What are
Partial Hospitalization Programs?

Partial Hospitalization for Recovery from Addiction

More than 63,000 Americans died from an overdose of drugs in 2016, with more than half these fatalities resulting from prescription drug or opioid misuse. 1 There are thousands of substance abuse treatment facilities in the US.

These facilities range from outpatient centers to hospital inpatient treatment, with varying treatment choices in between. About 46% of these facilities have partial hospitalization programs. 2

What Is a Partial Hospitalization Program?

A partial hospitalization program (PHP) is also known as a “day treatment” program. Those who enter a day treatment program for substance abuse can expect to receive a high level of care with near-daily intervention over a short period of time. Patients travel to a PHP facility, almost daily, either from home or from a recovery residency.

PHP’s and Dual Diagnosis

Partial hospitalization programs were originally begun to treat mental health patients only. They have now expanded to include treatment for those suffering from addiction to substances. This makes a partial hospitalization program a good choice for not only addiction recovery, but also for those who have been given a dual diagnosis of addiction coupled with a mental health or other behavioral issues.

The structure and high level of supervision in a partial hospitalization program is a great fit for those who have completed a residential treatment program and now require a transition before re-entering their living community. A PHP is also highly recommended for those who need that structured lifestyle and intense supervision that is may not be readily available at a residential inpatient program

Medical Monitoring

As part of a PHP treatment plan, you will be monitored for medical issues and treated for co-occurring mental health disorders, such as anxiety and depression, that can contribute to substance use. Both disorders, addiction and mental issues, are treated concurrently so you can recover in whole. 

Does Detox Take Place In a PHP?

Most patients enter a partial hospitalization program having already undergone detoxification from substances. In fact, a client will often enter a PHP center after completing detox in a residential addiction treatment facility.  

Some partial hospitalization programs, however, do offer medically supervised detox under the care of physicians who can provide you with medications to relieve withdrawal symptoms. In this way, you can safely detox in relative comfort. This is usually provided by a PHP if you suffer from a mild or moderate substance addiction and not a life-threatening situation. 

Once a client has undergone detox and withdrawal from the substances they’ve been addicted to, their needs may not encompass the intensive treatment provided at full-time inpatient and residential facilities. They no longer require around-the-clock care, but still need to work on their addiction recovery. 

Length of Stay

According to the Commission on Accreditation of Rehabilitation Facilities (CARF), a partial hospitalization program (PHP) is a medically supervised program that is limited in the amount of time a patient undergoes their visits to this hospital-like care.3 

These programs provide patients with comprehensive, well-coordinated and highly structured clinical services that are therapeutically intensive. In regards to helping people with substance use disorders, a partial hospitalization program addresses behavioral disturbances, provides active treatment and is also used to prevent relapse. 

In order to successfully participate in a PHP, you must be stable enough to take part in all therapeutic activities. You also must not require 24-hour care, as a partial hospitalization program is not full-time, inpatient treatment.You do not remain overnight in a PHP setting.

Partial hospitalization programs are short-term in length. The duration of any individual’s treatment will depend upon that person’s needs. The length of stay at a PHP can vary widely due to each client’s unique requirements.

These programs, however, are not designed to continue indefinitely for anyone. The average length of stay is roughly one to two weeks, though some people who are suffering from more severe issues may need treatment for a few months.

Treatment is usually short for most, though. In fact, discharge planning is discussed and considered from the time of entry into a program. 

Certain factors will help determine the period of time you may need to complete the program or when you can begin treatment.

The length of stay may depend on insurance coverage, how much space is available in the program desired and other important factors, such as:

  • Severity of substance use disorder
  • Whether any mental or physical health issues co-exist
  • Which, if any, types of support are available, including community and family support
  • Whether family or work responsibilities must be addressed

If your experience with drug addiction is on the milder side, and you have no mental health problems and a good support system, your involvement in a partial hospitalization program will be of a shorter duration. Someone who suffers from a severe substance use disorder and is also coping with mental health issues, physical disorders, a lot of stress and little support, will require a lengthier care term.

Clients participating in a PHP spend a recommended number of hours of treatment there each day. The treatment regimen can be completed sometimes in full- or half-day blocks of time. The hours needed for participation may decrease in hours if your treatment team deems it appropriate.

PHP Services

The main services offered during a partial hospitalization program will include all or most of the following, depending upon your needs: 4

  • Group counseling
  • Individual counseling
  • Medication management
  • Psychoeducational programming
  • Alcohol and/or drug use monitoring
  • Case management
  • Support groups in community
  • Medical treatment
  • Holistic treatments
  • Psychiatric exams, psychotherapy
  • Employment services
  • Family involvement
  • Family counseling
  • Comprehensive screening and assessments
  • Program orientation
  • Intake and admission services
  • Individual treatment planning
  • Discharge/Aftercare planning

Some programs will include enhanced services that may encompass:

education

Adult Education

bicycle

Recreational Activities

relationship

Additional Therapies

family

Parenting skills training

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Transportation

house

Food, housing

chil-hand-on-the-hand-of-an-adult

Child care

A Day in a Partial Hospitalization Program

Sample Schedule

A typical sample schedule for your time spent in a PHP may begin at 10:00 a.m. and end at 4:00 p.m., usually five days per week, for 20 hours per week. Other facilities might begin at 7:30 a.m. and end at 1:00 p.m. The typical amount of time spent during PHP treatment, however, is usually six hours per day, Monday through Friday.

During those time periods, you may start the day with a community meeting, go on to an individual therapy session and then participate in a skills group. There is time built into the schedule for a lunch break. After the meal, you might take part in another skills group, a group therapy session and other educational, holistic or medical interventions necessary.

How is the schedule determined? 

Your schedule will be planned to meet your specific needs by a treatment team. If you require help with planning weekends that will help you avoid relapse and focus on healthy behaviors, then that may be part of your schedule, for instance. Some clients suffering from a dual diagnosis may need to be further educated about the ways in which addiction and mental health interact.

The Intake Process

Once you arrive at the facility, a team member or members will guide you through the admissions and intake process. You will be free to ask questions. Intake and referral clinicians will completely assess symptoms and physical, psychosocial and psychiatric status. If it’s determined that PHP is the best choice for you, you will have a team assigned to you. During your evaluation, it can be determined which individualized treatment modalities from which you will most benefit.

Impact on Family

It can be very important, in fact, critical, for loved ones and family members to be involved in recovery treatment. It helps those closest understand what is happening during treatment. In this way, loved ones can provide support to help you achieve success.

As a family member of someone undergoing treatment in a PHP, become aware of that person’s daily schedule in rehab. Seeing the schedule alone, though, doesn’t give you a full picture of what someone is actually going through.

Your closest friends and relatives should be aware that recovery doesn’t happen quickly or suddenly. It can take years, sometimes, for conflicts and emotions to resolve after recovery. Working through feelings and relationships in therapy helps the person in recovery and their families cope and adjust to change and eventual success.

Making Treatment a Success

Those suffering from substance addiction have been found to respond very successfully to a partial hospitalization program. The positive response has been rated second best, with outpatient treatment achieving the greatest response from patients. 5 Being in the least restrictive environment, such as a partial hospitalization program, helps patients more easily return to life after treatment.

Resources

  1. https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html
  2. https://www.statista.com/statistics/452486/distribution-of-substance-abuse-treatment-facilities-in-the-us-by-care-type/
  3. http://www.carf.org/Programs/ProgramDescriptions/BH-Partial-Hospitalization/
  4. https://www.ncbi.nlm.nih.gov/books/NBK64094/
  5. https://www.sciencedirect.com/topics/medicine-and-dentistry/partial-hospitalization

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