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Ins and Outs of Outpatient Treatment

Mental health care exists in many forms, including outpatient care. During outpatient treatment, individuals receive a variety of mental health services within a clinical setting rather than being admitted to a residential treatment center or a hospital. Learn more about its benefits.
Ins and Outs of Outpatient Treatment
Monica Clayborn, LPC
Monica Clayborn brings nearly a decade of experience in the outpatient treatment setting as the new Director of Outpatient Services for the Sierra at Southlake satellite clinic. 

Learn more about Monica Clayborn, LPC

Scott Webb: Mental healthcare exists in many forms, including outpatient care. And during outpatient treatment, individuals receive a variety of mental health services within a clinical setting rather than being admitted to a residential treatment center or a hospital. Treatment plans in outpatients may range from short-term counseling to long-term treatment programs that are individualized to focus on the patient's specific struggles.

And here to help us better understand outpatient treatment it's benefits and how to access it is Monica Clayborne, Regional Director of Outpatient Services for the Sierra Tucson Group. This is let's talk mind, body spirit by Sierra Tucson, Sierra Tucson ranked number one best addiction treatment centers, 2021 in Arizona by Newsweek I'm Scott Webb.

Monica. So great to have you here today. Can't wait to dig into this topic. As we get rolling here. What is outpatient care?

Monica Clayborn: I want to dive in a little bit deeper into that term. So when you're accessing mental healthcare, it can be a bit confusing for the consumer and we live it on a day-to-day basis, being a clinician. And so I kind of want to dig deep into that because like I said, a lot of times, people that are calling in for services are a bit confused to rather what outpatient actually means and what services we provide. And so I want to address the levels of care within the behavioral health continuum.

And so when I review this with families, sometimes I have to break it down. And for those that are visual learners like myself, I like to break down the levels of care with that similar to the food pyramid. And so if you visualize that, at the top of the pyramid, you have, for the food pyramid, the sugars. And so typically, the sugar is something that you're not supposed to have an access and it's a little bit more restricted there. So when you look at the top of the triangle for the behavioral health continuum, you look at that being inpatient care. So inpatient care is your most restrictive treatment environment. You're not able to have a lot of your belongings. You're being evaluated 15 minutes at a time, making sure that you're safe within that environment.

And then you move down, right under that is residential treatment. So less restrictive environment, you're there about 30 to 60 days. Sometimes you can even be in a residential setting up to six months. And you have a little bit more freedom in that environment and that you have some more room to kind of be on your own. You're not being as monitored as you are in an inpatient setting. The rooms look a little bit different, more like a hotel feel, make you feel more comfortable than more or less in a hospital setting, such as an inpatient facility.

And then you move down into our programming, which is technically considered outpatient level of care. But there's some terminology that's important for us to review. Although we're outpatient care, the service line that we offer is PHP, which is short for partial hospitalization program. And so that word right there in itself, hospitalization, can be a bit alarming for those that have done a higher level of care, because then they automatically think, "Oh, this is not what I expected. It's not outpatient. It's not something where I want to find myself back into. I need to be able to be home. I need to be with my family, with my kids, maybe be able to work a little bit more." And so we do on our end have to do a little bit of education most of the time for most clients that do come into our environment, because even though we're still outpatient, that terminology, like I said, can be pretty scary for somebody wanting outpatient treatment.

And within the PHP realm, it's basically a more structured environment than if you were to be in a one-on-one traditional outpatient setting. And so within the PHP environment, you are there almost like if you were going to work and you get to go home. So you get to go home at night, you get to be with your family. Sometimes folks go to work. And so it's a more structured environment in which the client is there Monday through Friday, typically five hours a day. And so within that realm, you're getting group therapy, you're getting individual therapy, family sessions, and also meeting with providers for medication management as well.

Then, you move out of that PHP realm and step down into IOP. This is all considered still outpatient care, if you will. IOP is a less structured environment being that you're only there for three hours a day for four days a week, Monday through Thursday for our program specifically. And so once a client is in this level of care, the goal is typically getting them prepared for discharge to step into more of that community care. So that will bring us to the bottom of the pyramid, if you're still following me there. The bottom of the pyramid would be community-based resources, which can also be considered outpatient care. And that is what kind of makes it most confusing for folks is that they are thinking traditional one-on-one counseling where you're meeting with a clinician one time a week is outpatient care as well.

And so we really have to be clear on what the levels of care that we provide, that we call outpatient care from a treatment program. And so you have those community-based resources that are traditional one-on-one counseling, your appointments with a psychiatrist for medication management, which is sometimes one time a month, one time every other month. And then you also look at services such as NA, AA, Celebrate Recovery, Al-Anon including recovery coaches in that dynamic, as well as even some transitional living homes that folks step down into within an outpatient continuum.

And so with all that kind of being said, sometimes folks come directly to us in outpatient care that have never received treatment before. Sometimes folks step down that continuum. So they've maybe done inpatient, they went to residential and then they come see us and PHP and IOP, and then we help them successfully integrate back into the community and see community providers.

Scott Webb: Yeah, that's really helpful. And I am also a visual learner, so I was following along, visualizing the pyramid. So, really helpful. I'm sure it is for listeners as well. And we think about when it's right for us or right for a loved one, why or when would someone seek outpatient mental healthcare?

Monica Clayborn: For many people, everybody has their own journey, but we typically see clients in outpatient that have maybe completed a residential program, like I just discussed and require less intensive care, meaning that they actually get to leave the residential facility, come home or maybe stay at a sober living house and have a little bit more freedom, being that they're only an outpatient, you know, workday, if you will, Monday through Friday. And then sometimes we have folks that come to us who have also completed an inpatient stay and stepped down for support within their discharge care plan. And an inpatient length of stay is about seven to ten days. And so sometimes they need that additional support after leaving an inpatient program, if they don't go right to a residential level of care.

Other times, we have folks stepping up, if you will, from traditional outpatient into our program. So maybe they've seen a counselor once a week and they're not where they want to be. Maybe they need some additional medication management and we have providers here on site that will work with clients in regards to tweaking some of that medication and adding any as needed. And some also just want to come back in for maintenance. Maybe they've done residential, they've been with us for the past couple of years, they've been in recovery and they've noticed, "Okay, I need to come back in," for some additional proactive treatment to prevent that spiral that helps also avoid inpatient treatment. And then sometimes we have folks that do PHP at another program maybe that was attached to their residential center and come step down to our outpatient program and do IOP back in their hometown and we help with their transition once they're with us in IOP.

Scott Webb: Yeah. And you mentioned earlier some of the benefits of outpatient care, whether that's more freedom, flexibility, go home, go to work and so on. Are there some other benefits as well?

Monica Clayborn: Yes, of course. So our main goal is always to work with each client individually to establish a treatment plan with them to determine what kind of course of treatment are they looking for specifically when they're coming into admit. And so we're always working with them to establish some smart goals to make sure that they're meeting short-term and long-term goals to meet their overall wellness and expectations for treatment.

A lot of the benefits for being in PHP and IOP is that they're in a group setting. So they have a supportive, safe space to meet with others on a daily basis. And that's group members, as well as clinicians. Typically, benefits are regained confidence within the individual once they leave our program. And then again, stabilization of medications is a huge one at our level of care, being that they see the physician sometimes two to three times a week in PHP, and then the psychiatrist also will see them one time a week. And so that's a bit different than your traditional psychiatrist office and that you're only seeing them once a month. Oftentimes, that can be very helpful for clients in our program. And then again, they're able to leave with additional toolkits, if you will, to manage triggers, have additional coping strategies to decrease those unhealthy behaviors that were present upon admission.

Scott Webb: Yeah, it really does sound like there's a lot of benefits. And what should we be considering when we're trying to find the right program?

Monica Clayborn: We definitely want to treat everyone we can at Sierra Tucson, but we also know we're not the best fit for everybody. And so regardless if you are coming to us on an intake call, if you are coming to us and admitting into one of our levels of care, if we're truly not the best fit, it's our goal and our responsibility as the clinical provider to make sure we find you a right fit. And so if you are looking at scheduling an admission or finding the right program for you or your loved one, I would encourage everybody to really sit down and identify what is it that I want to get out of treatment. Do some research, find different providers in which you are doing some research because it is an investment in yourself as well, and your continued success. And it's oftentimes helpful to really sit down and look at what do I want out of a treatment program. Sometimes treatment programs will have different specialty tracks that focus on eating disorders, OCD, substance use, emerging adults sexual addiction, pain management, maternal mental health, veterans. So it really depends too on what you want out of the treatment program and making sure that it also fits your needs in regards to a specific specialty track. One of our biggest focuses in outpatient is the mood and trauma track. But again, it just really depends on the patient's symptoms and what they're wanting to get out of treatment.

And then, once a program is identified as a good fit, then the client can speak with the provider, typically of that treatment team, schedule an assessment. It's also important to know that you can ask as many questions as you need to ask to feel comfortable about your decision because, again, the time you're spending in treatment is not just a day or two. You're spending quite a chunk of your life momentarily, if you will, in treatment. When you look at even inpatient being away from your family for 10 days, sometimes that can be a very challenging time for a client. And so really making sure that it is the right one. Sometimes clients even want to come in for tours. We always welcome tours so that they can meet the staff and know that they're coming to a place in which they feel welcome and they feel safe so that they can have a safe space to process.

Scott Webb: Yeah, that's awesome. You can get a better understanding that it's not a one-size-fits-all. Really cool to know that you have these different tracks for folks. And it really does come down to what do you want to get out of this, what do you need to get out of this, what's the right fit for you. And just great to know that folks can come in and ask questions and go on tours and all of that. Just love Sierra Tucson. Monica, as we wrap up here, what would be your final thoughts and takeaways? When it comes to outpatient care, what do you most want folks to know?

Monica Clayborn: What I would most want folks to know is that our main goal is to really heal the mind, body, soul, and emotions, and we really strive to make an impact. And everybody has the ability to make changes for themselves. And we are here to help within that change and help find that longterm recovery and success.

We have a big alumni group that you can also join post-treatment, which is often beneficial in this success of continued recovery. And so we're very proud to offer that. And we have a lot of good turnout with our alumni program. And we're really focused too, not only on the care that we provide while you're in house with us, but your continued success once you leave us.

Scott Webb: Yeah, that's definitely something that I've learned, is that Sierra Tucson is very much interested in really keeping up with and staying with and having these alum groups for support and just all the positive reasons it would be for past, you know, kind of success stories to connect with newer patients, newer clients. Always great to speak with you. This was really informative today. And I can really hear the compassion in your voice as I'm sure listeners can as well. So thanks so much, Monica. You stay well,

Monica Clayborn: Thank you. Take care. Bye-bye.

Scott Webb: And visit or call 800-842-4487. Sierra Tucson, we work with most insurance.

And if you find this podcast to be helpful, please share it on your social channels. And be sure to check out the full podcast library for additional topics of interest. This is Let's Talk: Mind, Body, Spirit from Sierra Tucson. I'm Scott Webb. Stay well.