Helping people struggling to overcome addiction is Anna McDonald\u2019s passion. \u201cA good day is when I know I have done my job well, when I see a client who at one time was very hesitant about treatment begin to realize that there is hope for another way of life, that it\u2019s obtainable.\u201d Knowing that she\u2019s helped someone gain the tools for lasting sobriety \u201cis the best gift.\u201d\r\nThe Road to Right Step\r\nFor the first 10 years of her life, Anna lived in Alaska, moving to Texas when her dad retired. After attending San Jacinto College, she\u2019s one class short of her A.A.S., is a level 3 licensed chemical dependency counselor-I and is close to becoming fully licensed as an LCDC. How Anna got into the field is a story laced with rich experience. She worked as the program coordinator of an intensive outpatient program (IOP) for a nonprofit treatment center in the area whose clients were mostly criminal justice referrals ordered into treatment as a condition of probation. There, she also taught offender education classes such as DWI education, drug offender education and parenting classes. Looking for greater opportunities, Anna found her current job through networking. At The Right Step, as a program coordinator at the North Houston IOP, Anna facilitates groups, does individual counseling and case management, and works with UDS results.\r\nWhy Choose an Intensive Outpatient Program (IOP)\r\nIntensive outpatient treatment is a good choice for those who have commitments to work and\/or school and don\u2019t require a higher level of care. It allows time for clients to be with their family members, which is especially helpful for those who can\u2019t be away from their work\/family responsibilities for a 30- to 90-day residential addiction treatment program. IOP lasts six weeks. Many of The Right Step clients have dual diagnosis, or substance abuse and a co-occurring mental health disorder, most commonly bipolar disorder or depression and substance abuse. Many clients abuse drugs to medicate those disorders. Once they\u2019re able to regulate the symptoms of bipolar or depression, they\u2019re better able to focus on their sobriety. Some people confuse intensive outpatient treatment with AA, or think that IOP means AA. IOP is in between residential addiction treatment and AA. \u201cYou get the education and learn coping skills and relapse prevention like you do in residential, and have regular meetings like in AA,\u201d Anna explains. \u201cThere\u2019s also the family component in IOP, as in residential. But you don\u2019t stay there. You go home with your family and tend to your work\/school responsibilities.\u201d After the six-week IOP, clients graduate into the aftercare program where they attend process groups and check in with other graduates in a kind of fellowship in the aftercare meeting. \u201cWe recommend clients attend at least one year of aftercare, but they are free to continue as long as they want,\u201d Anna says.\r\nHow Intensive Outpatient Addiction Treatment Works\r\nClients come to meetings four days a week for three hours a day, attending either morning or evening groups. Three of the days are group meetings, 1-1\/2 hours of chemical dependency (CD) education, such as teaching relapse prevention and new ways to cope with stress. Clients learn that by controlling their thoughts, they can control their behavior. And by changing their feelings, they can change their behavior. There\u2019s also 1-1\/2 hours of process groups, where clients complete assignments; for example, they may do a goodbye letter to alcohol or 10 triggers in the past to use. Process groups allow peers to answer questions. Let\u2019s say someone shares something and a group member may say that you\u2019re rationalizing, using a defense mechanism. \u201cYou\u2019re in denial.\u201d Hearing it from a peer, the IOP client is more likely to accept the comment. There\u2019s also an adolescent program, which is two hours (compared to three for adults), four days\/week. The first hour is chemical dependency education, followed by a process group. Adolescents attend family group with adults. \u201cThe teaching format with adolescents is a little different,\u201d Anna continues. \u201cWe do a lot of games and interaction, as well as teach drug refusal skills.\u201d\r\nWhy Is IOP Beneficial?\r\nResidential treatment isn\u2019t necessary or practical for everyone. Some people have family or work responsibilities and can\u2019t be away for the 30 to 90 days of residential treatment. It could be financial reasons that prevent them from going into residential treatment. At the same time, AA is not enough for them. They need the structure and discipline that they\u2019d get with IOP. IOP works for all of these reasons. In IOP, random drug tests are conducted twice weekly. Clients are also required to attend three 12-step meetings each week. \u201cWe keep them very busy.\u201d\r\nAll in - Family Group\r\nThe family program is an educational outlet and is mandatory for IOP participation. Someone that is supportive of the client\u2019s recovery has to be present one day a week. Many times, the family is in great need of education about addiction. If clients go through treatment and their environment at home hasn\u2019t changed, they\u2019re more likely to relapse. In family group, clients do activities like making a concerns list and then sharing it with the group. \u201cInitially, family members may be reluctant to share what they\u2019ve written, but they\u2019re encouraged by hearing other family members (it\u2019s a multi-family group) open up and share in this safe environment,\u201d Anna says. Another rule is that family members and clients refrain from talking about the concerns list for one day afterward. \u201cWe find that the more a client has family involved, the more successful the client will be at maintaining sobriety.\u201d\r\nWhat to Look for in an IOP\r\nIn Anna\u2019s estimation, positive regard for counselors is the top thing to look for in an IOP. \u201cFinding counselors who genuinely care about clients is vital,\u201d she comments. \u201cThe mark of a good counselor is the number of clients who attend the aftercare program and who continue their recovery efforts.\u201d Anna says that getting the most out of the intensive outpatient treatment experience means \u201cbeing open to learn.\u201d Clients who are closed off to the help being offered or are defensive throughout treatment probably won\u2019t find IOP works for them. \u201cYou can only get out of the treatment experience what you\u2019re willing to put in.\u201d IOP is affordable and includes aftercare for as long as the client wants to participate in it.