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What is a Partial Hospitalization Program (PHP)?

A Partial Hospitalization Program (PHP) is an intensive treatment program. It usually requires a four to five day per week commitment of five to six hours per day for four to six weeks. Those with more severe disorders receive more intensive treatment.

Comparing Treatments

There are some similarities between PHP and inpatient and outpatient treatments, but each is different and features benefits and drawbacks.

inpatient

Partial Hospitalization Programs vs. Inpatient Treatment

The advantage of PHP versus inpatient treatment is that patients go home at night.  

Many patients start in the inpatient level of treatment, for psychiatric stabilization, or detoxification, in the case of addiction and /or dual diagnosis treatment. After a brief stay in the inpatient unit, a patient is often ready to ‘step down’ to another level of care. The treatment team in the inpatient setting makes recommendations and helps the patient decide what the best option is for their next step.

Another advantage of PHP over inpatient treatment is cost. Inpatient treatment is expensive, and most insurance companies push for the shortest stay possible for inpatients.  PHP, which offers a lower level or less intensive level of care is more often approved by insurance providers for a longer stay. PHP participants have a better chance of insurance coverage for their treatment.

outpatient rehab

Partial Hospitalization Programs vs. Outpatient Treatment

The outpatient level of care is the least intensive. This is usually a weekly office visit with a therapist in a non-hospital setting. 

Some patients begin treatment in the outpatient setting, especially if it’s their first time seeking services. The need for a higher or more intensive level of care, such as PHP, Intensive Outpatient (IOP), or even inpatient stabilization, is quickly apparent to the outpatient therapist and a referral is made. 

When a patient does not need a PHP, IOP, or inpatient, or has completed these programs, then outpatient therapy is the best option.  

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How Do Partial Hospitalization Programs Work?

Partial hospitalization programs offer structured outpatient psychiatric services. These programs are an alternative to inpatient psychiatric care.

PHPs offer more intense care than patients receive in a doctor’s or therapist’s office. The treatment takes place during the day and doesn’t require an overnight stay. Programs such as these are based on the belief that individuals have a better chance of recovery and healthy life when they pursue treatment in their home communities. This means treatment occurs where they work, attend school, or have established family and community ties.

Structure 

Partial hospitalization offers daily structure. The goal is to provide support during the early stages of recovery and learn skills that allow a person to remain sober. 

Patients in PHP work with a counselor to identify your strengths, goals, and weaknesses. Together they create a treatment plan to meet these goals. 

The daily schedule in a PHP can include:

  • Time with an attending physician on a weekly or twice-weekly basis
  • Access to a nurse for any issues that arise between doctor visits
  • Daily therapy sessions that address the substance use disorder and any co-occurring conditions

Additionally, PHP therapists collaborate with patients on a long-term treatment plan, conduct family sessions (if needed), and create a step-down and discharge plan.

Services Offered 

Services offered in PHP include:

  • Group therapy sessions with peers to learn more about addiction and recovery
  • Music or art therapy to learn new ways to express your emotions
  • Family therapy to address poor communication and repair relationships
  • Ongoing access to resources and staff prepared to answer questions and help patients reach their goals

PHP varies from patient to patient and program to program. Some provide holistic therapies, while others focus on traditional 12-step recovery methods. The goal of treatment is to build a strong foundation, discover that other people have similar challenges and that people are there who understand the challenges of achieving and maintaining sobriety.

How Effective Is Treatment?

Partial hospitalization is a highly effective treatment option for those willing to commit to it. It is intensive, time-consuming, and requires a dedication to making lasting change.  

Prospective patients usually take a leave of absence/FMLA work or at least reduce their hours significantly. Programs include therapeutic homework assignments and many attend twelve-step (or comparable) meetings outside of PHP hours.  

Patients receive a high standard of treatment and achieve success when all clinical direction in PHP is followed. 

treatment

Treatment Costs & Insurance

The cost of PHPs tends to range from $300 to $500 per day. This makes treatment more affordable and accessible to more people. Insurance companies cover PHP because it reduces the risk of needing inpatient treatment.

Most people receiving benefits from state and federally supported health insurance programs are eligible for at least partial PHP coverage. This might include coverage of occupational therapy that’s part of a mental health treatment plan and individual patient training and education about a condition. Medicare won’t cover meals, transportation, support group, or career training in PHPs. 

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Resources

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“Partial Hospitalization Coverage.” www.Medicare.Gov, www.medicare.gov/coverage/mental-health-care-partial-hospitalization.

Neuhaus, Edmund C. “Fixed Values and a Flexible Partial Hospital Program Model.” Harvard Review of Psychiatry, U.S. National Library of Medicine, 2006, www.ncbi.nlm.nih.gov/pubmed/16513586.

Neuhaus, Edmund C. “Short-Term Cognitive Behavioral Partial Hospital Treatment: ... : Journal of Psychiatric Practice®.” LWW, Journal of Psychiatric Practice, Sept. 2007, journals.lww.com/practicalpsychiatry/Abstract/2007/09000/Short_Term_Cognitive_Behavioral_Partial_Hospital.3.aspx.

Weiss, Hom M.A., et al. APA PsycNet, American Psychological Association, 2020, psycnet.apa.org/fulltext/2020-39749-015.html.

Hoge, Michael A., et al. “The Promise of Partial Hospitalization: A Reassessment.” Psychiatric Online, Psychiatric Services, 1 Apr. 2006, ps.psychiatryonline.org/doi/abs/10.1176/ps.43.4.345.

Beard, Courtney, et al. “Predictors of Depression Treatment Response in an Intensive CBT Partial Hospital.” Wiley Online Library, John Wiley & Sons, Ltd, 2 Mar. 2016, www.onlinelibrary.wiley.com/doi/abs/10.1002/jclp.22269.

Doan, Richard J., and Theodore A. Petti. “Clinical and Demographic Characteristics of Child and Adolescent Partial Hospital Patients.” Journal of the American Academy of Child & Adolescent Psychiatry, Elsevier, 4 Jan. 2010, www.sciencedirect.com/science/article/pii/S0890856709659001.

Robitschek, Christine, et al. “Personal Growth Initiative: A Robust and Malleable Predictor of Treatment Outcome for Depressed Partial Hospital Patients.” Journal of Affective Disorders, Elsevier, 25 Dec. 2018, www.sciencedirect.com/science/article/pii/S0165032718320093.

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