---
title: "In-Patient & Out-Patient Treatment"
description: "\tIn-Patient Treatment – Evidence-based practice\r\n\tOut-Patient Treatment – Evidence-based practice\r\n\r\n\r\nSummary of the Evidence\r\n\r\n•\tBoth in-patient (residential) and out-patient (community-based) treatment for alcohol and drug use are evidence-based practices shown to reduce both drug use and recidivism.\r\n•\tTreatment that follows the RNR principles is more effective than treatment that does not.\r\n•\tIn-patient and out-patient care can include many of the same services (i.e., individual therapy, group therapy, etc.) but they differ in the amount they control the client’s environment while receiving services.\r\n\r\n\r\nWhat Are In-Patient and Out-Patient Treatment?\r\nMost individuals who enter the criminal legal system (the “criminal justice” or “legal” system is referred to as the criminal legal system in this document) either have substance use difficulty or were using alcohol or illegal drugs during the time of their crime.\r\n•\tAlcohol and drug treatment offered to those on supervision can reduce substance use and subsequently reduce recidivism.\r\n•\tThe treatment offered by supervision comes in many types, including alcohol and drug education (see psychosocial education for drug use statement for more), intensive out-patient, out-patient treatment, in-patient treatment, and medication-assisted treatment.\r\n•\tIn-patient/residential treatment broadly refers to therapeutic interventions provided in varied residential settings where patients live during some periods of treatment.\r\n•\tOut-patient treatment broadly refers to interventions provided in settings where recipients live in the community at their usual place of residence.\r\n\r\nHow Are They Used?\r\n•\tTreatment programs that follow the risk-need-responsivity (RNR) principles are more effective than those that do not.\r\n•\tThe RNR principles for effective treatment include the following:\r\no\tconducting comprehensive actuarial assessment of static (unchanging) and dynamic (changeable) risk factors with periodic reassessment\r\no\tprioritizing treatment resources for higher-risk clients or clients with higher needs in a particular area\r\no\ttargeting specific criminogenic needs \r\no\tproviding treatment that is responsive to an individual’s temperament, learning style, motivation, culture, and gender\r\n•\tIn-patient treatment is effective for the following reasons:\r\no\tit removes individuals from environments that promote alcohol and drug use\r\no\tit provides an environment where treatment efforts can be concentrated\r\no\tit offers medical/psychiatric care and emotional support to patients\r\n•\tOut-patient treatment is effective for the following reasons:\r\no\tit keeps individuals in their environment \r\no\tit allows the individual to apply their skills in managing themselves and the environment\r\no\tit provides opportunities for the client to address difficulties “real-time” and coping strategies to be created and tested while having the support provided by the treatment\r\no\tit can teach clients to mobilize support within their environment to manage relapse\r\n•\tBoth in-patient and out-patient treatment can include some combination of the following:\r\no\tindividual therapy sessions\r\no\tgroup therapy sessions\r\no\tmedication services \r\no\tCBT interventions\r\no\talcohol and drug use education\r\no\tlife skills \r\no\tmental health services\r\no\tcompulsory self-help meetings (i.e., 12-step recovery)\r\no\tsupport services\r\n\r\nHow Can They Be Used to Monitor Compliance?\r\n•\tClients are often mandated to treatment as a part of their conditions of supervision. If this is the case, their participation and progress in treatment can be monitored.\r\n•\tTreatment providers and officers should be familiar with each other to offer the client the best possible support for participation and progress in treatment.\r\n•\tQuality working relationships with the client increase the possibility that clients will discuss difficulties they are having with treatment. This can prevent clients from abstaining from treatment and thus violating their supervision.\r\n\r\nHow Can They Be Used as a Supervision Tool?\r\n•\tBoth in-patient and out-patient treatment are rehabilitative tools designed to help clients reduce their use and improve their lives.\r\n•\tAn officer can reinforce their position as a change agent by offering treatment services in response to their client’s difficulty with substance use.\r\n•\tIf a client relapses, an officer can reinforce their position as a change agent by understanding and encouraging while working with their client to determine what adjustments would improve chances of long-term abstinence.\r\no\tOften clients need multiple attempts at treatment programming before they remain abstinent long-term. Because of this, officers should not view treatment failure as proof that their client is not capable of change.\r\no\tSubstance use is a relapsing disorder that requires various strategies to obtain long-term success.\r\n\r\nWhat Are the Costs of In-Patient and Out-Patient Treatment?\r\n•\tDue to the considerable costs of treatment, referrals to both in-patient and out-patient treatment are limited\r\n•\tTreatment services should only be offered to someone who has gone through a validated substance use evaluation and diagnosed with a substance use disorder\r\n\r\nWhat Do Supervision Staff Think?\r\n•\tSupervision staff report that in-patient and out-patient treatment are\r\no\tsometimes appropriate for all low-risk clients and\r\no\talways appropriate for all medium- to high-risk clients.\r\n\r\nCompliance Level\r\n•\tSupervision staff report that psychological sanctions like in-patient and out-patient treatment are\r\no\tsometimes appropriate for low-risk clients who are in low, medium, and high compliance with their supervision conditions,\r\no\talways appropriate for medium- to high-risk clients in low compliance with their supervision conditions, and\r\no\tsometimes appropriate for medium- to high-risk clients in medium and high compliance with their supervision conditions.\r\n\r\n\r\nWhat Should You Expect When Using In-Patient and Out-Patient Treatment?\r\n•\tThere is substantial evidence that both in-patient and out-patient treatment can reduce alcohol and drug use as well as reduce recidivism.\r\n•\tTreatment that is structured to follow the RNR principles is more effective than treatment that does not.\r\n•\tHigh-quality substance use treatment programming often is multimodal, offering an array of services that both educate clients about substance use and teach the skills needed to successfully abstain from using.\r\n\r\nAre In-Patient and Out-Patient Treatment Evidence-Based Practices?\r\n•\tYes, a substantial body of empirical evidence exists to support both in-patient and out-patient treatment.\r\n\r\nWhat Do People Formerly Involved in the Criminal Legal System Think About In-Patient and Out-Patient Treatment?\r\n•\tPeople with lived experience in the criminal legal system report that in-patient and out-patient treatment are\r\no\tsometimes appropriate for all low-risk clients and\r\no\tsometimes appropriate for all medium- to high-risk clients.\r\n\r\nCommunication That Strengthens the Officer-Client Relationship (Messaging)\r\n•\tOfficers should openly discuss the results of substance use evaluations with their clients.\r\n•\tOfficers should openly discuss the potential treatment options available to the client.\r\n•\tOfficers should make room for the client to express their feelings, both positive and negative, about the different treatment options and their prior experience in treatment.\r\n•\tOfficers should be open to modifying treatment plans based on the client’s changing needs.\r\n•\tOfficers should reach a mutual agreement with the client regarding their chosen treatment option.\r\n•\tIf treatment is mandated by the court or as a condition of supervision, officers should be transparent about the potential consequences if the client does not complete or relapses during treatment.\r\n\r\nSpecial Considerations When Using In-Patient and Out-Patient Treatment with Subpopulations\r\n\r\nGang-Involved\tNone\r\nGeneral Violence\tNone\r\nIntimate Partner Violence\tIPV clients have a high likelihood of having a history of substance abuse. Additionally, research suggests that addressing any substance use disorders should be a part of an intervention plan for IPV clients. As such, both in-patient and out-patient treatment may be important for both client success on supervision and the safety of victims.\r\nSerious Mental Illness\tSubstance use is the norm rather than the exception for this group with rates as high as 85% for justice-involved individuals with mental illnesses. Aside from the typical reasons that individuals use substances, individuals with mental illnesses often use substances to deal with their mental health symptoms—anxiety, paranoia, auditory and visual hallucinations, etc. Because of this, both in-patient and out-patient treatment services may be especially helpful for SMI clients.\r\nSubstance Use Disorder\tIndividuals with a diagnosed substance use disorder (via substance use disorder evaluation) who are willing to seek treatment should be given the information and resources that make this possible."
url: "https://www.gmuace.org/appropriateness-statement-package/treatments/in-patient-out-patient-treatment/"
updated: "2023-06-14"
category: Treatments
tags:
  - Behavioral Health
  - "Evidence-Based Practices"
  - Programs
  - Treatments
---

# In-Patient & Out-Patient Treatment

***In-Patient Treatment – Evidence-based practice
 Out-Patient Treatment – Evidence-based practice***

Summary of the Evidence

- Both in-patient (residential) and out-patient (community-based) treatment for alcohol and drug use are evidence-based practices shown to reduce both drug use and recidivism.
- Treatment that follows the RNR principles is more effective than treatment that does not.
- In-patient and out-patient care can include many of the same services (i.e., individual therapy, group therapy, etc.) but they differ in the amount they control the client’s environment while receiving services.

 

What Are In-Patient and Out-Patient Treatment?

How Are They Used?

How Can They Be Used to Monitor Compliance?

How Can They Be Used as a Supervision Tool?

What Are the Costs of In-Patient and Out-Patient Treatment?

What Do Supervision Staff Think?

Special Considerations When Using In-Patient and Out-Patient Treatment with Subpopulations

 

**Similar Topics**

## [Treatment Implementation Considerations](https://www.gmuace.org/appropriateness-statement-package/treatments/treatment-implementation-considerations/)

## [Mental Health Screening and Evaluation](https://www.gmuace.org/appropriateness-statement-package/treatments/mental-health-screening-and-evaluation/)

## [Substance Use Screening and Evaluation](https://www.gmuace.org/appropriateness-statement-package/treatments/substance-use-screening-and-evaluation/)