Exploring the Intensive Outpatient Program at Alta Mira: An Interview with Susan Montana

Leaving residential treatment can be a time of tremendous joy, accomplishment, and the beginning of a new life. However, it can also be a time of trepidation and vulnerability as you seek to forge a new path free from addiction. The Intensive Outpatient Program (IOP) at Alta Mira seeks to bridge the gap between residential addiction treatment and full reimmersion in independent life, through tailored support for people in specific stages of recovery. IOPs can provide the guidance, structure, and nurturing essential for easing the transition while maintaining sobriety.

Recently I had the opportunity to speak with Susan Montana, Alta Mira’s Executive Director of Outpatient Programs, about the challenges addicts and families encounter upon the completion of residential treatment, and how IOP can be a vital component of recovery.

The Next Step In Recovery

Alta Mira’s IOP is an 8-week program that clients attend three to four days per week for the first four weeks, and three days per week for the remaining four weeks. Alta Mira offers both day and evening programs to accommodate varying schedules. Clients take part in both individual therapy sessions and process groups, along with holistic therapies, skill-building workshops, and family support sessions to address the full range of emotional, social, and behavioral needs for maintaining sobriety and psychological well-being.

IOP is comprised of clients who—for many of them—are experiencing the most consistent, extensive level of clean time that they’ve had, sometimes since they first started using. They’re going to be living much more independently, whether it’s a sober living environment or they’re returning home to family, and so there’s not that structured, every-hour-accounted-for kind of safety net. Now it’s about them structuring their time around being clean and sober.

Residential care has created a strong base for sobriety, but now it’s time to integrate the insights and skills learned in early recovery into everyday life. And that can pose special challenges, both practically and emotionally. Having the support of clinicians and peers who understand this piece of recovery is vital for guarding against relapse at a time of heightened vulnerability and intense personal growth.

This is a very unique stage in the recovery process. It’s a whole new learning process of how you handle yourself, how you set up structure, how you develop a support network, and learning how to experience feelings that aren’t all positive, and not turn to substances to obliterate yourself. If you think about that, that’s pretty huge. We do a minimum of 2 process groups a week, where clients have the opportunity to really be honest about all of that—the struggles they’re having, shame, guilt, frustration, mourning their addiction—which is a big reality that people often don’t talk about, because they think they’re not supposed to. They can do that in this environment where other people understand this stage of recovery and we can address it, acknowledge it, and in some ways show respect for that, and then identify ways in which to handle it that don’t lead to relapse.

The curriculum is thoughtfully designed to create a safe environment for people in early recovery to take the next steps in their journey. Emotional, spiritual, and physical healing practices are chosen both to strengthen each client’s sense of well-being and to avoid potential triggers that can interfere with the recovery process.

We approach the curriculum holistically. We have a woman teaching 12-step recovery yoga who is in recovery herself, working with clients to bring yoga in alignment with the principles of 12-step recovery. A common practice in yoga is breathing through one nostril to inhale and breathing out through the other. She said ‘I don’t do that at this stage of recovery because it can be triggering for somebody who was snorting opiates or amphetamines.’ So it’s nuances like that that we’re paying attention to, and really making sure that the treatment we’re providing meets the clients where their needs are at right now.

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Supporting Families

Completion of residential treatment does not only present a unique time for recovering addicts, but also for their families, as fears, anxieties, and protective instincts heighten.

During residential care, families are so relieved that the client is in a safe place and is starting to receive treatment. When their loved one leaves residential care, the family members’ concerns and anxieties escalate. Not because they anticipate that they’re going to relapse, but because they no longer have that safety net.

To deal with these anxieties, many family members step up their efforts to ensure their loved one’s sobriety. “It comes from love and care and concern, but a lot of times, especially clients who are in their 20s and early 30s are saying, ‘If my mother doesn’t stop sending me clippings of different ways to recover…’” For many families, particularly parents, learning how to relate to their newly-sober loved one requires recognizing their own limits, needs, and role within recovery—and our IOP’s family support services can be instrumental in creating these healthy, positive family structures.

There is a point at which they need to realize that they cannot do this for their loved one. They can put them in treatment, but recovery is something that they can’t do for them—and that can be a horrible, helpless feeling. What they can do is recognize where they have power and where they don’t, where they have control and where they don’t, and where they can take care of themselves in this process. We work with families to help them understand how taking care of themselves is really going to be most helpful for the process.

Toward Lasting Wellness

The focus of IOP is not only on the immediate needs of people in recovery, but on laying a foundation for sobriety after the program has ended, by connecting clients with support services in the communities to which they will be returning. Aftercare planning is woven into the program to ensure continuation of care, to strengthen support networks, and to create a vision for sustained, ongoing recovery.

A huge part of addiction involves isolation, so we strongly encourage establishing social connections through modeling in the groups as well as establishing support networks in their personal lives through 12-step meetings or other community meetings. When there’s a co-occurring disorder, which is the case for most of our clients, we make sure that they have ongoing individual therapy scheduled with their therapist in the community; and when they are on any kind of medication, that the relationship with the psychiatrist who’s prescribing is set up and maintained.

Alta Mira itself is expanding its aftercare services to act as an ongoing resource in the healing journey. Both program alumni and recovering addicts in the community are now able to participate in a weekly aftercare group at Alta Mira, allowing them to explore struggles, challenges, and successes with others who share in the recovery experience. The group serves as a critical part of IOP’s growing programming to help clients achieve their goals.

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Making the Transition

If you are coming out of residential care, IOP can be an integral part of the transition back to everyday life for both you and your family. The innovative program at Alta Mira offers you the therapies and support you need within a caring, compassionate community of clinicians and peers who understand this crucial stage of recovery and allow you to taper care at a pace that is right for you. With treatments designed for this unique stage of recovery, you can optimize your chances of success and build a healthier, more joyful future free from addiction.

The journey through the developmental process of recovery calls for courage, hope, trust, dedication, and support. IOP treatment is an integral part of this journey.

Alta Mira offers a full range of residential and intensive outpatient services for people struggling with addiction as well as co-occurring mental health disorders. Contact us for more information about how we can help you or your loved one on the journey towards recovery.