In recent years there has been a proliferation of Intensive Outpatient Programs (IOPs). Traditionally, IOPs consist of attending 4-8 hours a day at a treatment facility with other individuals that are not severe enough to require hospitalization or a residential treatment facility.  Most IOPs will have individuals who have diagnoses ranging from mood, personality, anxiety and obsessive-compulsive disorders in the same program, with individuals having a range of ages and life experiences. A typical day may include several group sessions, physical experiences such as Pilates, meditation and stress management.  On a weekly basis several individual sessions are common, supplemented by multiple daily group sessions, as well as outings with other clients to the beach, shopping or unique events like equine therapy.

IOPs can be very effective, as they have a large number of staff to assist with their client and often have well-developed structures and plans.  However, they can be time intensive (usually 30-90 days), costly (while insurance can help cover costs at some facilities, $500 to $2,000 a day is not uncommon), and are predicated on the use of group formats (most IOPs have 1-3 individual sessions per week, the remainder of the work being done in groups). IOPs are excellent is certain situations and we refer to them not infrequently for those with personality disorders, people who could benefit by being in group settings, and as a step down for those coming from a hospital or partial hospitalization programs.

After speaking with families and other professionals over the past two decades, we’ve come to realize that a large number of individuals were falling through the cracks: those who need more treatment than a few times a week, but those whose needs aren’t well served in a tradition Intensive Outpatient Format. Based on this feedback, the OC Anxiety Center has been developing a new approach: a Personalized Individual Outpatient Program (P-IOP).  Its focus is to assist an individual complete treatment in one to four weeks by utilizing multiple providers for multiple hours per day.

This individualized intensive format is predicated on treatment protocols first investigated in the 1990’s and 2000’s on Panic Disorder and Agoraphobia with Drs. David Barlow and David Spiegel at the Center for Anxiety and Related Disorders at Boston University.  Dr. Hsia was involved in this research and became in charge of the intensive programs for specific phobias and panic disorder during his time there as a post-doctoral fellow, first learning about the protocol, then applying it clinically, and finally teaching it to others and engaging in research based on the results.

So, what happens in a P-IOP?

• Phone screen: We want to ensure as much as possible that our program is a good fit for the individual and family. If we believe the person can be better served in a different milieu, we are connected with other programs throughout the nation.
• Assessment: Each person who comes to our center has a thorough 2-3 hours assessment after filling out ~30 minutes of self-report forms via our patient portal. When we have minors, the parent(s) are also interviewed.  Based on the results of the assessment, we will not only have diagnoses established, but enough detailed information to construct a treatment plan, which is then given to the individual or family and discussed.
• Treatment: We begin with psychoeducation and quickly move into helping a person understand their brain and body’s response to feared situations, normalizing physical and emotional responses, identifying and challenging nonlogical thinking, and finally facing fears. As this program is highly individualized, the amount of time per day and number of days of week can be personalized based on the needs of each person.
• Follow-up: We will continue to provide support for each person graduating from our program to ensure the best outcome and maintenance of their gains.

Who is the P-IOP for?

• People who having a limited amount of time. We have worked with:
  • Executives who need to address an issue before a specific event
  • High school and college students on Winter or Spring Break
  • Individuals who are ‘stepping down’ from a hospital or PHP setting
  • Individuals who fly in who cannot fly services in their local area
  • Locals who are on disability but need to get back to work quickly
• We can treat a number of disorders in this manner, from OCD, Specific Phobias to Panic Disorder and Separation Anxiety. Please contact us to assess if it’s a good fit for your situation.

When is not advisable to consider a P-IOP?

Intensive programs are not for everyone or for every situation.  People entering our P-IOP have to be ready do work hard, not only in session but daily at home as there are assignments given after each session.  For children, their families also have to be willing and able to give of their time in the evenings too, for their own readings and to assist in homework for their child. The assumption is that during the time of the P-IOP, the primary focus in their life will be the program.  If there are multiple life stressors or diagnoses that complicate the situation, it may also be advisable to consider other options as well.

We are excited to offer this program and ff you have any questions about the P-IOP, please call Dr. Hsia directly at 949-689-5892 or email him at hsia@ocanxietycenter.com.