nor do I like mindfulness groups (I can only do it alone, I am uncomfortable closing my eyes around people), and I especially despise spirituality group since the chaplain is a terrible educator (it's not even spirituality, it's really basic concepts about self-worth and your values.) There's going to be things in there you don't like. That's okay. Keep trying them. There's been parts of the art group that I have enjoyed even though I'm typically not an art person.

Group therapy I've found particularly beneficial. The way ours is structured is that typically one or two members will take the time for the day, and then we will continue learning DBT skills (ie: radical acceptance) after they're done. It can feel as though people are hijacking the group at times. I know one woman in my group takes forever to explain concepts and is a very slow talker, while I'm the opposite - very blunt and to the point, and if I have difficulties articulating my thoughts I will immediately say so and drop the topic for later (I like to a long time intentionally thinking about a response, and sometimes I need hours). I consider it to be frustration tolerance. People have different ways of expressing themselves, and you're all there for a reason. Show others compassion, and they will show it to you. Remember, everyone there is going through something. Be patient, and try not to judge them too harshly. You wouldn't want them to be harsh to you right? In many ways I'm jealous of how that patient is able to describe her emotions while I have the stereotypical man responses. Both serve their own purposes and are equally valid. Other patients don't like to talk much but like to instead, listen. You don't have to be chatty if you don't want to. Listening is the most important part.

Be sure to actively participate. I've seen 2 patients so far who have been completely shut down, to the point of refusing to even sit in a chair when asked. They didn't last beyond the 3rd hour. That being said they're very tolerant. I've had panic attacks in group and managed them fine. I've had to leave group a few times due to anxiety attacks, once I even had to leave because my chest was tightening so badly that the therapist thought I was having a heart attack. They might do lab work and urine samples. Those can't be used against you legally so if you're on illegal drugs they can't use it as evidence in court. Otherwise, they're trying to look out for your physical health.

While attending be sure to cease use of any substances if you're using them. If you relapse, that's fine. I for one used daily for many years and relapsed after nearly 2 weeks of PHP. Reframe the thought into "I went from daily use to being able to abstain for 2 weeks. That's awesome!" The staff agreed with my statement.

PHP for me has been an overall positive experience even if my issues are are very complex. Being able to connect with the other patients has been great. I'm even in contact with one of the patients outside of it (you're not supposed to but c'mon we're adults sue us). That being said be careful with who you trust outside of it. I wouldn't recommend any irl meetups, at least not initially. Having a new friend who has severe mental illness can be damaging, that's why they tell you it's not recommended.

I wasn't a fan of the program mostly being lectures since I intellectualize a lot, so most of the stuff I know, but some things I didn't and were interesting and helpful. We did get to do some fun things, and it's the connected experience that helps the most. It has also put into perspective what issues I need to work on the most with my psychotherapist. They've given me a lot of resources, the question is whether or not I will put them to practice. Remember: It's all you. They can teach you as much as they want, but it's up to you to apply it.

If my text wall is too much there's just one thing you need to know: Participate. Be active. What you put into it is what you get out of it. If you have any other questions lmk but my text wall is big enough for now.

 

[gattara]

i just want to believe that this can be a good thing for me because i'm so close to giving up. that phone call with the receptionist shook me into realizing i care more about living than i thought i did. just that one person listening to me and offering sympathy was enough to convince me to actually do something to take care of myself.

i would follow that instinct. honestly just having the routine of going to the outpatient group every weekday for the couple months i was there helped me a lot. being around other people, getting out of the house. even though i had that one bad experience at the end, i wouldn't change my decision of going there. i really struggle with self-isolating behaviors and they contribute to my poor mood. idk if thats the case for you, but i really do think it can help to get that structure. let us know how it goes for you if you're up for it.