When Is A Partial Hospitalization Program (PHP) Appropriate?

By Patrick O’Neil (RADT, MFA), Group Facilitator, Cast Centers

It is estimated that 24 million Americans suffer from drug addiction and alcohol addiction, another 47 million have mental health issues, and 9.2 million have co-occurring substance use disorder and mental illness. Unfortunately the Substance Abuse and Mental Health Services Administration reports that, “Only 11 percent – 2.6 million – receive the treatment they need.

This disheartening discrepancy is due in part to the outdated perception that a residential treatment program or full hospitalization are the only available options that work. Leaving many people that truly need treatment reluctant or outright refusing to go. The majority of them are fearful that a prolonged stay would totally disrupting their lives, possibly losing their jobs, and having to be separated from their families and loved ones. Another concern is the staggering cost of residential treatment and navigating the complex intricacies of most insurance companies. Thankfully there are several different treatment alternatives to residential inpatient programs. One of these options, and the fastest growing alternative, is the Partial Hospitalization Program, or PHP.   

Partial hospitalization programs are an intensive therapeutic environment for people suffering from and require mental health treatment and substance abuse treatment, who do not require twenty-four-hour care, yet are in need of a more structured environment than traditional outpatient treatment. Typically most PHP’s involve four to six hours of treatment per day, five days a week. The National Association of Private Psychiatric Hospitals (NAPPH) and the American Association for Partial Hospitalization (AAPH) define PHPs as outpatient programs, “specifically designed for the diagnosis or active treatment of a serious mental, and/or substance abuse disorder, when there is a reasonable expectation for improvement or when it is necessary to maintain a patient’s functional level and prevent relapse or full hospitalization.

The NAPPH and APPH maintain that partial hospitalization programs are appropriate for a variety of issues; including substance abuse, anxiety, depression, bipolar disorder, PTSD, and dual-diagnosis. However, like residential and outpatient programs, the general consensus is that the type of treatment that will work best for you really depends on what stage of recovery you are in. Your best resource for determining what level of care is needed—whether it’s the residential level of full hospitalization or PHP—is consulting your therapist, doctor, or healthcare provider.

The benefit of attending PHP day treatment while living at home or a sober living environment and having the support of your family and loved ones—as opposed to a residential inpatient or complete hospitalization—can lead to a much more significant treatment experience. As your recovery progresses you will be able to fully explore and utilize your therapeutic community while establishing the outside support network you will need to help maintain your program of recovery.

If you have attended a residential inpatient treatment program and your acute issues have stabilized, you have made significant progress, and/or are being discharged then a partial hospitalization program is the perfect step down. PHPs can serve as a transition from a fully structured environment of constant supervision, to keeping you involved enough that the transition isn’t as challenging. PHPs have also been used as a precursor to residential treatment as clinicians can make a much better diagnosis—having more time than just an hour of evaluation and assessment—to then recommend a higher level of care.  

Ultimately getting help is the first priority. If you are suffering from substance abuse, mental health, or a dual-diagnosis, and you need a more intensive program than outpatient, but you’re not at the level of requiring a residential program, a partial hospitalization program is the solution you have been looking for. 

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