The Essentials of a Partial Hospitalization Program

With over 8 percent of American adults battling addiction in 2014, according to the National Survey on Drug Use and Health (NSDUH), several different options are needed to treat the highly individual disease. What works for one person may not be best for the next person.

In general, there are two main forms of addiction treatment: residential (or inpatient) and outpatient programs. Residential addiction treatment programs provide around-the-clock supervised and structured care in a specialized facility while outpatient programs offer more flexibility and have a few different levels of care. Traditional outpatient programs may allow for services to be provided at times that can work around a person’s existing obligations or schedules while intensive outpatient programs (IOPs) are more similar to a residential program during the day, with the main difference being that the individual returns to their home to sleep each night.

A partial hospitalization program (PHP) is a type of outpatient addiction treatment program where a person requires medical care and attention in a structured facility for around 20 hours a week, generally 4-6 hours a day, five days a week. Individuals may not require around-the-clock medical care and supervision; however, they may also not be quite ready for a traditional outpatient program either. A PHP can work as a kind of in-between for these two models of care.

As explained by Psych Central, a PHP is a short-term and intensive treatment program offered in a clinical setting for those who require acute care, but may not need it 24 hours a day, seven days a week. PHP programs are a great resource for people who do not require the strict structure of a residential treatment program, but require more than traditional outpatient programs offer.

PHP Explained

Often, a partial hospitalization program is offered as a step-down level of care for those who have just completed a residential treatment program. It may also be a step-up for individuals who suffer a relapse while attending traditional outpatient addiction treatment programs as well. People attending PHPs continue to live at home during the duration of the program and go to a treatment facility for several hours each day during the week.

Often, PHPs will have similar rules and structure to IOPs or residential programs while the individual is on site, requiring them to adhere to structured programming and not use smartphones or communicate with the outside world during the time they are there. Components of a PHP may include:

  • Detox: Mild to moderate withdrawal symptoms can be managed during a PHP; however, more significant withdrawal symptoms may require medical detox in a more secure setting
  • Medication management: Medications are often a beneficial component of addiction treatment and recovery as they can help to minimize cravings, manage withdrawal, and treat co-occurring disorders
  • Medical care: Individuals may have medical needs that require attention and care from trained professionals during a PHP.
  • Psychiatric care and evaluation: The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that almost 8 million people in the United States battled both a mental health disorder and addiction at the same time in 2014, so it is important for addiction treatment programs to screen for, identify, and simultaneously treat any potential co-occurring disorders.
  • Group and individual therapy: Therapy and counseling sessions are some of the most important tools used during addiction treatment programs. Individuals can learn vital skills for improving how they think, feel, and act, which can in turn dictate behaviors, coping mechanisms, communication and relationship skills, and social interactions.
  • Educational programs, relapse prevention, and life skills trainings: Relapse is a part the disease of addiction, as the National Institute on Drug Abuse (NIDA) reports that 40-60 percent of those suffering from the disorder will struggle with relapse. Prevention techniques, coping mechanisms, learning how to recognize triggers, and education into the disease of addiction and recovery can all help to minimize relapse and help people to lead full and healthy lives.
  • Holistic methods: Things like spa treatments, massage therapy, yoga, mindfulness meditation, equine-assisted therapy, chiropractic care, art therapy, acupuncture, nutrition planning, fitness regimes, and more are all adjunctive and complementary methods that can be helpful during a PHP.

As addiction is individual, components of a partial hospitalization program may differ as well. Trained professionals will first do a thorough mental health and medical evaluation upon, or prior to, admission into a PHP to determine what types of methods should be employed and how to best serve the individual.

When a PHP Is Helpful

A PHP is generally more cost-effective than a residential program, and it may be covered by health insurance at different rates as well, depending on the person’s policy and coverage. For instance, Medicare coverage may be applied to eligible PHP programs. It may be a great resource for those who live in a stable home environment and who are able to safely return home each night.

When drug or alcohol dependence is not as severe, a PHP program can be ideal; however, in the case of opioid, benzodiazepine, or alcohol dependence and/or addiction, individuals should seek out a comprehensive medical detox program. Withdrawal symptoms for these substances may be life-threatening and should be managed with continuous supervision of vital signs and mental health status. Withdrawal from other substances, or less severe cases of physical dependence, may be managed by a PHP.

Individuals who have already completed a residential addiction treatment program may also benefit from the step down into a PHP as offered through a full continuum of care. Individuals may transition into a sober living home or community, or another form of transitional housing, after a stay in a residential treatment center and continue on with a partial hospitalization program during the day. Treatment providers may even provide transportation to and from the transitional living arrangements and the PHP. This can provide people with a middle ground before returning back into society and everyday life, allowing individuals time to heal and develop healthy habits that can be sustained long-term.

People enrolled in PHPs during the day may also attend support group or 12-Step meetings in the evenings or on weekends to further enhance recovery. PHP programs provide more structure and supervision than a traditional outpatient program and can also be a great choice for people wishing to step up into a more comprehensive and structured level of care.

After completing a short-term PHP program, individuals should transition into outpatient care. Outpatient services, including group, family, and individual therapy sessions, support group meetings, relapse prevention programs, education and training programs, medication management, and alumni and aftercare services, can all help to enhance a long recovery following a PHP. Follow-up care and aftercare programs provided by trained professionals within the confines of a specialized addiction treatment facility or program are important for sustained recovery after completing a PHP.

Again, partial hospitalization programs are often provided as step-down or step-up programs within a full continuum of care provided by a specialized addiction treatment program. Trained providers can help individual and families determine placement into an addiction treatment program, and people may move between levels of care as needed.