Partial Hospitalization (PHP) Addiction Treatment
According to the National Survey on Drug Use and Health conducted in 2019, 19.3 million people in the U.S. are struggling with addiction.1 This population is diverse both demographically and in terms of the abused substance, health condition, and other co-occurring disorders.
In order to cater to these diverse needs, it is necessary to have several different addiction treatment options, including partial hospitalization programs (PHP). Addiction is a highly individual disease and treatment programs that work for one person may not be the best option for everyone.
Treatment Options Overview
In general, there are two main forms of addiction treatment:
- Residential (or inpatient) addiction treatment programs, which provide around-the-clock supervised and structured care in a specialized facility.
- Outpatient addiction treatment programs, which offer more flexibility and have a few different levels of care.
Traditional outpatient programs may allow for services to be provided at times that can work around a person’s existing obligations or schedules while intensive outpatient programs (IOPs) for addiction treatment are more similar to a residential program during the day, with the main difference being that the individual returns to their home to sleep each night.
What Is PHP Treatment?
PHP treatment programs are a great resource for people who do not require the strict structure of a residential treatment program, but require more than traditional outpatient programs offer. These programs have a multidisciplinary team of professionals who can provide or connect patients to a range of services such as medically supervised evaluation, detoxification, and referral. Many PHP treatment programs in the U.S. have close clinical and/or administrative ties to hospital centers.2
A PHP treatment program is often offered as a step-down level of care for those who have just completed a residential treatment program. It may also be a step-up for individuals who suffer a relapse while attending traditional outpatient addiction treatment programs as well. People attending PHP treatment programs continue to live at home during the duration of the program and go to a treatment facility for several hours each day during the week.
PHPs will commonly have similar rules and structure to IOPs or residential programs while the individual is on site. This means that patients in PHP addiction treatment are required to adhere to structured programming and not use smartphones or communicate with the outside world during the time they are at the treatment facility.
Is PHP Considered Inpatient?
A partial hospitalization program (PHP) is a type of outpatient addiction treatment program where a person requires medical care and attention in a structured facility for around 20 hours a week, generally 4-6 hours a day, five days a week.
Individuals in PHP addiction treatment may not require around-the-clock medical care and supervision. However, they may also not be quite ready for a traditional outpatient program either. A PHP treatment program can work as a kind of in-between for these two models of care.
What Is the PHP Level of Care?
The American Society of Addiction Medicine (ASAM) encourages both treatment providers and receivers to think about the models of care as a continuum in substance abuse treatment, rather than discrete levels of care. The five main points on this continuum are the following:3
- Level 0.5: Early intervention treatment
- Level 1: Outpatient treatment
- Level 2: Intensive outpatient/PHP treatment
- Level 3: Residential/Inpatient treatment
- Level 4: Medically managed intensive inpatient treatment
The Components of PHP Treatment Programs
Components of a PHP may include:
- Detox. Mild to moderate withdrawal symptoms can be managed during PHP addiction treatment. However, more significant withdrawal symptoms may require medical detox in a more secure setting.
- Medication management. Medications are often a beneficial component of addiction treatment and recovery as they can help to minimize cravings, manage withdrawal, and treat co-occurring disorders.
- Medical care. Individuals may have medical needs that require attention and care by trained professionals during a PHP.
- Psychiatric care and evaluation. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that 9.5 million people in the U.S. battled both a mental health disorder and addiction at the same time in 2019.4 It is therefore important for addiction treatment programs to screen for, identify, and simultaneously treat any potential co-occurring disorders.
- Group and individual therapy. Therapy and counseling sessions are some of the most important tools used during addiction treatment programs. Individuals can learn vital skills for improving how they think, feel, and act, which can in turn improve their behaviors, coping mechanisms, communication and relationship skills, and social interactions.
- Educational programs, relapse prevention, and life skills training. Relapse is a part of addiction as a chronic disease. According to the National Institute on Drug Abuse (NIDA) reports that 40-60% of those suffering from the disorder will struggle with relapse.5 Prevention techniques, coping mechanisms, learning how to recognize triggers, and education into the disease of addiction and recovery can all help to minimize relapse and help people to lead full and healthy lives.
- Holistic methods. Things like spa treatments, massage therapy, yoga, mindfulness meditation, equine-assisted therapy, chiropractic care, art therapy, acupuncture, nutrition planning, fitness regimes, and more are all adjunctive and complementary methods that can be helpful during a PHP treatment program.
As addiction is individual, the choice of components of PHP addiction treatment may differ as well. In order to establish which treatment options are optimal, trained professionals first do a thorough mental health and medical evaluation upon or prior to admission into a PHP treatment program to determine which methods should be employed in order to best serve the individual.
Are Partial Hospitalization Programs Effective?
A PHP treatment program is generally more cost-effective than a residential program. It may also be covered by health insurance at different rates, depending on the person’s policy and coverage. For instance, Medicare coverage may be applied to eligible PHP programs. It may be a great resource for those who live in a stable home environment and who are able to safely return home each night.PHP addiction treatment can be ideal when drug or alcohol dependence is not as severe.3 However, it is not the most effective solution in the case of opioid, benzodiazepine, or alcohol dependence and/or addiction. In these cases, individuals should seek out a comprehensive medical detox program. Since withdrawal symptoms for these substances may be life-threatening, this process should be managed with continuous supervision of vital signs and mental health status. Withdrawal from other substances, or less severe cases of physical dependence, can be managed by a PHP.
Frequently Asked Questions
- If the assessment shows that 24-hour supervision and medical support are not necessary, then the patient is a candidate for a PHP treatment program. This decision will also depend on the patient’s home situation (support of family members) and access to treatment facilities.
Individuals who have already completed a residential addiction treatment program may benefit from the step down into a PHP treatment programas offered through a full continuum of care. Individuals may transition into a sober living home or community, or another form of transitional housing, after a stay in a residential treatment center and continue on with a partial hospitalization program during the day.
Treatment providers may even provide transportation to and from the transitional living arrangements and PHP. This can provide people with a middle ground before returning back to society and everyday life, allowing individuals time to heal and develop healthy habits that can be sustained long-term.
People enrolled in PHP treatment programsduring the day may also attend support groups or 12-Step meetings in the evenings or on weekends to further enhance recovery. PHP treatment programs provide more structure and supervision than a traditional outpatient program and can also be a great choice for people wishing to step up into a more comprehensive and structured level of care.
After completing a short-term PHP treatment program, individuals should transition into outpatient care. Outpatient services that can help to enhance a long recovery following a PHP include the following:
- Group, family, and individual therapy sessions
- Support group meetings
- Relapse prevention programs
- Education and training programs
- Medication management
- Alumni and aftercare services
Follow-up care and aftercare programs provided by trained professionals within the confines of a specialized addiction treatment facility or program are important for sustained recovery after completing PHP addiction treatment.
Again, partial hospitalization programs are often provided as step-down or step-up programs within a full continuum of care provided by a specialized addiction treatment program. Trained providers can help individuals and families determine placement into an addiction treatment program, and people may move between levels of care as needed.
According to NIDA recommendations, the duration of intensive outpatient treatments should be 90 days minimum since a longer period of care correlates to more positive treatment outcomes.6 However, there is no one set standard that fits everyone. The optimal length of treatment will depend on many factors, including the person’s clinical needs, psychological condition, and the support system that they have.
1. Substance Abuse and Mental Health Service Administration. (2020). National Survey on Drug Use and Health.
2. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment (Treatment Improvement Protocol Series, No. 45).
3. Center for Substance Abuse Treatment. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment (Treatment Improvement Protocol Series, No. 47).
4. Substance Abuse and Mental Health Service Administration. (2020). Mental Health and Substance Use Disorders.
5. National Institute on Drug Abuse. (2020).Treatment and Recovery.
6. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.