Partial Hospitalization Programs

Partial Hospitalization Programs (PHP) were treatment programs originally developed to help people struggling with mental illness. Initially called “day hospitals,” these programs were designed in the 1960s to help those who needed an intensive level of psychiatric care but who would also benefit from living in the larger community as well as those who had stable, safe home lives to return to after a full day of treatment ended.

After changes to Medicaid laws in the 1980s, Partial Hospitalization options expanded rapidly, until financial restrictions were placed on them in the late 1990s. As the idea that addiction is a mental and behavioral illness with biological roots, rather than an issue of willpower, took hold, PHPs began to develop for people struggling with substance abuse issues.

PHPs still exist primarily to work with individuals who struggle with mental illness, but many subsets of these programs across the country exist as an in-between, or even outpatient, method of helping people who want to overcome substance addiction and abuse. These programs come in many ranges of options, from flexible outpatient to full-day intensive programs, but they have several core tenets in common. The most important common factor among all PHPs is the desire to find a way to prevent people overcoming substance use from becoming a patient in a hospital.

How Partial Hospitalization Works

Partial Hospitalization is a highly structured psychiatric treatment program which, in the case of substance use prevention, also offers some medical oversight. Typically, a PHP is an option for treatment after a person has been hospitalized due to substance use issues, and the person is deemed fit to be discharged from the hospital. PHPs are often used as steps between inpatient and fully outpatient programs for substance abuse as well.

Some general criteria for Partial Hospitalization include:

  • A current, documented diagnosis of a substance use disorder from a medical professional is needed.
  • The individual needs consistent medical monitoring, but is stable enough to go overnight without monitoring.
  • The individual is not at risk of self-harm.
  • Detox symptoms are considered to be mild or moderate, so the individual can manage them at home for part of the day.
  • The individual is physically, emotionally, and mentally able to tolerate several hours of therapy, both group and individual, several days a week.
  • The individual is still not deemed able to function on a daily basis, but has enough community and familial support to avoid relapse.

For substance use disorders, Partial Hospitalization does offer medical detox, but only to people who do not face life-threatening withdrawal symptoms. Withdrawal is rarely life-threatening for many substances of abuse, especially with a medical professional’s oversight; however, withdrawal from some substances – like alcohol and benzodiazepines, for example – requires 24-hour medical monitoring to ensure clients do not suffer from seizures, heart attack, or other severe side effects.

For individuals working on a tapering regimen, and who will benefit from intensive therapy sessions for several weeks to change their behaviors, Partial Hospitalization is a great option. It is also a perfect step between completely inpatient and completely outpatient programs.

Who Benefits from a PHP?

  • People who struggle with substance use, but who have a supportive community and/or home environment
  • People who are not likely to suffer dangerous withdrawal symptoms, like delirium tremens
  • People who will benefit from some flexibility in their personal schedule
  • People who are ambulatory (i.e., physically capable of transporting themselves to and from the program)
  • People who are able to work intensively in group and individual therapy sessions
  • People who are capable of self-regulating prescription medications, if needed

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