Inpatient vs Outpatient Rehab

The efficacy of inpatient vs. outpatient rehab for addiction depends greatly on the type of addiction involved and the severity. This article gives an overview of the types of treatment for specific addictions - including drugs, alcohol, tobacco, and eating disorders.

Anorexia Nervosa

Although you may not have thought of eating disorders as an addiction, not only has anorexia nervosa been constructed as an addiction to weight loss, but in addition the use of excessive exercise that may be used by anorexics to stay thin or bulimics as an alternative to purging, has been substantiated as an addiction, in and of itself.

Patients with anorexia nervosa are only hospitalized if they have fallen to less than 75 percent of their ideal body weight, although other factors are weighed as well. For less compromised patients, outpatient treatment is possible. Currently, one therapy that has been found to be very helpful in treating adolescents with anorexia is one in which parents initially retake control of the teen’s nutrition. In this therapy, the anorexic teen is treated in his or her home.

Bulimia Nervosa

There has been less research on treating teens with bulimia nervosa than on treating teens with anorexia nervosa. Nevertheless, what evidence there is, shows that especially when the disorder is not severe, a three-phase family-based treatment plan is optimal, with support from outpatient services, such as psychotherapy. The plan begins with the parents working with the teen to disrupt the cycle of binge eating and subsequent weight control measures. Once the teen has stopped those behaviors, the parents cede control back to the teen. Third, the family works to deal with any ramifications that the eating disorder has caused.


Quitting smoking and other tobacco products is almost always done on an outpatient basis. Some patients are able to simply quit without help of any kind. Others use a type of counseling in which they focus on changing behaviors. Over-the-counter medications such as nicotine patches, gum, lozenges, and other products may also be used. Sometimes the antidepressant medication buproprion is used.

Alcohol and Drugs

Treatment for alcohol or drug addiction in teens can encompass a variety of treatments, including outpatient, inpatient or residential treatment, or - if applicable - within the criminal justice system. At some point, a group home may be an option as a transition from one treatment environment to another.

For alcohol, outpatient treatment may include brief interventions or therapy combined with self-help programs, family therapy, and treatment for any coexisting conditions. For drug addiction and severe alcohol dependence, treatment may begin with planned withdrawal or medically-assisted detoxification, which may take place in a treatment location or a special detox center. Medically-assisted detox is not required in all cases.

After withdrawal is taken care of, the next stage of treatment may involve medications (if necessary) combined with therapy on an outpatient basis, for example, regular clinic visits, or a residential program. This will partly depend on the presence of coexisting disorders, both physical and mental.

Residential choices may include one of a number of options. Therapeutic communities (TCs) are programs that usually involve a 6 to 12 month residency and in which the community is an agent of change. Because adolescents may be open to inadvertent effects of being in a group, it is important to choose a facility and staff that is skilled and experienced in handling teens.

Therapeutic boarding schools, where attention is paid both to a teen’s medical needs and to her or his education, are another residential option.  Essential in this case is finding a school that is a good match for the teen’s specific needs and stage of recovery, and one that the teen wants to attend. Therapeutic boarding schools may be coeducational or one gender only. They may have a religious mission, a secular outlook, or some specialized pedagogical or counseling approach.


Related Article: Teen Drug Treatment >>