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Treatment options can be confusing and overwhelming as there are many options to choose from. This article will explore levels of care in substance abuse treatment and break down the difference of IOP and PHP.

Levels of Care:

Starting with the most intensive is detox level of care, this includes 24 hour monitoring at an acute or sub acute facility. Following detox is residential level of care and similar to detox, residential is also inpatient. Following inpatient care, it’s recommended to participate in continuing care. Detox and residential programs have 24 hour monitoring, whereas in IOP and PHP are outpatient levels of care. It’s generally recommended and encouraged for patients to reside in sober living during outpatient treatment.

What is PHP?

PHP stands for partial hospitalization program although this does not need to be held in a hospital setting. Many outpatient substance abuse centers have a PHP program for ongoing support and continuing care after inpatient treatment. A client may enter treatment at PHP level of care if medical necessity isn’t met for detox or residential services. PHP requires 6 hours of treatment per day and is generally held 4-5 x per week. PHP is similar to residential in the context of treatment hours and added support, although patient’s live at home or at a local sober living. PHP is not exclusive to substance abuse. Mental health providers also offer PHP. PHP is intensive, comprehensive, and structured. The focus of many groups in lower levels of care includes relapse prevention tools to cope with stressors and combat cravings. It can also offer community support and access to informal community support groups such as 12-step meetings. 

What is IOP?

IOP stands for intensive outpatient and requires 3 hours of treatment per session. Intensive outpatient programs are very involved and are designed to attend 3 to 5 days per week. The studies over the years have presented data confirming longer lengths of time in treatment directly informs a better prognosis, thus reducing risks of lapsing into maladaptive behaviors. An intensive outpatient program offers more flexibility for patients with outside obligations such as work or familial responsibilities. 


PHP and IOP are both outpatient treatment programs, although one is less intensive than the other. IOP stands for intensive outpatient program and includes 3 hours of treatment, whereas PHP includes 6. Patient’s will be assessed by outpatient providers to determine their level of care and work collaboratively with each patient to ensure it adheres to scheduling needs. Patient’s can attend PHP and/or IOP from home or a local sober living program. Many patients choose to live in sober living during IOP and PHP for added community support and monitoring. According to NIH, “IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies.” 

The Bottom Line

PHP and IOP’s are a crucial part of the continuum of care and offer structured treatment to continue working on recovery efforts with more “freedom” than residential. PHP and IOP are outpatient programs whereas detox and residential programs have 24 hour monitoring. A patient can reside at home or in a supportive living environment such as a sober living during treatment. Continuing care is not only widely recommended by treatment professions, it’s backed by research. PHP is a great starting off point after inpatient treatment or if indicated for other circumstances as a direct admit. PHP reinforces the tools and strategies needed to reduce overall risk and improve daily functioning. IOP is designed to continue building on learned skills and relapse prevention. Patient’s will be assessed by outpatient providers to determine their level of care and individual needs. Once level of care is determined, finding an appropriate treatment program is next! Call a dedicated admissions manager at Carrara Treatment Wellness & Spa to answer any questions you have. 

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