About Blue Ridge First Step
First Step offers a 20-day intensive outpatient program (IOP) for people with chemical dependency. IOP is a 20-session program that meets four days a-week for five weeks. The program uses a multi-disciplinary, holistic approach to recovery, compatible with the 12-step recovery model.

Components of the program include group therapy, educational groups, assignments, family group meetings, and the fostering of sober fellowship through the IOP group and required attendance at AA or NA meetings.

Weekly Schedule:

The IOP meets Monday, Tuesday, Thursday, and Friday
5:00 to 8:00 p.m.

Clients are expected to attend each session during the 20-day cycle of their enrollment.


Every Thursday night is Family Night. Family members and loved ones are encouraged to attend all of these sessions, in order to receive support and increase their understanding of the disease of addiction and the recovery process.

For the first hour of Family Night, family members and loved ones of First Step clients meet in a support group with a counselor who answers questions and helps group members process their feelings about this process.

From 6:00-8:00 p.m., family members and loved ones join the clients for an educational group session.



After completing IOP, clients are encouraged to attend the Aftercare Group for one year. Aftercare meets every Wednesday night and offers clients a safe, confidential, and familiar place to talk about the rewards and challenges of first-year sobriety.

The primary goal of the First Step program is to help individuals develop the coping strategies needed to resume productive and successful lives without the use of mood-altering substances.

Overview of IOP
The following is a list of the core components of the First Step program. To read a description of each component, click on the component link.
Clinical Evaluation Treatment Planning Group Therapy
Individual Counseling Doctor’s Group Education Group
Presentation and Feedback Group Assignments Multi-Family Group
Family Support Group Attendance at AA, NA Aftercare Group
Clinical Evaluation
In the first several days of your participation in the First Step program, you will receive a comprehensive clinical evaluation and medical screening by the medical director. Any identified problems will be referred to your primary care physician and/or treating psychiatrist. If you have not had a recent physical examination, you will be encouraged to do so. At this time, any co-occurring disorders will be addressed and an initial plan for addressing these problems will be developed.
Treatment Planning - (back to top)
Your individualized treatment plan will include specific problems to be addressed in treatment, inlcuding: short- and long- term goals, family goals, and discharge plan. You will have an opportunity to review your treatment plan with a First Step counselor.
Group Therapy - (back to top)
Group Therapy meets for one hour three times weekly and is led by a licensed clinician. It provides an opportunity for you to practice skills critical to recovery, like sharing with others and giving and receiving both support and critical feedback. Therapy gives you the opportunity to talk about your problems and share your feelings about your addiction and recovery with a caring and supportive group. The other group members can often help you clarify the thoughts and feelings which can be confusing in early recovery.
Individual Counseling - (back to top)
Although the group setting is sufficient for most clients in IOP, sometimes more is needed. For clients with significant co-occurring disorders or critical family or social stressors, individual therapy referrals may be necessary.
Doctor's Group - (back to top)
The Doctor's Group meets for one hour weekly and is led by the First Step Medical Director. The doctor will address medical and biological aspects of substance abuse, recovery, and related issues.
Education Group - (back to top)
Education Group meets three to four times weekly and is led by a First Step counselor. Topics that will help you to understand more about your addiction and its treatment will be discussed, including: disease concept, powerlessness, denial, first step, program tools, cross-addiction, feelings, defenses, daily planning, relapse triggers, and recovery roadblocks, and relapse prevention.
Presentation and Feedback Group - (back to top)
Presentation and Feedback Group meets two to three times weekly and is led by a First Step counselor. In this group, a client will present his/her first step and relapse prevention plan assignments to the other group members and receive feedback. Other areas of recovery that may be discussed in this group include: weekly meeting attendance, getting a sponsor, and weekend-planning.
Assignments - (back to top)
Treatment requires active participation. Several written assignments during their stay allow clients to engage in this active process. The first assignment is called "The First Step." In it, clients detail specific recollections of drinking, using, and the resulting consequences in an effort to confront denial, minimization, and other defense mechanisms that protect addictive substance use. The first step assignment is a critical part of treatment and something on which clients need to spend a considerable amount of time. After completing it, clients present the first step to other group members who give feedback to the presenter. Clients with any reading or writing difficulties can complete an alternative assignment or receive extra support in completing the First Step.

In the last week of participation in IOP, clients are required to complete and present to the group a relapse prevention plan. This plan serves to set a daily/weekly plan for ongoing recovery; identify social supports and and set a plan for regular interaction with these supports; identify internal and external triggers; and develop a response plan in case of relapse or near-relapse.
Family Support Group - (back to top)
Family Support Group meets once weekly and is led by a First Step counselor. This is a group just for family members where they can ask questions about treatment, address their concerns, and give and receive support.
Family Education Group - (back to top)
Family Topic Group meets once weekly, includes family members and patients, and is facilitated by a First Step counselor. Topics related to the family and the disease of alcohol and drug addiction are discussed including: progression of the disease, enabling and codependency, alcoholic family systems, communication; and the relapse and recovery process.
Multi-Family Group - (back to top)
Multi-Family Group meets once weekly and is facilitated by a First Step counselor. In this group, clients and their loved ones are given the opportunity to listen and share about personal experiences through active addiction, in treatment, and into recovery. Multi-family group is a place to help clients and their family members begin the healing process by examining issues such as trust, communication, and feelings.
Attendance at AA or NA - (back to top)
First Step is not a “stand-alone” program. In other words, it is not intended to be the only tool of recovery clients use to stay sober. The First Step framework is based on an understanding of the benefits of twelve-step programs; this treatment works in conjunction with clients' attendance at twelve step meetings. While in treatment, clients are required to attend a minimum of three AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) meetings weekly. Clients are also strongly encouraged to obtain an AA or NA sponsor before being discharged from the program. After completing the First Step program, clients are encouraged to attend a meeting every day for three months (“90 in 90”), followed by the minimum of three meetings weekly.
Aftercare Group - (back to top)
Upon successful completion of the First Step program, clients are eligible to attend weekly Aftercare Group. Its purpose is to help clients maintain the gains acheived during treatment, share about early recovery, problem-solve relapse triggers, and give and receive support. Aftercare Groups meet on Wednesdays from 5:00 p.m. - 6:15 p.m. and 6:30 p.m. - 7:45 p.m. Clients are encouraged to choose one group and to maintain regular attendance for a year.