Partial Hospitalization Programs

Last updated: 01/3/2022
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Treatment for substance use disorder is available on many levels of care, from inpatient rehab to individual counseling. Often known as “day treatment,” a partial hospitalization program (PHP) involves attending many hours of addiction treatment at a facility and returning home during non-treatment hours.1 Unlike traditional outpatient programs, a PHP is intensive and is a great option for people who need the structure and routine of an inpatient program during the day.

What are Partial Hospitalization Programs?

A partial hospitalization program is often part of a step-down service provided in long-term care of substance use disorders. However, not everyone needs inpatient treatment or round-the-clock medically supervised detox. Those with less severe withdrawal symptoms that are manageable with or without medication on an outpatient basis are a good fit for PHPs, as well as those with moderate to severe addictions who have a strong support system at home.2

In addition to medication management, participants in a partial hospitalization program attend daily therapeutic services for at least four hours daily and twenty or more hours weekly. PHPs may be affiliated with an inpatient hospital, acting as a branch of the hospital, or it can be a stand-alone facility. Most day treatment programs provide a team of professionals for each participant, including a physician, nurse, licensed addictions therapist, and support staff. PHP services take place in individual and group formats.2

During the initial evaluation, your therapist will decide the level of addiction care by the information you provide, like the following:2

  • Severity and history of withdrawal symptoms
  • Severity of mental health or medical disorders
  • Willingness to follow treatment recommendations, rules, and policies
  • Willingness and ability to show up every day
  • Risk for suicide or violence
  • Readiness for change
  • Strengths
  • Risk for seizures and delirium tremens during withdrawal
  • Presence of a sober support system

If any of these factors change and become severe, PHPs will refer a person to intensive services like inpatient and help them transition. They also have connections with less intensive services when transferring someone who has completed a PHP out of the program.

What Services Are Offered at PHP?

There is no one-size-fits-all program or service for overcoming substance use disorders. Partial hospitalization programs offer various services to ensure everyone receives treatment that teaches them the skills necessary for long-term recovery.

Behavioral therapies focus on changing your thoughts so you can change your behaviors. They teach skills necessary to prevent relapse, such as recognizing problem behaviors and taking action to avoid them. Below are common behavioral therapies and services used at a partial hospitalization program:

Cognitive-Behavioral Therapy (CBT)

CBT is a form of talk therapy that helps you change the way you think so you can change the way you feel and behave. Someone with substance use or mental health disorder often struggle with distorted thoughts. This distortion leads to unwanted behaviors, like misusing alcohol or drugs. CBT helps you avoid or rectify unhealthy thoughts. CBT has many sub-therapies that make it easy to personalize treatment based on a person’s addiction, history, and goals. Cognitive-behavioral therapy is a good choice for treating co-occurring disorders as well, such as comorbid depression, anxiety, or bipolar disorder.3

Contingency Management (CM)

Contingency management involves receiving a reward for a desired behavior. This technique is common in the recovery treatment process. The voucher-based system is an example of contingency management. With this technique, a person in a partial hospitalization program can earn tangible rewards when they do well or reach a goal. For example, for every substance-free urinalysis, a person may earn a token that represents a dollar amount. They can spend their tokens on site for food and products. Prize incentives may mean earning chances to enter a giveaway.4

Motivational Interviewing (MI)

Not everyone entering partial hospitalization will be eager to change behaviors. Some will be ambivalent and resistant. With motivational interviewing, therapists can guide someone towards being receptive to change. MI is a non-confrontational therapy that uses effective listening and responding that builds motivation for change but allows the PHP participant to remain in control of making the changes.5

12-Step Facilitation Therapy

Joining support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) offers free peer support and access to a sponsor who can help you progress through the 12 steps. Working the steps aids in recovery by helping someone realize their substance use has become uncontrollable and unmanageable. They accept they need help and learn they are not alone in the recovery process. In 12-Step facilitation therapy, the therapist attempts to motivate the patient to join AA or NA.6 There may be some people who want a different type of support group. Fortunately, there are 12-step alternatives like SMART Recovery, which is secular and science-based.

Family Therapy

Substance use disorders are a family issue. Therefore, all family members can benefit from learning how to prevent relapse. Some family members may need to change their thought patterns and behaviors regarding substance misuse. Others may need to heal from relationships damaged by addiction. The family is a unit made up of smaller parts, and when one of the parts breaks, it affects the entire system. Family therapy teaches members how to influence change, encourage a loved one to enter treatment, improve functioning, and start healing individually and as a group.7

Pharmacotherapy

A partial hospitalization program has physicians on-site who can prescribe medicines to treat withdrawal symptoms, reduce cravings, decrease relapse risk, and treat mental health disorders co-occurring with a substance use disorder. Medications like buprenorphine, naltrexone, topiramate, acamprosate, disulfiram, and clonidine effectively treat someone in early recovery when medically supervised, like in a PHP. Medication, when combined with individual and group therapies, family therapies, and other PHP services, increases the chance of recovery success.8

Psychoeducation

Understanding that substance addiction is a brain disease and chronic condition is essential for both PHP participants and their families. They need to know how substances affect the brain, the body, and the patient’s behaviors and that misusing alcohol or other substances is not a choice. Psychoeducation teaches you about risk factors, deficits caused by substance misuse, why cravings happen, and brain recovery.9

How Long Is a Partial Hospitalization Program?

A partial hospitalization program, including an online partial hospitalization program, offers services at least five days a week. The average time commitment each day is six hours, though it can range from four to eight hours. The time it takes for a participant to complete partial hospitalization can vary, but 90 days is the average.10

Most PHPs will tailor a treatment plan to meet your personal needs. One person may need 90 days, while another may need 30 days or 130 days. If you feel another level of treatment will better meet your needs at any time during PHP, you can transition. For example, if an unexpected crisis happens, you may want to transition to inpatient rehab to receive extra support and escape stressors from your daily environment. Or, if you feel you are ready to step down in treatment, you can transfer to intensive outpatient or individual counseling. It will be up to you and your therapist to determine your length of stay.

Who Is PHP Best For?

A partial hospitalization program can benefit various individuals with drug or alcohol addictions, including those who:11

  • Need acute treatment but are not at risk for harming themselves or someone else
  • Need structure and routine during the day but have a stable home environment where they can stay at night
  • Need healthy coping skills that support recovery
  • Are motivated to participate in treatment
  • Are transitioning from a different level of care
  • Have been diagnosed with co-occurring disorders
  • Have a desire for change
  • Are not functioning personally, professionally, or socially due to substance misuse

You may want to consider the group environment and how well you can function and participate in that setting. PHP is great for those who will make it a priority to show up and do the work necessary for long-term recovery.

Is an Online Partial Hospitalization Program a Good Choice?

Online addiction treatment has become far more prevalent in recent years, increasing patient access to treatment, especially for those living in rural areas or without reliable transportation.

An online partial hospitalization program provides you with the opportunity to recover from your addiction via video therapies and group counseling, making it easier to work sessions into your schedule.

Studies show online PHP is just as effective as in-person PHP. Many of the same treatments are used, including cognitive-behavioral therapy, acceptance and commitment therapy, and mindfulness. Also, mental health symptoms improved throughout the online partial hospitalization program. This includes depression, anxiety, and desire to live.12

Benefits of an online partial hospitalization program for psychiatry and PHP include an increase in:14

  • Access to treatment
  • Privacy
  • Personal safety
  • Attendance
  • Scheduling opportunities
  • Time not spent in travel and away from work or other obligations

Find Partial Hospitalization Near Me

When surveyed one month after completing partial hospitalization for substance misuse, participants reported improvements in emotional and physical health, as well as community and lifestyle factors. Many of these factors are associated with maintaining abstinence.15

When searching for “partial hospitalization near me,” you are searching for the closest program. However, the closest may not always be the best fit for you. Instead, consider factors like setting, individualized treatment plans, family involvement and therapy, medications used for detox and management, and types of therapies utilized. Find out what the partial hospitalization expects, their admission process, and availability.16

There is a partial hospitalization program available to meet your recovery needs. If you need help finding the right one, call us at (800) 662-HELP (4357).

Resources

  1. Center for Substance Abuse Treatment. (2014). What Is Substance Abuse Treatment? A Booklet for Families. HHS Publication No. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  2. Center for Substance Abuse Treatment. (2015). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
  3. Chand SP, Kuckel DP, Huecker MR. (2021). Cognitive Behavior Therapy.
  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.
  5. Resnicow, K., & McMaster, F. (2012). Motivational Interviewing: Moving from Why to How With Autonomy Support. The International Journal of Behavioral Nutrition and Physical Activity, 9, 19.
  6. Donovan, D. M., Ingalsbe, M. H., Benbow, J., & Daley, D. C. (2013). 12-step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview. Social Work in Public Health, 28(3-4), 313-332.
  7. Substance Use Disorder Treatment and Family Therapy. (2020). Substance Use Disorder Treatment: Working With Families. Treatment Improvement Protocol (TIP) Series, No. 39. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
  8. Elias, D., & Kleber, H. D. (2017). Minding the Brain: The Role of Pharmacotherapy in Substance-Use Disorder Treatment. Dialogues in Clinical Neuroscience, 19(3), 289-297.
  9. Ekhtiari, H., Rezapour, T., Aupperle, R. L., & Paulus, M. P. (2017). Neuroscience-Informed Psychoeducation for Addiction Medicine: A Neurocognitive Perspective. Progress in Brain Research, 235, 239-264.
  10. The Association for Ambulatory Behavioral Healthcare. (2021). Standards and Guidelines for Partial Hospitalization Programs and Intensive Outpatient Programs.
  11. Khawaja, I. S., & Westermeyer, J. J. (2010). Providing Crisis-oriented and Recovery-Based Treatment in Partial Hospitalization Programs. Psychiatry, 7(2), 28-31.
  12. Puspitasari, A. J., Heredia, D., Coombes, B. J., Geske, J. R., Gentry, M. T., Moore, W. R., Sawchuk, C. N., & Schak, K. M. (2021). Feasibility and Initial Outcomes of a Group-Based Teletherapy Psychiatric Day Program for Adults With Serious Mental Illness: Open, Nonrandomized Trial in the Context of COVID-19. JMIR Mental Health, 8(3), e25542.
  13. Baweja, R., & Ramtekkar, U. (2021). Child and Adolescent Tele-Partial Hospitalization Programs: Opportunities and Challenges. Journal of the American Academy of Child and Adolescent Psychiatry, 60(10), S15.
  14. Chen, J. A., Chung, W. J., Young, S. K., Tuttle, M. C., Collins, M. B., Darghouth, S. L., Longley, R., Levy, R., Razafsha, M., Kerner, J. C., Wozniak, J., & Huffman, J. C. (2020). COVID-19 and Telepsychiatry: Early Outpatient Experiences and Implications For the Future. General Hospital Psychiatry, 66, 89–95.
  15. Blevins, C. E., Abrantes, A. M., Kurth, M. E., Gordon, A. L., & Stein, M. D. (2018). Quality of Life and Well-Being Following Inpatient and Partial Hospitalization Treatment for Opioid Use Disorder. Archives of Psychiatric Nursing, 32(3), 505-509.
  16. National Institute of Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.

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