What happens after IOP
The intensive phase ends on a clinical review, not on a date, and what follows is fewer hours rather than no hours. Here is what the step down holds, who keeps the relationship, and what happens if things slip.
Hours come down. Care does not stop.
When the clinical review says the intensive phase has done its work, the next level is standard outpatient care at ASAM level 1.0: fewer hours in the week, the same clinical record, and in most cases the same individual clinician you have been seeing.
If you came in with an outside therapist or prescriber, they keep the relationship. We coordinate with a signed release and hand the patient back rather than displacing anyone. If you came in without one, finding the right fit is part of the discharge plan instead of something you do alone afterwards.
Going back up is also normal. Recovery is not a flat line, and a step up in hours is a clinical call made on the same criteria as the step down, not a judgment about you.
The pieces that carry over.
Standard outpatient care, ASAM level 1.0, at fewer hours a week.
Continues, in most cases with the same clinician.
Keeps the patient. We coordinate with a signed release and do not displace them.
Medication follow-up continues when it is part of the plan.
The family programming and couples track continue into the step down when they are clinically indicated.
A licensed clinician on a documented review against the ASAM Criteria.
Hours go back up. A step up is a clinical decision, not a restart from zero.
42 CFR Part 2 protections apply to the whole substance use treatment file, during the program and after it.
Standard outpatient care is billed at a different level than intensive outpatient. The benefit check covers both so the number does not surprise you later.
A sober living placement, a fellowship, a mutual aid group. We help you find them; we do not run them and we do not take or pay a fee for a referral.
We read your plan before you commit to anything.
Covered by many PPO plans. We check your benefits first.
Shift bills most major commercial plans on an out-of-network basis, and in-network credentialing is in process. We read your plan, tell you what it pays toward intensive outpatient care, and give you that number in writing before your first appointment.
Medi-Cal. We cannot bill Medi-Cal today, because we hold no county contract yet. If Medi-Cal is your coverage, tell us and we will point you to a county provider who can help now.
More on coverage: what it costs, what out-of-network means, your carrier.
The ones people ask first.
What is the next step after IOP?
Standard outpatient care at fewer hours, with individual therapy continuing, and whatever support outside the clinical plan belongs in your week.
Can I keep my own therapist during and after IOP?
Yes, and we would rather you did. With a signed release we coordinate with them while you are in the program and hand the work back at the step down.
What if I need to come back?
Then the hours go up again. That decision is made on the same clinical criteria as every other level-of-care decision.
Does insurance cover outpatient care after IOP?
Usually, at a different benefit level than intensive outpatient. We check both in the same benefit check. See what sets the number.
How long does the step down last?
It is set in the clinical plan and reviewed as you go, the same way the intensive phase is. There is no fixed term on it.
Ask what the whole arc looks like.
On the first call we walk through the intensive phase, the step down and what the discharge plan has to contain, before you commit to any of it.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide and Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Related: How long IOP lasts · How outcomes are measured · After detox · Family program.