What is a Partial Hospitalization Program?

A partial hospitalization program (PHP) is for individuals struggling with severe substance abuse. In continuum of care treatment, PHP treatment is a step-down from inpatient treatment. However, some people have personal barriers which prevent attending inpatient treatment. In this case, PHP provides the intensity of inpatient treatment while clients live at home.

PHP treatment is ideal for those with a healthy and stable home environment. But, if you lack a strong support system and struggle to manage your addiction, you may consider attending inpatient treatment.

What is the PHP Level of Care?

PHP treatment is the most intensive form of outpatient treatment. Often called day treatment, people spend each day in psychotherapy, group therapy, or 12-step meetings. While a partial hospitalization program schedule is intense, this comprehensive treatment can benefit those who are treatment-resistant or have chronic relapses.

PHP treatment provides:

  • Structure
  • Discipline
  • Individual therapy or psychotherapy
  • Group sessions
  • Family therapy
  • Relapse prevention
  • 12-step programs

PHPs offer access to psychiatrists, nurses, psychologists, and counselors. These professionals understand that whether you’re a week, a month, or years into recovery, relapse is always a risk. As a result, they monitor each client closely for signs of addiction struggles.

Partial Hospitalization Programs as Step-Down Programs

According to the American Society of Addiction Medicine (ASAM), being part of a step-down approach from an inpatient treatment is one benefit of PHP treatment. It allows individuals to adjust to the triggers and stress of daily living while receiving intensive treatment.

A continuum of care plan or step-down plan may look like:

  • Medical detox (if needed) for 3-10 days
  • Residential or inpatient treatment for 30-90 days to address acute issues and for stabilization
  • A PHP for 30-90 days to continue stabilization and build recovery tools and skills.
  • An intensive outpatient program (IOP) teaches ways to manage triggers and sobriety.
  • A general outpatient program strengthens the skills learned in IOP

Can PHP Treatment Be an Alternative to Inpatient Treatment?

In addition to being a step-down program, PHPs are also an alternative to inpatient treatment. However, there are specific criteria that must be met and includes:

  • The individual needs intensive treatment for substance abuse but doesn’t need 24-hour supervision.
  • A person needs the intensity of inpatient treatment but cannot afford it. 
  • Factors such as work, school, and family responsibilities prevent inpatient care.
  • All co-occurring mental health disorders are manageable in outpatient treatment.
  • The individual either doesn’t need withdrawal management, or it can be managed in an outpatient setting.

What is a Typical Partial Hospitalization Program Schedule?

A partial hospitalization program schedule is typically 4-6 hours Monday through Friday. It also encourages going to 12-step meetings on Saturdays and Sundays. A significant benefit of PHP treatment is time in treatment can vary depending on a person’s needs.

For example, as a person progresses through a PHP, they may spend less time in therapy. However, if they are at risk of relapse, treatment time can increase. And once they are secure in their recovery, they can again reduce PHP treatment.

Behavioral Therapies in PHP Treatment for Substance Abuse

Partial hospitalization programs use a variety of therapies in addiction treatment. Which therapies will benefit each client is based on their initial evaluation. However, as treatment progresses other therapies may be added if needed. 

Behavioral therapies focus on the current problems and how to fix them. However, the long-term goal is to change unhealthy thoughts and beliefs and develop healthy thinking and behavior patterns.

Cognitive Behavioral Therapy

Cognitive behavioral therapy or CBT focuses on changing unhelpful behaviors. Clients learn and apply coping skills, explore cravings, and learn to avoid triggers. Individuals also practice these coping strategies when situations may lead to relapse. 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) helps those in recovery learn mindfulness, distress tolerance, emotional regulation, and interpersonal skills. As a result, the client’s behaviors, friends, and environment changes to encourage recovery.   

Motivational Enhancement Therapy

Motivational enhancement is a therapy approach that helps build the motivation to make positive changes. This approach is highly beneficial for individuals with mixed feelings about recovery and changing their behavior. 

Motivational enhancement therapy helps clients:

  • Build self-confidence and trust in themselves
  • Take responsibility for their actions
  • Lowers the risk of relapse
  • Be more receptive to treatment
  • Learn they have the power to change

12-Step Therapy

First developed by Alcoholics Anonymous (AA), the 12-step program focuses on recovery through supporting one another. While AA was initially based around a higher power, today, people go to 12-step meetings to share their stories, listen and support others, and encourage recovery. 

12-step meetings are also beneficial for building emotional and mental transformations, including:

  • Recognizing and admitting a substance abuse problem
  • Self-observation and awareness of addiction behaviors
  • Builds self-esteem when restraint is shown
  • Self-acceptance and the ability to change
  • Compassion for self and others
  • Tools to continue a life in recovery

Individual Therapy is Vital In a Partial Hospitalization Program Schedule

Perhaps the most crucial therapy in PHP treatment, individual therapy allows people to expose their traumas and issues in a safe and private setting. With help from a therapist, individuals work through emotional and mental issues that led to substance abuse.

Group Therapy in PHP Treatment

Addiction is known as a disease of isolation. So, for some people, the thought of sharing their shame of addiction with others is frightening. But, connecting with others battling the same struggles reminds you that you’re not alone. 

The format of group therapy typically changes. Sometimes the therapist may give a specific topic to discuss. Other times, it may be an open discussion.

Group therapy in PHP treatment may include the following formats. 

  • Psychoeducational groups – addiction and mental health education 
  • Interpersonal process groups – revolve around clients’ issues, problem-solving, and group dynamics, communication skills
  • Skills development group – build relapse-prevention tools and everyday skills
  • Problem-solving groups – learn to recognize thoughts and patterns that contribute to self-destructive behaviors, develop problem-solving skills, and set goals
  • Support groups – help in maintaining recovery in day-to-day challenges, provides support and accountability

Family Therapy Sessions in Partial Hospitalization Programs

While addiction is known as a disease of isolation, it affects all the people who love you. For example, addiction is the third leading cause of marriages failing. 

In addition, children growing up in environments with substance abusing parents are 40-60 percent more likely to develop a substance use disorder and co-occurring mental health disorders.

For these reasons and more, family therapy is crucial to repairing the damage from substance abuse. Family members share difficult emotions in a safe environment and build healthy communication skills. Above all, family therapy helps build a strong support system which is crucial for lifelong recovery.

How Long Does PHP Treatment Last?

Like all treatment programs, the length of partial hospitalization programs greatly depends on the severity of substance abuse. It also depends on the individual, any co-occurring mental disorders, and traumas. 

Generally, PHP treatment for addiction lasts up to 30 days. However, some individuals may stay in treatment for up to 90 days. While people like to know their time commitment before entering addiction treatment, the progress through treatment depends on their progress.

Are an IOP and PHP the Same?

An IOP or intensive outpatient program is the next step-down after PHP treatment. It is also an effective program in treating mild substance abuse issues. As a result, some people start in IOP treatment which focuses on:

  • Psychotherapy
  • Relapse prevention skills
  • Group therapy sessions

An IOP does not offer the intensity or the structure of a PHP. Clients may go to treatment three times a week for just a few hours at a time. This allows for more freedom and testing of the skills learned in treatment. 

If you are deciding between an IOP and a PHP, the following may help in your decision. If you answer yes to any of the following, an IOP may not be the best choice.

  • Will cravings be triggered in your environment?
  • Will you be around people who encourage abusing drugs or alcohol?
  • Do you have trouble arranging transportation back and forth to treatment?

What Are the Benefits of PHP Treatment?

A partial hospitalization program offers a variety of benefits. For many people, the cost of treatment is a concern. And, the cost of inpatient treatment stops many from getting help. 

However, PHPs offer a more affordable cost since there isn’t a charge for room and board. Individuals receive intense treatment during the day and go home in the evenings. This offers another benefit, the ability to still work, go to school, and tend to personal responsibilities after treatment. 

Other benefits include:

  • A strict and organized partial hospitalization program schedule instills the importance of sobriety. Addiction is a chronic disease that needs daily attention.
  • Entering PHP treatment as part of a step-down treatment plan increases the chances of lifelong recovery and provides an extra level of security. 

When is a Partial Hospitalization Program Not the Right Choice?

One of the most significant factors in whether PHP treatment is right is a person’s home environment. If the environment is not safe, positive, and free of drugs and alcohol, it makes recovery nearly impossible. 

Recovery also requires a solid and supportive family. A person can not beat addiction by themselves. If a person lacks a strong support system and safe home environment, they will do better in inpatient treatment. 

Although PHPs use the same methods and therapies as inpatient treatment, supervision isn’t 24/7. Some people need more guidance, support, and motivation than PHP treatment provides. For this reason, inpatient treatment gives them the best chance at lasting recovery.

Find Partial Hospitalization Programs with BRC Healthcare

If you or someone you love struggles with addiction or mental health issues, you are not alone. With individual and group and various holistic therapies, you can heal and build the tools to succeed in recovery. Contact us today to find out how we can help you. 

References:

https://pubmed.ncbi.nlm.nih.gov/10106610/

https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/

https://www.hopkinsmedicine.org/substance_abuse_center/treatment/settings.html