Partial Hospitalization Programs
For Freedom and Support
PHP (Partial Hospitalization Programs) offer effective treatment for substance abuse. As of 2019, it is estimated that 130 Americans die from opioid overdose each day. Addiction costs the United States more than $78 billion annually due to lost work, healthcare costs, addiction treatment and crime.1
The need for alcohol and drug rehab is demonstrated by the high numbers of people affected by addiction:
- In 2015, more than 15 million adults 18 and older had an alcohol use disorder (AUD).2
- Only about 7% of these people received treatment.
- In 2014, more than 20 million Americans had a substance use disorder. 3
- Almost 8 million Americans had a substance use disorder and a mental health disorder (dual diagnosis).3
Where PHP Fits within Addiction Treatment
A partial hospitalization program (PHP) can give you or a loved one the level of addiction care without the need of a residential stay. A PHP gives a higher level of care when compared to standard outpatient treatment. The levels of care for addiction treatment are:4
0.5: Early Intervention
1: OP (Outpatient Treatment)
2: (IOP) Intensive Outpatient / (PHP) Partial Hospitalization Program
3: Residential Inpatient Treatment
4: Medically-managed Intensive Inpatient Treatment
A PHP level of care has clients living at home or in a home-like setting such as sober living homes. Day visits are made to the substance abuse treatment center to receive services.
While, partial hospitalization programs are often the second step of treatment, individuals can enter and exit at different levels, depending on their circumstances. For example, a person can:
Enter Level 1 Outpatient Treatment
Enter Level 3 Residential Treatment
As a precaution against another relapse, the person may then transfer into a PHP Level 2 program.
The guidelines that determine the best level of care and how long it is needed is based on the person’s:
Level of intoxication
Potential for withdrawal
Other medical conditions
Other mental health conditions
Level of motivation to change
Risk of relapse or continued drug use
What is a Partial Hospitalization Program?
The PHP level of care treats substance abuse issues, mental illness, or a combination of both. Individuals live at home outside of treatment. They commute to a drug and alcohol treatment center to receive treatment during the day. PHPs usually offer between 3 to 5 days of treatment each week. PHPs have their clients attend for a full day or at least 4-6 hours.
PHPs are very much like intensive outpatient (IOP) treatment. Both offer:
- Individual and group therapy
- Social and psychological education
- Life skills training
- Vocational counseling
- Assessments for medications
- Medical evaluations
The level of care a PHP provides can also address other issues related to addiction such as:
- Trauma-informed therapy
- Anger management
- Co-occurring disorders such as depression, anxiety or bipolar disorders
A PHP major benefit is that it has the comprehensive clinical benefits of inpatient rehab, but with a flexible schedule that comes with intensive outpatient (IOP) treatment.
A PHP differs from residential rehab because of the treatment schedule. Individuals in inpatient rehab live in the treatment center and are monitored around the clock. Stays can range from a few weeks to several months or longer in inpatient rehab. PHPs are shorter-term and meant as a stabilization phase.
The name partial hospitalization program implies that it takes place in a hospital. Despite its name, most PHPs take place outside of hospitals. Treatment centers are the most common place you’ll find PHPs.
Benefits of PHP
The many benefits of a PHP include:
PHPs help individuals who have family, school, or work commitments and need rehab as well. Flexible days and hours leave room for other obligations.
Great Stepping Stone from Inpatient to Outpatient Services
A PHP is a good way to shift from inpatient treatment to outpatient care. PHP bridges the gap between the two.
More Affordable Option
A PHP costs less than a residential treatment program. The affordability of this type of rehab opens it to a wider range of private pay clients. A PHP can also make health insurance go further with longer treatment time at less expense.
Who is PHP a Good Fit For?
PHPs are a good fit for people who need outpatient services for the treatment of serious substance abuse and/or mental disorders. PHPs are also well suited to those who need a more structured program to prevent relapse.
People who have a support system outside of rehab and a stable residence are good candidates for a PHP recovery setting. People who don’t have a home or a support system may be a better fit for residential treatment.
A partial hospitalization program can be a good way to adjust to independent living. The individual stays independent a good part of the time and spends a lot of time in intensive treatment as well.
PHPs suit people with mental health issues by offering a protectie environment. the safe haven a PHP provides helps individuals deal with psychiatric and substance abuse symptoms more effectively.
About 11 million people in the United States struggle with substance abuse along with a mental health disorder (dual diagnosis). In 2017 among Americans ages 18 and older, there were close to 19 million people with a substance use disorder.5 In this group, 8.5 million (45.6%) had some form of mental illness. Among them, 3.1 million (16.5%) had a form of serious mental illness.
Goals of PHP
The goals of PHPs include helping people with addictions maintain a life free of drugs and alcohol by:
Offering daily visits within a structured setting.
Drug testing to make sure a person remains sober.
Providing psychiatric services and medications. Both can help manage psychiatric disorders and dual diagnosis.
Giving classes on skill building that helps people effectively deal with daily life.
Providing a supportive environment to foster long-term recovery.
What is Detox Like in PHP?
A medically supervised detox is an important first step in any type of drug or alcohol treatment. Detox reduces and prevents painful and sometimes dangerous withdrawal symptoms. Withdrawal happens once the person stops or cuts down on drugs or alcohol.
A medical detox can happen on an outpatient or inpatient basis, which will depend on:
Severity of the addiction
Amount and length of the history of abuse
Co-occurring medical and/or psychiatric conditions
An initial assessment helps determine the best detox option. Residential rehab programs provide detox services to people in danger of severe withdrawal. Potentially dangerous withdrawal needs the highest level of medical intensive care. PHP provides services for mild to moderate withdrawal symptoms that are not severe or life-threatening.
What Does a Day in PHP Look Like?
Partial hospitalization programs help people with substance abuse problems maintain their sobriety. Within their structured settings, partial hospitalization programs provide:
Counseling and Therapy Sessions
Medical care is given by healthcare professionals. Psychologists, psychiatrists and therapists provide individual and group counseling and psychotherapy sessions. Traditional therapies can include:
CBT (Cognitive Behavioral Therapy)
Aims to change negative thoughts and harmful behaviors by replacing them with healthy, positive habits for staying sober.
DBT (Dialectical Behavioral Therapy)
Teaches mindfulness, tolerating distress, and regulating emotions.
Aims to help people find motivation for getting and staying sober within themselves.
Trauma Informed Therapy
Helps people who have suffered trauma or have PTSD (post-traumatic-stress-disorder).
Provides tools for family healing. Also helps the family deal with addiction in positive ways.
Uses 12 steps as a framework for staying sober.
Dual Diagnosis Treatment
All disorders in a person need treatment at the same time. Without it, relapse is likely. PHP psychiatric services, therapy and medications help people manage all their disorders at the same time.
The PHP supportive setting helps people deal with stress and anxiety issues in a protective environment. Within this sheltered setting, they learn how to deal with triggers, cravings and stress. They also learn how to manage their psychiatric and substance abuse symptoms.
Holistic therapies are sometimes called alternative therapies. When given in PHP settings, they can include:
Art and music therapy
Yoga and mindfulness classes
All these can enhance successful recovery and long-lasting sobriety.
Education and Skills Training
Classes may be held to teach people how to deal with daily life without alcohol or drugs.
All these can enhance successful recovery and long-lasting sobriety.
Drug and Alcohol Monitoring
Testing for drugs and alcohol may be done to make sure everyone is safe and sober.
Clients undergo psychiatric and medical exams. These exams determine the severity of drug or alcohol abuse. The results help choose the most appropriate care needed.
Any type of drug or alcohol treatment will affect your family. A partial hospitalization program offers an effective alternative to inpatient treatment.
You can reduce the impact on your family by choosing a PHP because:
PHP allows you to fulfill family commitments on evenings and weekends.
PHP shortens the length of treatment.
PHP is cheaper than residential rehab.
Less treatment time lightens the emotional and financial burdens on your family.
How Can I Make My Treatment a Success?
You can do the following make sure you have a successful recovery:
Detox as a First Step
A medically supervised detox prepares you for treatment. Drugs and/or alcohol create changes in the brain that can trigger withdrawal. Detox helps you stop drugs or alcohol and avoid painful and dangerous withdrawal symptoms.
Look for a Holistic (Whole Person) Treatment Approach
No one treatment works for everyone. A “whole person” approach that uses a variety of treatments will be most effective. Look for a PHP that uses recovery tools that are both traditional and alternative.
Be sure to talk with your therapist about your reactions and feelings to your PHP. They will use your feedback to change your treatment plan when needed.
Maximize Therapy Effectiveness
PHP is a part-time program. Outside of the program, be sure to do any journaling or homework assignments. Practice the skills you’re learning. The more you practice , the better your outcomes can be.
Build a Friend and Family Support System
Recovery is difficult without the support of your loved ones. They can help motivate you to stay in treatment and give you a safe place to live. Loved ones who live with you are there to talk with you when you need it. Friends and family can also attend a PHP family therapy program to help them heal. Family therapy also helps guide them on the best ways to be helpful to you.
Rely on Peer Support
Partial hospitalization programs provide peer support groups. Most of these groups are based on the 12-step made popular by AA (Alcoholics Anonymous). Peer support meetings are important during and long after PHP. Meetings provide sobriety support, fellowship, and recovery tools.
Stay in Treatment
Some people leave treatment too soon once they begin to feel better. Early exit means probable relapse. Successful, long-term recovery needs continuous support, so do not leave treatment too early.
Stay Completely Sober
A drink or illicit drug can bring back a severe addiction worse than before. Addiction is a chronic disease that can be treated and controlled, but there is no cure. One drink or drug can bring on a full-blown addiction. Abstinence avoids relapse.
Follow Your Relapse Prevention Plan
Relapse is a real possibility. To prevent it, you’ll need a relapse prevention plan. Once formal treatment is complete, an aftercare plan will be ready for you to follow. If you feel like you are going to relapse or have already relapsed, you can:
Schedule a therapy session
Go to an emergency support group meeting
Call a friend, family member, or peer for support
Go back into treatment
Where Can I Find PHP Care?
Consult with your doctor or addiction specialist/counselor. They can help you decide what level of care is best with an assessment. An assessment finds:
Any co-existing disorders
The nature of the addiction
The level of severity of the addiction
The strength of your support system
These factors will help you make the best choice.