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"Intensive outpatient program"

Edward A Wise, David L Streiner, Robert J Gallop
Research on routine outcome monitoring in psychotherapy settings is plentiful but not without implementation obstacles. In fact, there is a relative dearth of real-time outcome monitoring in substance use treatment settings. Numerous barriers to the development and implementation of clinical decision support tools and outcome monitoring of substance use patients, including the need to establish expected trajectories of change and use of reliable change indices have been identified (Goodman, McKay, & DePhilippis, 2013 )...
June 7, 2017: Substance Use & Misuse
Laura Meyers, Emily K Voller, Ethan B McCallum, Paul Thuras, Sandra Shallcross, Tina Velasquez, Laura Meis
Rates of comorbidity between borderline personality disorder and posttraumatic stress disorder (PTSD) are high in veteran populations, and clinicians are hesitant to treat PTSD given high rates of suicidality. Given promising early work integrating dialectical behavior therapy (DBT) and prolonged exposure (PE) therapy, we created a 12-week intensive outpatient program combining these two treatments. PE and DBT were provided concurrently to 33 veterans with PTSD symptoms and BPD symptoms at a large, midwestern Veteran Affairs medical center...
March 22, 2017: Journal of Traumatic Stress
Catherine C Classen, Robert T Muller, Nigel P Field, Carrie S Clark, Eva-Marie Stern
The impact of chronic trauma can be longstanding, affecting survivor affect regulation, consciousness, interpersonal functioning, perceptions of self and others, self-regulation, and somatic experience. There is a growing consensus that multimodal and staged approaches to treatment are necessary to promote healing. However, empirical investigations of such treatments are still needed. The current study used a naturalistic design to examine the impact of a brief, yet intensive, outpatient program on complex PTSD symptoms and attachment classification among women with histories of chronic trauma...
February 1, 2017: Journal of Trauma & Dissociation
Steven J Krause, Mark J Stillman, Deborah E Tepper, Deborah Zajac
OBJECTIVE: To evaluate the efficacy of an intensive outpatient program designed to improve functioning and reduce psychological impairment in chronic headache patients. BACKGROUND: Chronic headaches, occurring 15 or more days per month, for three or more months, may arise from multiple International Classification of Headache Disorders diagnoses: Chronic Migraine, Chronic Tension Type Headache, New Daily Persistent Headache, Chronic Post Traumatic Headaches, and Medication Overuse Headache...
March 2017: Headache
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
February 1, 2017: JAMA Internal Medicine
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
January 2017: Contemporary Clinical Trials
(no author information available yet)
This final rule modifies the TRICARE regulation to reduce administrative barriers to access to mental health benefit coverage and to improve access to substance use disorder (SUD) treatment for TRICARE beneficiaries, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and governing laws. This rule seeks to eliminate unnecessary quantitative and non-quantitative treatment limitations on SUD and mental health benefit coverage and align beneficiary cost-sharing for mental health and SUD benefits with those applicable to medical/surgical benefits, expand covered mental health and SUD treatment under TRICARE to include coverage of intensive outpatient programs and treatment of opioid use disorder and to streamline the requirements for mental health and SUD institutional providers to become TRICARE authorized providers, and to develop TRICARE reimbursement methodologies for newly recognized mental health and SUD intensive outpatient programs and opioid treatment programs...
September 2, 2016: Federal Register
Eric M Schmidt, Shalini Gupta, Thomas Bowe, Laura S Ellerbe, Tyler E Phelps, John W Finney, Steven M Asch, Keith Humphreys, Jodie Trafton, Megan Vanneman, Alex H S Harris
BACKGROUND: Measures of substance use disorder (SUD) treatment quality are essential tools for performance improvement. The Veterans Health Administration (VHA) developed a measure of access to and engagement in intensive outpatient programs (IOPs) for SUD. However, predictive validity, or associations between this measure and treatment outcomes, has not been examined. METHODS: Data on veterans with SUD came from 3 samples: the Outcomes Monitoring Project (N = 5436), a national evaluation of VHA mental health services (N = 339,887), and patients receiving detoxification services (N = 23,572)...
July 19, 2016: Substance Abuse
Christina Gezelius, Björn Wahlund, Lars Carlsson, Britt Wiberg
PURPOSE: The main aim of this clinical study was to explore how adolescent patients with eating disorders and their parents report their perceived self-image, using Structural Analysis of Social Behavior (SASB), before and after treatment at an intensive outpatient program. Another aim was to relate the self-image of the young patients to the outcome measures body mass index (BMI) and Children's Global Assessment Scale (C-GAS) score. METHODS: A total of 93 individuals (32 adolescents, 34 mothers, and 27 fathers) completed the SASB self-report questionnaire before and after family-based treatment combined with an individual approach at a child and youth psychiatry day care unit...
December 2016: Eating and Weight Disorders: EWD
Jessica Y Breland, Steven M Asch, Cindie Slightam, Ava Wong, Donna M Zulman
BACKGROUND: Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). METHODS: In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH...
March 2016: Healthcare
Cara Freudenberg, Rebecca A Jones, Genvieve Livingston, Virginia Goetsch, Angela Schaffner, Linda Buchanan
The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups...
May 2016: Eating Disorders
N Derakhshanrad, F Vosoughi, M S Yekaninejad, P Moshayedi, H Saberi
STUDY DESIGN: Prospective study. OBJECTIVES: The objective of this study was to determine whether an integrated and an intensive outpatient program would result in functional improvement of spinal cord injury (SCI) patients with American Spinal Injury Association Impairment Scale (AIS) A injuries as measured by the Spinal Cord Independence Measure (SCIM III). SETTING: Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Repair Research Centre (BASIR), Tehran, Iran...
December 2015: Spinal Cord
James R McKay, Michelle L Drapkin, Deborah H A Van Horn, Kevin G Lynch, David W Oslin, Dominick DePhilippis, Megan Ivey, John S Cacciola
OBJECTIVE: To evaluate the effect of providing choice of treatment alternatives to patients who fail to engage in or drop out of intensive outpatient programs (IOPs) for substance dependence. METHOD: Alcohol- and/or cocaine-dependent patients (N = 500) participated in a sequential, multiple-assignment, randomized trial (SMART). Those who failed to engage in an IOP at Week 2 (N = 189) or who dropped out after engagement (N = 84) were randomized for motivational-interviewing (MI) telephone calls that focused on engagement in an IOP (MI-IOP) or provided a choice of IOP type or 3 treatment options (MI-PC, or patient choice)...
December 2015: Journal of Consulting and Clinical Psychology
Jennifer A Y Johnston, Jesine S X O'Gara, Stuart L Koman, Christina Wood Baker, Drew A Anderson
OBJECTIVE: The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training. METHOD: Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals. RESULTS: Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology...
June 2015: Journal of Clinical Psychology
Tabatha H Blount, Ann-Louise T Lockhart, Rocio V Garcia, Jeslina J Raj, Alan L Peterson
Recent randomized clinical trials have established the efficacy of Comprehensive Behavioral Intervention for Tics (CBIT) in treating children and adults with Tourette syndrome and persistent tic disorders. However, the standard CBIT protocol uses a weekly outpatient treatment format (i.e., 8 sessions over 10 wk), which may be inconvenient or impractical for some patients, particularly patients, who are required to travel long distances in order to receive care. In contrast, an intensive outpatient program may increase accessibility to evidence-based behavioral treatments for Tourette syndrome and other persistent tic disorders by eliminating the necessity of repeated travel...
October 16, 2014: World Journal of Clinical Cases
Zev Schuman-Olivier, Roger D Weiss, Bettina B Hoeppner, Jacob Borodovsky, Mark J Albanese
Emerging adults (18-25 years old) are often poorly retained in substance use disorder treatment. Office-based buprenorphine often enhances treatment retention among people with opioid dependence. In this study, we examined the records of a collaborative care buprenorphine treatment program to compare the treatment retention rates of emerging adults versus older adults. Subjects were 294 adults, 71 (24%) aged 18-25, followed in treatment with buprenorphine, nurse care management, and an intensive outpatient program followed by weekly psychosocial treatment...
September 2014: Journal of Substance Abuse Treatment
Audrey Petit, Ghislaine Roche-Leboucher, Luc Bontoux, Valérie Dubus, Yohann Ronzi, Yves Roquelaure, Isabelle Richard
BACKGROUND: Chronic low back pain (cLBP) is a significant public health problem, being the primary cause of work absenteeism, as well as affecting sufferers' quality of life, in industrialized society. International guidelines recommend intensive multidisciplinary approaches for patients with cLBP. However, these costly and time-consuming programs can only be offered to a minority of the most heavily affected patients and therefore do not seem likely to respond to public health requirements...
April 16, 2014: BMC Musculoskeletal Disorders
Dennis McCarty, Lisa Braude, D Russell Lyman, Richard H Dougherty, Allen S Daniels, Sushmita Shoma Ghose, Miriam E Delphin-Rittmon
OBJECTIVE: Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This review assessed the evidence base for IOPs. METHODS: Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, ERIC, and CINAHL...
June 1, 2014: Psychiatric Services: a Journal of the American Psychiatric Association
James R McKay, Deborah H A Van Horn, Kevin G Lynch, Megan Ivey, Mark S Cary, Michelle Drapkin, Donna Coviello
The goal of this study was to determine which cocaine dependent patients engaged in an intensive outpatient program (IOP) were most likely to benefit from extended continuing care (24 months). Participants (N=321) were randomized to: IOP treatment as usual (TAU), TAU plus Telephone Monitoring and Counseling (TMC), or TAU plus TMC plus incentives for session attendance (TMC+). Potential moderators examined were gender, stay in a controlled environment prior to IOP, number of prior drug treatments, and seven measures of progress toward IOP goals...
March 2014: Addictive Behaviors
Richard H Dougherty, D Russell Lyman, Preethy George, Sushmita Shoma Ghose, Allen S Daniels, Miriam E Delphin-Rittmon
The current policy environment provides the opportunity for federal and state agencies to work with private and nonprofit sectors to transform the American health care system through development of a comprehensive set of community-based, recovery-oriented, and evidence-based services for people with mental and substance use disorders. This Assessing the Evidence Base Series (AEB Series) provides science-supported information about selected mental health and substance abuse services for health care leaders. Series authors conducted reviews of research on 14 behavioral health services: behavioral management for children and adolescents, trauma-focused cognitive-behavioral therapy for children and adolescents, recovery housing, residential treatment for individuals with substance use disorders, peer support services for individuals with serious mental illnesses, peer recovery support for individuals with substance use disorders, permanent supportive housing, supported employment, substance abuse intensive outpatient programs, skill building, intensive case management, consumer and family psychoeducation, medication-assisted treatment with methadone, and medication-assisted treatment with buprenorphine...
January 1, 2014: Psychiatric Services: a Journal of the American Psychiatric Association
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