Are Partial Hospitalization Programs Right for You?
What kind of care is offered in a partial hospitalization program (PHP)? The answer is right there in the name.
In a PHP, you’ll spend part of your time in a hospital-like setting as you work on your addiction. The rest of the time, you’ll be at home or in a sober living home.
If full hospitalization and completely outpatient programs are two extremes of addiction care, a PHP works as a bridge. It’s appropriate for people who need a little more attention than an outpatient program can offer, but who don’t quite need the full inpatient care experience.
How Does a PHP Work?
Enroll in a PHP, and you’ll spend at least part of most days in a clinical setting. Here, you’ll work with trained professionals on your addiction issue.
The National Institute on Drug Abuse says PHPs are sometimes called “day treatment” programs, and often, they involve six-hour sessions at least five days per week. In each session, you might access:
- Individual therapy. You’ll work with a mental health professional. Together, you’ll explore your addiction triggers and determine what skills you’ll need to keep from acting on them.
- Addiction education courses. How do addictions develop? How do they change the way you think and feel? These are the sorts of questions you’ll answer in training classes.
- Group therapy. You’ll share a therapist with other addicted people. You’ll learn from one another and the mental health professional.
- Medication management. Addictive drugs change your brain at the cellular level. Severe damage can make it hard for you to focus on your therapy and your lessons. Medications like buprenorphine, methadone, and acamprosate can help to amend those chemical imbalances. You might get your doses each time you come to the PHP, and you might have some you can take at home too.
- Family therapy. The goals of this form of treatment are to repair the damage caused by addiction and help you develop a closer relationship with those you love. You might meet with a therapist as a group, or you might talk individually.
- Support groups. You’ll meet other people also struggling with addiction. Together, you’ll talk about how you cope. You may also study the so-called “Big Book” that works as the foundation for Alcoholics Anonymous and other 12-step sobriety organizations.
PHPs can be remarkably helpful, but they’re relatively rare. In Philadelphia, for example, fewer than 15 percent of addiction treatment facilities offered PHPs, according to the 2016 National Survey of Substance Abuse Treatment Services. Other states have similar numbers.
What Makes a PHP Different?
There are several ways to treat addiction, and many of them involve living outside of the treatment facility. To understand what sets a PHP apart, it’s important to consider severity.
In outpatient addiction treatment programs, you’ll live at home or in a sober community, and you’ll head to the clinic for your appointments. You might get some of the same help we’ve mentioned above. You might even work with the same types of treatment professionals.
But you may only spend four or five hours per week in care. You might not have a medication management component. And you may work with social workers and case managers rather than psychiatrists and psychologists.
In other words, you’ll get care in an outpatient program. But it won’t be as stringent as the treatment in a PHP.
On the flip side, you could enroll in an inpatient program. Here, you’ll have care around the clock for your addiction, and you won’t leave the facility until the team deems you ready to do so. This is a significant (and expensive) form of addiction care, and it’s not right for everyone.
As authors writing in The Journal of Nervous and Mental Disease explain, a PHP’s main function is to keep an inpatient admission from ever becoming necessary. The care you’ll get here should help stop your addiction from progressing, so you can get better and stay in your community. It’s a way to catch you as you fall.
The American Society of Addiction Medicine says you and your doctor can work together to determine if a PHP is the right place for you. You’ll make that decision by examining your:
- Addiction history. A longstanding drug abuse problem might be harder to address than one that’s just begun.
- Severe withdrawal and other side effects can require intense care you can’t get in an outpatient setting.
- Prior treatment approaches. If you’ve tried recovery before and it didn’t work, you might need a different treatment type this time.
- Mental health. Post-traumatic stress disorder, borderline personality disorder, anorexia, depression, and other mental health issues can complicate treatment, and they might need a more significant level of care.
- You have a say in the treatment program that’s right for you. One type may appeal to you over another, and that is always respected.
Paying for PHP
You’ve decided that a PHP is the right choice for you. How will you pay for the care? If you thought of your insurance plan, you’re not alone. Most people hope that their policies will cover at least some of the medical bills. But you’ll need to tread carefully.
Insurance program administrators like to keep costs low, and often, that means they’d like their enrollees to use the least expensive option available. Outpatient care is preferred as a result.
If you know you need a PHP, make sure you can document why it’s the best choice for you and your recovery. Get your doctor, therapist, or other professional to jot notes down you can share. And ask your treatment provider to talk with your insurance company directly and authorize your care before you enroll.
That way, you’ll ensure there will be no payment complications standing in your way when you start your recovery.
Does PHP Work With Other Recovery Options?
It’s easy to think in black-and-white terms about your recovery. If you choose one option, the others don’t seem available to you. Addiction professionals think differently. To them, recovery works on a spectrum. You might need some or all of the different types of help available as you fight back.
Your journey might include:
- Medical detox. This is the first part of recovery. You’ll help your body ease from intoxication to tentative sobriety with the help of medications and medical monitoring.
- Sober living. If you don’t have a safe place to live, your recovery is tenuous. Moving into a sober home can give you the foundation you can build on in your PHP.
- Outpatient care. If you’re feeling stronger in recovery, you might transition from the PHP to this less restrictive form of care.
- Inpatient care. If your PHP doesn’t seem to help and you need more assistance, you might need this level of care until you feel stronger.
Research from the Journal of Substance Use suggests that PHP success is dictated by aftercare planning, not addiction severity. The more people went to support group meetings and met with counselors after discharge, the better they did. That was true even if their addictions were severe.
Studies like this prove that PHPs work if you work them. They also highlight how critical it is for you to follow up on your treatment and keep working on your addiction, even when you’re done with the program. Your hard work will pay off with sobriety that persists.
Your provider should offer discharge plans that help you understand your next steps. You should have the option to come back for more help if you feel yourself starting to slide. It’s not a sign of weakness. It’s part of your recovery. And it’s worth fighting for.