Partial Hospitalization Program: A Higher Level of Care Without Being Inpatient

A partial hospitalization program (PHP) is a treatment model for many substance misuse and psychiatric disorders. PHP serves as an intermediate treatment option between inpatient and outpatient addiction treatment, and it is the most intense non-residential treatment option.

How Are Inpatient And Outpatient Treatment Different?

Inpatient care—whether it be for addiction, medical, or mental health treatment—refers to around-the-clock structure and oversight. Whether inpatient treatment takes place in a hospital setting or a rehab center, it is the most intense level of addiction treatment. Depending on your circumstances, inpatient hospitalization or residential rehab takes place over several days to weeks and often includes medical detoxification.1

The term “outpatient care” essentially covers all other addiction treatment services, which are offered over a continuum of care levels. Outpatient services include: 1

  • Visits with your primary care provider
  • Individual counseling
  • Group therapy
  • Structured addiction treatment programs

Outpatient programs can consist of as little as one hour per week and as much as several hours per day. The latter, more intensive, outpatient option is often an alternative to the expense and restrictions of inpatient care.1

What Is a Partial Hospitalization Program?

A partial hospitalization program (PHP) is the highest level of intensive outpatient treatment. Other types of intensive outpatient programs (IOPs) require frequent attendance and participation but not to the extent of partial hospitalization.2

PHPs may involve spending most of your day in a treatment center—from 5-8 hours per day—usually on weekdays. To qualify for a PHP, participants need to be present for at least 20 hours per week.2

PHPs are a step down from inpatient care. You may be enrolled in partial hospitalization as part of ongoing care after an inpatient stay or you may enter a partial hospitalization program as initial treatment instead of inpatient care.

Inpatient programs provide full-time focus on addiction recovery, however, they come with the cost and challenges of living onsite. Individuals in inpatient programs typically cannot leave the facility for family, personal, or work reasons without voluntarily discharging, which may void their insurance coverage and prohibit them from reentering the program. PHPs often offer similar services with an attendance policy instead of onsite living and a lower program cost.

When and if you participate in PHP depends on factors such as:2

  • The severity of your alcohol use disorder
  • Your willingness to engage in treatment
  • Your legal status
  • Your physical health
  • The presence of any underlying mental illness
  • Your financial resources

How Does a Partial Hospitalization Program Work?

A partial hospitalization program for alcohol addiction offers focused and structured time to assist you in the initial, and often most difficult, stages of early recovery. Depending on the symptoms associated with your alcohol use disorder, you may require medical stabilization to help you withdraw safely. Both inpatient and partial hospitalization programs can offer withdrawal management—or detox—services.1

PHPs offer several other core services that are used in most addiction treatment programs, including: 1,3

  • Mental health counseling
  • Group therapy
  • Development of peer support networks
  • Medication management for withdrawal symptoms, medical conditions, or mental health conditions
  • Mutual-support groups where you can interact with others recovering from addiction, including 12-step groups and SMART recovery

Mental health professionals in PHPs may use several therapeutic modalities, such as motivational interviewing and cognitive-behavioral therapy (CBT). These modalities may be used in individual or group settings.

Any addiction treatment will include some combination of these components. One benefit of partial hospitalization is that it can offer you all three in one place, as well as resources to help you maintain support and medical management as you progress toward less intensive treatment.

Housing Assistance

Because you do not live at the facility during a PHP, many programs offer services for finding and retaining alcohol– and drug-free housing. Some PHPs collaborate with sober living houses. These services allow you to attend your PHP for structured daily sessions and to spend your unstructured hours in a safe space that promotes your recovery with others going through the same thing.1

Mental Health Treatment

Mental health providers today recognize the overlap between mental illness and substance misuse and often employ techniques that address both. It is common for someone with alcohol or other substance use disorders to have an underlying, untreated mental illness.2

Studies show that this high rate of co-occurring disorders—also called dual diagnosis—relates to a number of factors, including the prevalence of substance use, especially alcohol and cannabis use, as a socially prevalent and acceptable coping mechanism. When an individual does not have other coping mechanisms to deal with profound mental health symptoms, social or recreational substance use is more likely to become misuse or develop into addiction.4

Partial hospitalization programs are well-established for mental health conditions. They are not used for substance misuse alone but also for conditions like mood disorders such as major depressive disorder, trauma, eating disorders, and psychotic disorders such as substance-induced psychotic disorder.3

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Community Supports

PHPs rarely work in isolation. They are often a bridge between inpatient and outpatient programs. You may be referred to a PHP to increase your level of care from an outpatient program or as part of a discharge plan from inpatient care.

Your PHP may collaborate with community resources such as 12-step groups like Alcoholics Anonymous (AA), local physicians, medication management clinics, counseling services, and legal entities to help you develop a comprehensive plan of care.

Is a Partial Hospitalization Program Right for Me?

Whether partial hospitalization is right for you is a decision for you and those coordinating your care, based on your needs.

Treatment Needs

Generally speaking, partial hospitalization tends to be appropriate for you if you have moderate to severe alcohol use disorder—with or without a dual diagnosis—and cannot maintain abstinence with less intensive modalities.

Your care team may also consider your ability to modulate behaviors that: 1,3

  • Threaten your physical safety or medical wellbeing
  • Affect your ability to attend less intensive programming
  • Affect your ability to actively participate in therapy and other activities

Your ideal treatment should offer the frequency and scope of care that will optimize your recovery and ensure your safety.1,4

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Program Outcomes

Generally, partial hospitalization is more long-term than inpatient care. You might be admitted to an inpatient unit for one to four weeks. If you participate in a PHP and IOP, or intensive outpatient program, your treatment plan could take place over several months. This timeframe allows you to set long-term goals for desired program outcomes, such as:1

  • Allowing you to stabilize your home and family situations while in treatment
  • Providing time to build up a supportive community of peers who are in recovery
  • Teaching you to practice new skills and behaviors that help you deal with stressors and triggers
  • Providing the opportunity to bring real-life situations to your counselor and group as they come up in the course of your treatment
  • Allowing your counselors to get to know you in the context of your “real” life

Financial Eligibility

Partial hospitalization, depending on the program, can cost half as much as inpatient treatment.1 This is important to consider as insurance does not always cover addiction treatment services.2 Your safety and well-being are always a higher priority than cost, but your care providers will take into account cost when determining your appropriate level of care.

You may be eligible for a payment plan, cash patient discount, financing, or other alternative payment option if your insurance does not cover the entire cost of your PHP.

Partial hospitalization is not for everyone. Addiction treatment is most successful when it meets the specific needs of the individual.1

If you or someone you know needs help for alcohol addiction, call 800-839-1686Who Answers? to speak with a specialist about treatment options.

Resources

  1. Center for Substance Abuse Treatment. Intensive outpatient treatment for alcohol and other drug abuse. Treatment Improvement Protocol (TIP) Series, No. 8. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
  2. Gruber, D., & Boyd, S. (2017). Substance abuse: A crisis in need of disruption. Journal of Health Care Compliance, 19(5), 13-26,50-51.
  3. Beard, C., Hearon, B. A., Lee, J., Kopeski, L. M., Busch, A. B., & Björgvinsson, T. (2016). When partial hospitalization fails: risk factors for inpatient hospitalization. The Journal of Nervous and Mental Disease, 204(6), 431–436.
  4. Blevins, C. E., Grimone, K. R., Caviness, C. M., Stein, M. D., & Abrantes, A. M. (2019). Categorizing cannabis and alcohol use patterns of emerging adults in psychiatric partial hospitalization treatment. Journal of Psychiatric Practice, 25(6), 491–498.

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