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Partial Hospitalization Programs for Alcoholism

A Partial Hospitalization Program (PHP) is an intensive level of outpatient care for people with substance use disorders. Learn more about PHP's for alcohol use disorders as well as co-occurring disorders who who would be good candidates for them

What is a Partial Hospitalization Program (PHP)?

A partial hospitalization program (PHP) is an intensive level of outpatient care for people with substance use disorders. Though different programs may vary in terms of their precise schedules, PHPs can be expected to provide at least 20 hours of treatment per week.1,2 A PHP is relatively more time-intensive than an intensive outpatient program (IOP), which commonly provide 9 hours or more per week of substance use disorder treatment services.1

Partial hospitalization programs may also serve as an ideal outpatient setting for treating people with both substance use disorder and mental health issues, with the relative intensity of such a program facilitating the simultaneous treatment of both disorders.1 An important feature of many PHPs is that they facilitate patient access to intensive medical and psychiatric services, when needed.2

Learn more below about partial hospitalization programs, who is a good candidate for this level of care, what to expect in treatment.

Who is a Good Candidate for PHP?

Candidates for PHPs are sometimes those who need intensive care but are reasonably likely to refrain from drinking outside of a restricted setting. However, PHPs may also be an ideal destination for people who have just left a more restrictive hospital or residential treatment setting and remain at relatively high risk of relapse.2

However, evaluating the ideal level of care for addiction treatment is not always so straightforward, as there are several dimensions that need to be assessed for each individual and their unique needs in order to make this determination. According to the American Society of Addiction Medication (ASAM), factors to assess include:3

  • An individual’s level of intoxication and/or withdrawal potential.
  • Health history and current physical well-being.
  • Emotional, behavioral, or cognitive issues.
  • The individual’s readiness to change.
  • Relapse history and potential for relapse.
  • An individual’s living situation or recovery environment, including surround people, places, and things.

Often, those who participate in PHPs are those who’ve been treated in a hospital or residential setting buy may still require additional contact with treatment professionals to minimize the risk of relapse.4 These patients may have had prior relapses following treatment or are returning to a high-risk environment in which more support is needed for their recovery-focused efforts.4

Further, there are times when a PHP may not be an appropriate level of care. These situations include: 2,5

  • Having suicidal thoughts.
  • Experiencing an acute psychotic episode.
  • Having an acute medical condition that cannot be managed safely outside of an inpatient setting.
  • Not living in an environment that is supportive of treatment and recovery.
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Do PHPs Treat Co-Occurring Disorders?

Yes, many PHP programs treat people with co-occurring disorders. If you’re struggling with a mental health disorder or a comorbid health condition, research has indicated that programs that integrate their treatment approaches to more comprehensively address both issues may result in improved recovery outcomes.6 Integrated treatment means that your treatment team will address both the SUD and mental disorder within one program to treat the person as a whole more effectively.6

It may be helpful to note that there are different levels of integrated co-occurring disorder treatment within facilities. Programs can be “co-occurring capable,” meaning that they focus primarily on treating substance use disorders while providing access to treatment for relatively less severe types of behavioral health disorders, such as milder forms of depression, as needed.6 Other co-occurring disorder treatment programs focus mainly on mental health and treat substance misuse as needed.6

Programs considered “co-occurring enhanced” treat both types of disorders at the same time and have staff who are trained in both substance use disorder treatment and mental health.6 Prior to beginning a program, you may want to inquire about which level of co-occurring disorder care is offered.

What to Expect at PHPs

Although no two programs are exactly alike, treatment for alcohol abuse and alcoholism involves a combination of individual, group, and family therapy as well as medication administration and mutual support groups.7 Many partial hospitalization programs are able to provide treatment during evening or weekend hours to accommodate people who need to work during the day.4

Regardless of the format, many programs focus on keeping people stable in recovery by providing access to medical and psychiatric services along with reinforcing coping skills and other techniques to prevent relapse.2 The treatment components of partial hospitalization programs also aim to assist in individuals in transitioning into less intensive outpatient services while promoting self-reliance through relapse prevention classes and the active use of self-help programs.2

Cost of PHPs

The cost of any treatment program will be influenced by a number of factors including your insurance coverage, length of stay, additional amenities, and location. For example, a PHP in a location like Malibu, California will likely be more expensive than a program in the Midwest. If your treatment program offers luxury amenities such as massage therapy or gourmet meals, this could be factored into the cost as well.

Based on your specific insurance coverage, some plans cover longer stays while others limit the number of days they’ll cover within a year. Check with your insurance provider to learn more about what may and what may not be covered under you plan.

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Sources
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[1]. American Society of Addiction Medicine. (2015, May 13). What are the ASAM levels of care?

[2]. American Psychiatric Association. (2010). Practice guidelines for the treatment of patients with substance use disorders.

[3]. American Society of Addiction Medicine. (1991). What is The ASAM Criteria?

[4]. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.

[5]. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and substance abuse treatment.

[6]. Treatment Improvement Protocol (TIP 42). (2020). Substance use disorder treatment for people with co-occurring disorders. Substance Abuse and Mental Health Services Administration.

[7]. National Institute on Alcohol Abuse and Alcoholism. (2021, March). Treatment for Alcohol Problems: Finding and Getting Help.