IOP for Trauma: How Intensive Outpatient Programs Help Heal Trauma

If your trauma symptoms are sticking around despite once-weekly therapy, you might benefit from more intensive treatment—like an intensive outpatient program (IOP).

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If you’re a trauma survivor, you know that the aftermath of a traumatic event isn’t easy. You may feel intense emotions, have difficulty sleeping, struggle with relationships, and much much more. For some survivors, once-weekly therapy offers enough support to process trauma and improve their quality of life. However, many other people need some extra help to overcome trauma-related challenges. That’s where an intensive outpatient program (IOP) comes in. Here’s what you need to know about why and how an IOP for trauma can help.

IOP for trauma: what is it, and who can it help?

Put most simply, a mental health IOP is a type of treatment that is more structured and time-intensive than typical once-weekly therapy but less intensive than 24/7 residential or inpatient care. Individuals attend an IOP multiple days a week, for multiple hours each day, but can still maintain routines with school or work outside of treatment.

So –– how do you know if you need an IOP for trauma? Well, if you have trauma-related symptoms that are not getting better with traditional therapy, an IOP might be the solution you’re looking for. This is especially true for people with post-traumatic stress disorder (PTSD) who realize that symptoms are interfering with day-to-day life. 

Charlie Health Clinical Director Sam Adams puts it this way: “An IOP is useful when people notice their mental health causing significant functional impairments, like difficulties attending school or work, interpersonal distress or impairment, difficulties attending to basic needs like cleaning and showering, or social isolation and withdrawal.”

What are the benefits of the IOP treatment program for trauma?

IOPs offer unique benefits that can help people with trauma-related conditions, including PTSD, recover and thrive. Below, we delve into five benefits of IOPs for trauma.

1. Structured support

An IOP offers far more structure than once-weekly therapy, which can be super helpful for those who are actively struggling to manage mental health symptoms. “The more intensive nature of IOP, about 9 hours of group each week, can serve as additional support to help stabilize symptoms through learning new skills,” says Adams. 

Spending a large chunk of time every week in both individual therapy and groups will help you learn new skills much faster than you would if you were only working on your symptoms one hour per week. Plus, receiving consistent support and guidance from your care team will help create a predictable environment that can help you feel more stable throughout the treatment program.

2. A sense of community

Many people with mental health struggles, including PTSD, feel very alone and isolated in their struggles. You might feel like you’re the only one going through what you’re experiencing. An IOP will help you realize this is far from the truth.

“IOPs can help people be seen by others and validated, finding a special community to share their story with, and also reduce feelings of isolation and loneliness,” says Adams. “This can be a supportive safety net for those with lived experiences of trauma or PTSD, often experiencing intense symptoms.” 

Research has shown time and time again that social support is extremely beneficial during PTSD recovery and that it can even be key in predicting better treatment outcomes. For people who lack social support, an IOP can provide much-needed connections with people who get it.

3. Customized treatment plan

An IOP care team wants the best outcome for you, and they can achieve this by creating a customized treatment plan just for you. Whereas once-weekly therapy usually draws upon one or two specific kinds of therapy, IOPs include various therapy modalities that can target mental health struggles in unique ways.

Your care team will likely create a customized treatment plan, taking into account your age, your experiences, and if you have any co-occurring mental health conditions alongside your trauma. Even if multiple people share the same diagnosis (or diagnoses), no two people are exactly the same, and everyone’s healing journey looks different. This is why a customized treatment plan is so important. 

4. More time to address co-occurring conditions

When you’re limited to an hour or so of therapy each week, you may not have enough time to voice all your concerns and address your full range of symptoms. While trauma might be your primary concern, you may also have one or more other mental health conditions that you need help with, too. In fact, it’s very common. It’s estimated that 80% of people with PTSD have an additional diagnosis, too. For example, you might also struggle with anxiety disorders, depression, or a substance use disorder. The wide range of treatment modalities used in an IOP allows for the time, space, and resources to address all of your concerns properly. 

5. A holistic approach

One great aspect of IOPs is that the additional time allows for additional alternative treatment methods. For example, in addition to traditional talk therapy, an IOP schedule might include art therapy, music therapy, drama therapy, and dance and movement therapy. It may also incorporate mindfulness and meditation practices like breathwork and yoga. 

When you integrate all these different techniques on top of traditional talk therapy this results in a holistic approach that addresses the needs of trauma survivors, promoting healing on all different levels of the mind and body. 

What are some examples of PTSD treatment in an IOP?

IOPs use a mix of different treatment modalities to treat mental health conditions like PTSD. It’s also crucial to work with mental health clinicians who are trauma-informed, which means they can provide trauma survivors with the best, most comprehensive care.

“Charlie Health offers specific group programming targeted at the treatment of trauma, grounded in evidence-informed modalities,” says Adams. “We have many clinicians who are not only trained in trauma-informed care, but also specific strategies for trauma.” Below are six examples of different trauma treatment modalities.

1. Trauma-focused cognitive behavioral therapy (TF-CBT)

TF-CBT is a type of cognitive behavioral therapy designed specifically for kids and teens with PTSD. At times, treatment involves a parent or another trusted adult, as long as they are not the perpetrators of the trauma. In TF-CBT, you will learn coping strategies, complete exposure exercises, and develop a trauma narrative that captures the story of your trauma, Adams says. These exercises are all aimed at reducing the impact of PTSD symptoms.

TF-CBT includes psychoeducation on trauma, processing and working through the trauma, and helping set yourself up for success outside of therapy. It is an option for people with ongoing, complex trauma or victims of a single traumatic event. 

2. Dialectical behavioral therapy (DBT)

“DBT for PTSD usually implements skills training, including mindfulness and distress tolerance, to help people manage and cope with emotional distress,” says Adams. “This can be accessible for clients experiencing intense affective changes as a result of their trauma.”

For those in trauma treatment, the emphasis on building skills in emotional regulation and distress tolerance can be super helpful, providing practical, useful tools that help you navigate the intense emotions associated with trauma, especially when you’re triggered.

3. Prolonged exposure (PE)

PE is a specific type of exposure therapy used in PTSD treatment. Trauma survivors tend to avoid things that serve as reminders of their trauma. However, avoidance fuels fear. Ultimately, avoidance can worsen PTSD symptoms in the long run. PE aims to counteract this. 

The key aspect of PE is exposure to memories or stimuli associated with your specific trauma, says Adams. This is done gradually with careful support from a trauma-informed therapist. When you expose yourself to these memories or stimuli over and over again, you’ll ultimately experience a reduction in the overwhelming anxiety or fear associated with your trauma.

4. Cognitive processing therapy (CPT)

CPT is an approach that allows you to connect your trauma with how you think, feel, and respond to the world, Adams says. A therapist will help you dive into your current thought process and help you figure out where your unhelpful beliefs are keeping you stuck.

Working with a therapist, you’ll learn how to understand why recovery from trauma is difficult and how it affects your daily life. Once you identify your unhealthy, unhelpful beliefs and thought patterns, you can make positive changes.

5. Eye movement desensitization reprocessing (EMDR)

EMDR uses bilateral (side-to-side) stimulation to help you access and process traumatic memories, says Adams. Often, this is through side-to-side eye movements, but it could also be through sound or touch. In a specific, structured way, your therapist will have you recall your traumatic memories while engaging in bilateral stimulation. This will help you process your trauma as your brain stores the memories differently in your brain. After treatment, when you recall these memories, they will not be so distressing or evoke such a strong emotional response. 

6. Narrative exposure therapy (NET)

“Narrative exposure therapy for PTSD invites clients to re-write the story of their life,” says Adams. You will retell the story of your trauma from an adaptive, supportive lens while simultaneously using storytelling as a form of exposure to interact with your traumatic memories, she explains. It can be especially helpful for those who have experienced complex trauma. NET gives you a structured framework to make sense of your experiences and move toward healing.

Charlie Health: IOP for trauma 

If you or a loved one are struggling with severe trauma symptoms, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for teens and adults with serious mental health conditions, including PTSD and other trauma-related conditions. Our program is also often a good fit for people who have recently been discharged from a residential treatment facility or an emergency department and need extra support managing their mental health.

Our expert clinicians incorporate a variety of evidence-based, trauma-informed therapies into individual counseling, family therapy, and group sessions. Typically, a schedule includes:

• 1 hour of individual therapy every week
• 1-2 hours of family therapy every week
• 3 hours of group therapy sessions per day, held 3 days a week

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