This TIP, Substance Abuse: Clinical Issues in Intensive Outpatient Treatment, was written to help clinicians address the expansion of intensive outpatient treatment (IOT) represented by the development and adoption of new approaches to treat a wider variety of clients. Researchers and clinicians have begun to question the acute care model of treatment for substance use disorders; this reexamination has led to a more robust collaboration between researchers and practitioners. The resulting focus on evidence-based treatment approaches informs most of the material in this TIP. The consensus panel presents 14 guiding principles of IOT, supported by research and clinical experience.

This TIP also situates IOT within the continuum of care framework established by the American Society of Addiction Medicine, including outpatient treatment and continuing community care. The volume describes the core services every program should offer, the enhanced services that should be available on site or through links with community-based services, and the process of assessment, placement, and treatment planning that helps clinicians address each client's needs. Based on research and clinical experience, the consensus panel discusses major clinical challenges of IOT and surveys the most common treatment approaches used in IOT programs, including family-based services. More specialized sections address treatment of specific groups of clients: women; adolescents and young adults; persons involved with the criminal justice system; individuals with co-occurring disorders; racial and ethnic minorities; persons with HIV/AIDS; lesbian, gay, and bisexual individuals; persons with physical or cognitive disabilities; rural populations; individuals who are homeless; and older adults.

Contents
• Executive Summary
• Chapter 1. Introduction
• Chapter 2. Principles of Intensive Outpatient Treatment
• Chapter 3. Intensive Outpatient Treatment and the Continuum of Care
• Chapter 4. Services in Intensive Outpatient Treatment Programs
• Chapter 5. Treatment Entry and Engagement
• Chapter 6. Family-Based Services
• Chapter 7. Clinical Issues, Challenges, and Strategies in Intensive Outpatient Treatment
• Chapter 8. Intensive Outpatient Treatment Approaches
• Chapter 9. Adapting Intensive Outpatient Treatment for Specific Populations
• Chapter 10. Addressing Diverse Populations in Intensive Outpatient Treatment
• Appendix A. Bibliography
• Appendix B. Urine Collection and Testing Procedures and Alternative Methods for Monitoring Drug Use
• Appendix C. Resource Panel
• Appendix D. Cultural Competency and Diversity Network Participants
• Appendix E. Field Reviewers