The Benefits of Partial Hospitalization for Alcohol Abuse

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A partial hospitalization program (PHP) is an intensive, highly-structured outpatient program involving at least 20 hours of individual and group counseling per week. The benefits of partial hospitalization for alcohol abuse include the intensiveness of inpatient in an outpatient setting, access to various types of therapy, opportunity to involve family, and solid step-down care for someone who has completed an inpatient program. ^1,2

What Is Partial Hospitalization?

Alcohol treatment has multiple levels, ranging from highly structured to flexible. Participants and family members can experience benefits in each program.

Partial-Hospitalization Program (PHP)

The American Association of Partial-Hospitalization defines PHP as an outpatient program to treat serious mental disorders like those in the Diagnostic and Statistical Manual for Mental Disorder, 5th edition (DSM5). Alcohol use disorders are considered mental disorders. Only a licensed physician or mental health professional can diagnose and recommend PHP. It is beneficial for those who need a structured program and life factors that prevent going to an inpatient program. For some, PHP is a transition program, or step-down program, after completing inpatient treatment to help transition back into the home environment.³

You may experience short-term and long-term benefits of partial hospitalization for alcohol abuse. One of the biggest benefits is that PHP is a way for you to get intensive treatment without being admitted to an inpatient program. Also, because it is on the campus of a hospital, medical care is easily accessible. Other benefits of partial hospitalization for alcohol abuse include:⁵

Time-focused services so everyone puts in maximum efforts knowing the program has a deadline
Peer and professional support
Education regarding the disease of addiction
Skill development for coping and relapse prevention
Support for reintegrating back into the community
Aftercare planning
Cost-effective care
Case management

Partial-hospitalization programs offer 20 or more hours each week of individual and group counseling and education. Your family can also participate in learning how to support your recovery, set healthy boundaries, and rebuild your relationship. PHP therapists provide early recovery, relapse prevention, psychoeducation, and medication management. Although many PHPs meet at an alcohol recovery treatment center, you only attend during the day. At night you stay in your home environment where you can take care of your responsibilities.⁴

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Therapies Used in Partial Hospitalization Treatment

The Substance Abuse and Mental Health Services Administration considers intensive outpatient and partial-hospitalization programs level II care treatments. They divide them by labeling PHP as level II.5. The therapies used in the programs are the same, however. Several behavioral therapies are used in PHP.⁵

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a widely used behavioral therapy in PHP group and individual activities. CBT works by changing thought processes that lead to unhealthy behavior choices, such as excessive alcohol use. Led by a licensed mental health professional, you will learn to set goals and how to take steps to:

Achieve goals
Improve communication skills
Implement stress management techniques
Improve interpersonal skills.

CBT is often called the gold standard in treatment therapies. Numerous studies have supported the efficacy of CBT in helping people reach treatment goals. It is adaptable and pairs well with other treatment modalities.⁶

Contingency Management

Contingency management (CM) is another behavioral therapy that rewards you when you accomplish milestones in recovery, such as abstinence from alcohol. You receive rewards for met goals and contingencies when you do not meet your goals. However, they are appropriate and positive in the context of the program. A positive contingency may be to spend more time in an early recovery group.

A review of studies shows that contingency management leads to positive outcomes and reduced misuse of alcohol or drugs. The longer a person is in a CM program, the better the results. Not only does CM reduce alcohol misuse, but it also increases attendance in treatment programs.

Family Therapy

Family therapy and marital therapy are provided in partial hospitalization for alcohol abuse because AUD affects the entire family. Spouses, siblings, parents, grandparents, and anyone else you consider a loved one and who impacts your life can attend and learn new skills that promote recovery. Your therapist will help you improve communication, set healthy boundaries, address family issues, and heal your relationships.

Family therapy has a lengthy history of success. It helps families identify the strengths of each member. Family therapy also teaches you how to listen and communicate more effectively. It helps everyone be heard and kept accountable. Family members learn to set healthy boundaries and how to support their loved one in recovery.⁸

Relapse Prevention

Relapse prevention skills are taught in both group and individual activities. You learn strategies to deal with your issues in early recovery and avoid relapsing once you leave treatment. Understanding your triggers, learning coping skills, improving self-esteem, practicing alcohol refusal, and resolving conflict are a few focus areas.

Relapse prevention programs help you change lifestyle factors to help you avoid a relapse. You become more self-confident, recognize triggers, cope with urges and cravings, and take back control over your life. Studies have shown that relapse prevention program participants learn stronger avoidance behaviors that lead to sustained abstinence.⁹

Adjunctive Therapies

You and your therapist will create an individualized plan that includes the adjunctive therapies that are best for your recovery. Here are a few of the hundreds of adjunctive therapies:⁵

12-Step facilitation groups—Support groups led by peers in the recovery process are an essential part of partial hospitalization programs. Alcoholics Anonymous is the most popular support group, and studies show the 12-Step format helps people maintain long-term recovery.
Psychoeducational groups—Psychoeducation involves learning about the disease of addiction. Alcohol alters the structure of the brain and affects how neurons communicate. The choice to drink alcohol was yours, but it is how alcohol changes the brain that developed an alcohol use disorder.
Pharmacotherapies—Medications like Naltrexone may be prescribed as part of ongoing recovery. Medication can help ease your symptoms so you can focus on participating in partial hospitalization, learning the skills necessary for recovery.
Holistic therapies—Holistic or alternative therapies support healing. Mindfulness-based approaches, like meditation and yoga, teach you how to be present and aware of your body at the moment. Art and music therapy utilize creativity to help you progress in treatment.

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Who Is Partial Hospitalization Best For?

There is little research on who can benefit more or less from partial hospitalization treatment. Some people who may reap the benefits of partial hospitalization for alcohol abuse include:

Those who need the structure of inpatient with the flexibility of outpatient
Those who want to continue working, attending school, or fulfilling other major obligations during alcohol addiction recovery
Those who have completed an inpatient program and need step-down care.

However, some guidelines for eliminating participants from a group include:¹⁰

Someone with extreme social anxiety or introversion
Someone with severe psychiatric disorders such as schizophrenia
Someone with antisocial disorder
A victim whose perpetrator is already a member of this group
Someone whose family, neighbor, friend, spouse or anyone with some type of relationship is already present in the group

The primary factor in attending PHP for alcohol recovery is meeting the clinical criteria for alcohol use disorder. Initial screening with a licensed professional will determine if you meet the requirements, including feeling like you do not have control over your drinking, being unable to stop drinking alcohol even when you try, and consuming more than you intended.¹

Find a Partial Hospitalization Program for Alcohol Use Disorder

If you experience negative emotions when not drinking or feel like your life revolves around consuming alcohol, those are criteria for an alcohol use disorder. To see if you meet other criteria, schedule an assessment with a licensed professional today.

Depending on the assessment results, you can review the treatment options, including partial hospitalization programs. Please call us at 800-948-8417 Who Answers? 24/7 to speak with a treatment specialist with whom you can discuss your options for assessments and services regarding alcohol misuse.

Resources

National Institute on Drug Abuse. (2021). Alcohol Facts and Statistics.
Rapp, R. C., Xu, J., Carr, C. A., Lane, D. T., Wang, J., & Carlson, R. (2006). Treatment barriers identified by substance abusers assessed at a centralized intake unit. Journal of Substance Abuse Treatment, 30(3), 227-235.
Khawaja, I. S., & Westermeyer, J. J. (2010). Providing Crisis-oriented and Recovery-based Treatment in Partial Hospitalization Programs. Psychiatry, 7(2), 28-31.
Substance Abuse and Mental Health Services Administration. (2006). Intensive Outpatient Treatment and the Continuum of Care.
Substance Abuse and Mental Health Services Administration. (2016). Early Intervention, Treatment, and Management of Substance Use Disorders.
David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry, 9, 4.
McPherson, S. M., Burduli, E., Smith, C. L., Herron, J., Oluwoye, O., Hirchak, K., Orr, M. F., McDonell, M. G., & Roll, J. M. (2018). A Review of Contingency Management for the Treatment of Substance-Use Disorders: Adaptation for Underserved Populations, Use of Experimental Technologies, and Personalized Optimization Strategies. Substance Abuse and Rehabilitation, 9, 43-57.
Tuerk, E. H., McCart, M. R., & Henggeler, S. W. (2012). Collaboration in Family Therapy. Journal of Clinical Psychology, 68(2), 168-178.
Farabee, D., McCann, M., Brecht, M. L., Cousins, S. J., Antonini, V. P., Lee, A. B., Hemberg, J., Karno, M., & Rawson, R. A. (2013). An Analysis of Relapse Prevention Factors and Their Ability to Predict Sustained Abstinence Following Treatment Completion. The American Journal on Addictions, 22(3), 206-211.
Center for Substance Abuse Treatment. (2006). Services in Intensive Outpatient Treatment Programs. Treatment Improvement Protocol (TIP) Series, No. 47. Rockville (MD): Substance Abuse and Mental Health Services Administration (US)
Mochrie, K. D., Lothes Ii, J., Guender, E., & St John, J. (2020). DBT-Informed Treatment in a Partial Hospital and Intensive Outpatient Program: the Role of Step-Down Care. Research in Psychotherapy, 23(2), 461.