In the 1960s, clinicians sought out a new treatment approach for those who needed an intensive level of psychiatric care. Partial hospitalization programs (PHP) were initially created to help those who have mental health disorders. In the beginning stages, they were called “day hospitals” and helped people who needed intensive levels of psychiatric care who would also benefit from living in a large community.
These allowed for safe and stable home lives once treatment concluded. Twenty years later, Medicaid laws shifted, and partial hospitalization options began expanding at a rapid pace. In late 1990, financial restrictions were placed as the idea that addiction is a mental and behavioral illness took hold, and PHPs began to work toward helping those stuck in the cycle of substance abuse issues.
Today, PHPs exist mainly to work with people who are living with mental illness, but many types of other programs exist as an outpatient method of helping individuals overcome substance use disorders. The programs can range from outpatient to full-day intensive, but there are many common core tenets. The sole objective of PHP is to help find a way for individuals to overcome their substance abuse.
Partial hospitalization is a highly structured psychiatric treatment program. Its sole purpose is substance abuse prevention, but it also offers medical oversight. PHP is usually an option for treatment after a person has been hospitalized because of substance abuse issues, and the person has been given medical approval for discharge. PHP is used as a stepping-stone between residential and full outpatient programs for substance use disorders.
To attend a PHP, there must be a current and documented diagnosis of a substance use disorder from a medical professional. The person in question requires consistent medical monitoring but must be stable enough to go overnight without oversight. The person must not be at risk for self-harm, and detox symptoms must be mild or moderate so that they can be managed at home for part of the day. The individual is emotionally, mentally, and physically able to endure several hours of therapy, both group and individual, for several days a week. Lastly, the individual is still not deemed ready to function daily but has enough community and family support to avoid relapse.
For someone who is struggling with a substance use disorder, partial hospitalization does offer medical detox in some scenarios. To go through medical detox, the person must not be facing life-threatening withdrawal symptoms. While that is rare, withdrawal from substances like alcohol or benzodiazepines requires 24-hour medical monitoring to mitigate dangers such as seizures, heart attack, or other various side effects. Those with a tapering regimen will benefit from intensive therapy sessions for several weeks to alter behavior patterns. In this situation, a PHP is the perfect option. It is an excellent step between residential and outpatient programs.
Your schedule for PHP will vary depending on the severity of your addiction and the clinical recommendations to address your evolving needs. The length of stay will also change as the clients’ needs change, but typically, therapy sessions can range from two hours per day, three days per week, to eight hours per day, five days per week. A majority of the programs require four to five days of therapy per week with scheduled breaks, and range from four to eight hours per day .
The bare minimum of hours for PHP is 10 hours per week with the max reaching 50. Once treatment concludes for the day, the individual can return home. This arrangement gives them the ability to practice their newly acquired skills from therapy. PHPs bring in those who would be hospitalized on other occasions. New clients should have their medical requirements evaluated by the PHP in the first two to three days of being admitted. They must receive a psychiatric evaluation in the first three days.
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Those who are eligible for partial hospitalization programs on average stay between three and five weeks. When someone leaves a PHP, they will have detoxed the substance from their system and should be able to function on their own. They should have an understanding of their addiction and how to deal with triggers, but is this enough time? For some, perhaps, but the longer someone stays in treatment the better their outcome. The National Institute On Drug Abuse (NIDA) states that participation for less than 90 days limits effectiveness for maintaining positive results.
With PHP programs lasting up to five weeks, statistics back up that it is not enough. Addiction is a chronic disease, and only detoxing from a drug and participating in the minimum hours of therapy is not enough. Everyone progresses through drug addiction treatment at various speeds meaning there is no predetermined length, but research agrees that good outcomes are contingent on adequate lengths of treatment. If PHP is the program a person is placed into, they must consider admitting themselves to an outpatient treatment program after they complete a PHP. Unfortunately, if treatment is not continued, the potential for relapse is very high.
If the individual does not want to check themselves into an outpatient program, they may benefit significantly from a sober living home arrangement. A sober living home, sometimes referred to as a halfway house, operates as a bridge between PHP and the real world. Once the client leaves their program and returns home, it could be an adjustment to struggle with the rigors of daily life.
There are certain comforts you may experience from having structure and a routine; this will all disappear if you automatically leave it all. Sober living homes provide an in-between recovery option that allows you to reinforce the lessons you learned in either outpatient or PHP.
In many cases, sober living has been said to save the life of the person in question. A sober living home is a great option to alleviate concerns that may arise from going into an intensely monitored environment directly into daily life.
While it does not provide the same structure, it does present an intermediate environment that places you around others who are on the same path. A significant portion of sober living is to create positive friendships that help reinforce the desire to abstain from drugs or alcohol. These support systems allow the resident to avoid the isolation that sometimes can happen during recovery.
If you or a loved one has been struggling with drugs or alcohol and relapsed because your treatment was not long enough, it is time to get back on track. Lapses and relapse are a part of recovery, but you cannot let it get back to the point it was. Today is as good as any other day to take your life back.
National Institute on Drug Abuse. (n.d.). How long does drug addiction treatment usually last? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
Definition of partial hospitalization. The National Association of Private Psychiatric Hospitals and the American Association for Partial Hospitalization. (1990). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10106610