"Not that long ago, I was going through a super rough period in my life dealing with a terrible depressive episode and causing myself harm because I couldn’t deal with it all alone. Because of how worried my family and friends were, I ended up deciding it was time that I needed more help and support than I was receiving. My therapist told me about a Intensive Outpatient Program (IOP), where, for at least a month, I would have to go to more intense therapy sessions online that consisted not only of talk therapy.
Right when I started IOP, the world was entering into a period of utter chaos. People were stocking up on toilet paper like nobody’s business and glued to the news talking about the latest surge of COVID cases in the U.S. I couldn’t have chosen a better time to start intensive therapy. But due to quarantine restrictions, the program I decided to do made everything virtual. Like many other places, it was the first time the IOP program had ever been held virtually, so they were worried about how it would go and if it would be as effective. There were definitely pros and cons of it being held virtually. Read on to learn more about Intensive Outpatient Care and the lessons that I learned from my own experience.
What is the Intensive Outpatient Program (IOP)?
Before my therapist recommended IOP, I had absolutely no idea what it entailed. There are different types of IOP depending on individual needs. While it can look different to everyone or in different programs, it’s typically a short-term treatment, meaning more intensive focus than therapy sessions once or twice a week. IOP care is meant for anyone suffering from eating disorders, bipolar disorder, depression, self-harm, or chemical dependency. Doctors and therapists will recommend IOP to patients when they have been identified as needing a higher level of care in an outpatient setting. While most people spend 3-12 weeks in IOP treatment, it can be much more or less, depending on individual needs (my IOP program lasted for two months).
My experience doing IOP
During my IOP program, I did both group therapy and individual therapy, working on a combination of trauma therapy, Dialectical Behavioral Therapy (DBT), and relationship skills. For three days a week, I started with about an hour of individual therapy sessions (just me and my therapist), followed by three hours of group therapy. The first hour was dedicated to trauma therapy, which was about processing past difficult experiences (this one was the most difficult for me because it was so personal). The following hour focused on relationship skills, including discussing our attachment styles and how we show up in relationships. Lastly, the third session focused on DBT. DBT is meant to provide coping skills when someone is in emotional distress. DBT also hones in on the practice of mindfulness. I’m now able to turn to some of these skills whenever I feel emotionally triggered or upset.
While it sounds like a lot, I still had time to keep up with normal day-to-day activities, and doing it all online made it a little easier to fit into my days. Since it was online, I was still able to show up to classes, complete work, and keep up with outside clubs and activities at school. However, everyone is different and all patients should establish individual schedules that would work best with their lifestyle, needs, and program of choice.
How does it work when it’s all virtual?
Online IOP obviously worked a bit differently from how it would function in person. Everything was held via Zoom, with a moderator for extra safety. They wanted to make sure that no one besides group members and the therapist would go into the meeting. In the program I was in, people in person could usually choose their own therapy schedule that involved different groups of people. However, since it was online, we had to stick to the same schedule and have the same group members. Many programs had to cut a lot of the different types of therapy since not all therapists were comfortable switching to a completely virtual IOP.
One benefit of doing IOP online was having the freedom to still be at home with my family while I was going through intensive therapy. It was extremely helpful to have them around me during a difficult time. Another great thing was that I was in an environment where I felt comfortable. I don’t know about you, but my room is my safe haven. No matter what’s going on in my life, when I enter my own personal space, I feel calmer and less anxious. Intensive therapy can sometimes be draining and bring up a lot of difficult emotions, so it was nice to be in a familiar, comfortable place. It can also be difficult for me to express my feelings in a group setting, and the virtual option made group therapy a little bit easier for me to communicate without feeling intimidated.
But there were also challenges to the virtual setting. I get distracted easily, so sitting in front of a computer screen for four hours of total concentration was definitely difficult. It’s so tempting to scroll through Instagram or check my text messages instead of paying attention. But overall, I still feel as if I got as much as I could out of my experience with IOP despite it being done online.
What I learned from my experience
It’s powerful to be vulnerable
I am definitely someone who finds it difficult to share my emotions with other people. When I feel vulnerable, I tend to shut down and isolate myself. Although I was in talk therapy before, I still found it quite difficult to be completely open and honest with my therapist. I started IOP in a very vulnerable state; I had just gone through an intense breakup and was deeply depressed. The thought of having to talk to other people about what I was going through seemed terrifying. I just wanted other people to think that I was doing OK and pushing through it when really, I was suffering tremendously. During my time in IOP, we focused on how being vulnerable isn’t necessarily a bad thing.
Like Brené Brown says, vulnerability is an act of courage, not a weakness. It is so difficult to show and share with others what we’re really going through, but when we do it, it actually allows us to connect with others on a deeper level. When I opened up to my IOP group about my depression and past traumatic experiences, I learned that other people related to me and felt the same way. It made me feel heard and like I wasn’t alone in what I was going through. I’ve applied this practice in my own life too. I’ve started becoming more open and honest with my family and friends when I am struggling with something, and every single time it always has a positive outcome.
It’s OK to need help
I have always been a very independent person. I used to feel like a burden to other people if I ever asked for help. Although independence is good, we need support from others—it’s impossible to do everything alone. I was barely passing my classes, dealing with a breakup, and couldn’t get out of bed; yet I still thought I could do it all by myself. I thought I had to fix myself because I would look weak if I reached out for help. It was a huge decision for me to enter IOP.
A lot of it did have to do with my personal therapist saying that I needed it, but I also acknowledged that I wanted to get better but had no clue where to start. The first step to really getting better is finally accepting that you need help. Like me, you may have a lot of judgment around asking for help, but I promise you it’s worth it. People want to see you succeed and get better; you don’t have to deal with everything yourself. Although I still struggle with asking for help from others, I’ve realized that the benefits outweigh the challenges.
Accept the past and let it go
IOP brings up a lot of things from your past that you may not really want to relive. Sometimes during therapy, I would remember really painful memories that I had repressed for so long. There were times when it was really emotionally challenging to think of things that made me so upset, but talking through these past memories helps us acknowledge the hard times that we have endured in our past and be able to move on. Bad things may have happened in your past, but that doesn’t mean they should define your future.
One of the skills of DBT is radical acceptance, which means accepting things for how they are, even if it makes us feel uncomfortable. It’s a pretty hard skill to learn, especially since it sometimes feels impossible to accept some things we have been through. But there is so much power in letting go. We are getting rid of all the things that have been holding us back for so long. After talking through some of my most difficult memories, I was able to finally let go and get rid of so many negative emotions that I felt toward those particular experiences.
How to know if IOP is right for you
Before I started IOP, nothing was really working for me. I was in talk therapy, but it didn’t seem to be enough to process and heal from what I was going through. I knew that I needed more support than I was receiving. If you are experiencing severe depression, an eating disorder, addiction, or bipolar disorder and feel like you’re not getting the support you need, talk to your doctor or therapist about IOP options near you. You are not alone and people are here to help you.
National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)
Crisis Textline: text CONNECT to 741741