The PHP addiction treatment model emerged in the late 1980s and became widely accepted in the 1990s due to many successful patient outcomes. What is PHP treatment and why would it benefit people struggling with addiction in their lives?
We can think of a PHP or “Partial Hospitalization Program” as a hybrid between inpatient and outpatient treatment programs. PHPs offer the benefits of medical detox and nursing found in inpatient programs, but without the benefit of staying at an inpatient facility. The detox phase of their treatment may see them hospitalized for a few days or so as they clear the substances from their system.
Planning for PHPs typically begins during the inpatient phase of the treatment during the patients initial assessment by the medical and psychiatric team at the PHP or inpatient facility.
The treatment is a step-down program from intensive inpatient care or partial hospitalization. PHPs help the patient integrate into society after going through the hard work of cleaning up and committing to a sober lifestyle.
Patients who enter the outpatient phase of a PHP are mentally stable and they have control over their compulsive behavior. They’ve learned how to manage the emotional, psychological, physical, and environmental triggers that influence their addictive behavior.
A PHP helps the addict renter society and adjust their newfound sobriety to their living situation, their return to work, and their social circle. It teaches patients coping strategies to handle triggers and gives them a support framework to lean on when they experience compulsions to use again.
PHPs provide treatment services at dedicated locations throughout the day. It’s fully operational seven days a week, but the patient doesn’t live at the facility. They’ll turn up at the location for therapy sessions, holistic treatments, and mindfulness classes, but they return home after the session.
The reason why PHP is a “Partial Hospitalization” comes from the first phase of the treatment. Most addicts who enter these programs require immediate detox from their substance of choice, and they won’t be able to undergo the withdrawal process at home. Doing so might threaten their health or life, and in most cases, they won’t be able to find the mental fortitude to complete the detox process, relapsing into their addictive behavior.
By hospitalizing themselves for the detox process, the patient leverages the benefits of round-the-clock medical care for the withdrawal phase of their treatment. When they’re fully detoxed, they can go home and continue with the outpatient phase of their treatment plan.
Patients are required to be self-sufficient during the outpatient phase as they’re responsible for their self-care and managing their daily experience to avoid compulsions to use. Provided they maintain their therapy schedule and implement the strategies they use in their holistic recovery classes, they have a good shot at staying sober.
A PHP treatment facility is just like what you would expect from an inpatient facility. It’s a building with rooms dedicated to hosting private individual and group therapy sessions. It might have facilities for wellness and holistic recovery services, like workout areas, yoga studios, and pools.
PHP treatment centers usually have inpatient treatment facilities on-site to help patients through the detox process. However, they have limited lifestyle facilities on site, such as lounges and common areas that you might expect from dedicated inpatient rehabs.
As with inpatient treatment facilities, PHP venues come in varying degrees of amenities. Some venues are geared towards a luxury experience for high-net-worth individuals, and others are mid-range, while others are state-run. The reality is treatment cots money and the type of facility you choose depends on your budget and your insurance coverage.
So, in wrapping up this section, we can say that inpatient and PHP venues have one core difference between them: inpatient facilities have the patients stay on the property, sometimes for up to three months or longer at a time. While PHP venues only accommodate patients for the detox phase of their treatment.
What To Look For in a PHP Facility and Program
As mentioned, PHP venues differ in the amenities they offer. However, when you’re looking into PHPs for treatment and care programs, ensure the facility you’re interested in offers the following services at a minimum.
Breakthrough research in the 1980s and 1990s showed a link between mental health issues and addiction. Therefore, it’s become a benchmark practice for PHP and inpatient treatment centers to psychologically evaluate a patient before admitting them into treatment.
More than half of all patients with addiction problems have co-occurring mental health issues that are either a result of their addiction or closely tied to its manifestation in their life experience.
This is the first phase of a patient’s treatment when they enter PHP recovery. It’s the “hospitalization” phase of the program. The goal of this phase is to remove the drug or alcohol metabolites floating around in the patient’s bloodstream and tissues; while helping them manage their withdrawal to dampen the intensity of the symptoms they feel during the process.
Drugs like heroin and fentanyl create powerful withdrawals in users and without medical assistance, there is next to no chance that the patient will endure the process. In some cases, such as in patients dealing with Alcohol Use Disorder (AUD), the withdrawal could be so intense the patient experiences seizures that put them in a coma.
The medical detox program in PHPs involves the patient meeting with a medical doctor and a certified psychiatrist for a thorough evaluation of their physical and mental health.
After this assessment the doctors will plan their detox protocol using medications like benzodiazepines for AUD and methadone for heroin addiction. The doctor tailors the patient’s protocol to their specific needs to ensure they get the most benefit, with the lowest doses.
In some instances, the patient may undergo medically assisted treatment (MAT) without undergoing hospitalization. This might be the case if the patient cannot afford the cost of the treatment, for financial or insurance reasons, or if they feel they aren’t deep into an addiction and they can break the cycle at home under family supervision or in-house care.
The patient will go through the withdrawal process in a clinical setting, similar to what you would expect in a hospital ward. Some venues might have more luxurious recovery settings, such as private suites.
However, the average PHP facility will focus on turning over patients quickly, and that means they’ll also have more admissions and more people in the recovery ward compared to luxury inpatient or PHP care facilities.
A PHP hospitalization usually involves a nursing team monitoring the patient around the clock during the detox phase. The patient has access to staff 24 hours a day until they complete the withdrawal process.
Therapy is a big part of any PHP treatment program. The patient will usually complete around 16 to 20 hours of individual and group therapy sessions during the outpatient phase of their program.
Certified psychologists lead the sessions using evidence-based therapy strategies like Cognitive Behavioral Therapy (CBT) and Dialectal Behavioral Therapy (DBT).
They’ll attend the sessions at the recovery center and then go about their day, using what they learn about themselves and the skills they develop to help them navigate the challenge of staying sober.
The therapy sessions often involve the patient learning coping skills to help them deal with the triggers they experience using the outpatient phase of their recovery program. Environment, physical, emotional, and psychological triggers cause powerful responses in the patient’s mind. The coping skills they learn in these sessions help them contain the compulsion to relapse.
The patient is introduced to support groups where they can meet in an informal setting lead by the patients. The goal of these sessions is to connect with other people, share your story, and form a framework you can lean on when you experience the compulsion to use.
In the early 2000s, recovery centers started implementing “holistic” healing strategies alongside the more conventional treatment strategies of medical detox and therapy. Holistic services focus on restoring the physiology and mind in the wake of addiction.
Research shows that using mindfulness techniques is a powerful tool against falling prey to relapse. These classes teach coping strategies that patients use to navigate the triggers we spoke of earlier. They deploy these mindfulness strategies to stop their thoughts spiraling out of control, allowing them to reign in their mind and its emotional response to triggers.
Holistic treatments encompass a wide range of techniques and activities. Massage therapy, acupuncture and cupping, yoga, exercise, and nutrition planning are all examples of holistic recovery strategies that add value to conventional inpatient and PHP treatment programs.
Patients best suited to PHP treatments demonstrate a desire to participate in therapy programs during their outpatient treatment. They are mentally stable and capable of managing their sobriety at home with MAT, support, and therapy.
Patients entering PHP treatment typically have spent some time in an inpatient program at a residential rehab and they’re transitioning into the outpatient phase of their treatment plan. The patient should also have a stable living situation. If they can’t stay at home, then they must sign into a group home for support while they complete their outpatient recovery program.
Above all, the patient must be committed to using their support group and coping strategies to manage the triggers they experience. They must feel confident enough to maintain their sobriety and have people to lean on when things get rough for them.
Britney Elyse has over 15 years experience in mental health and addiction treatment. Britney completed her undergraduate work at San Francisco State University and her M.A. in Clinical Psychology at Antioch University. Britney worked in the music industry for several years prior to discovering her calling as a therapist. Britney’s background in music management, gave her first hand experience working with musicians impacted by addiction. Britney specializes in treating trauma using Somatic Experiencing and evidence based practices. Britney’s work begins with forming a strong therapeutic alliance to gain trust and promote change. Britney has given many presentations on somatic therapy in the treatment setting to increase awareness and decrease the stigma of mental health issues. A few years ago, Britney moved into the role of Clinical Director and found her passion in supervising the clinical team. Britney’s unique approach to client care, allows us to access and heal, our most severe cases with compassion and love. Prior to join the Carrara team, Britney was the Clinical Director of a premier luxury treatment facility with 6 residential houses and an outpatient program