IOP vs. PHP: Differences In Treatment and Care
If you are ready to enter rehabilitation for your addiction, it’s important to understand your options. There are different levels of care depending on how intensive your treatment plan is. Each patient’s needs are assessed based on the level of their addiction, whether they can take weeks off of work, their family obligations, whether the treatment is court-ordered, and so on. Your addiction specialist will work with you to develop the type of care plan that will work best. It’s important to understand the different types of treatment that might be available so you, with your care providers, can make the most beneficial choice.
Most people entering a rehab center begin with residential treatment. This is when you are housed at the treatment facility. This type of treatment can be short-term or long-term. Long-term plans can last as long as a year, while short-term stays, which are more common, last for three to six weeks on average. During this time, you will stay in a hospital or non-hospital setting. You’ll rely on the other patients, as well as the staff, for your socialization. Your contact with your family and friends outside of the facility might be limited, and you’ll be encouraged to re-learn how to socialize and interact to help you avoid a relapse.
After you leave the residential treatment phase, it’s very important that you continue your treatment on an outpatient or partial-hospitalization basis. This is because going from a protected environment directly into the type of environment you were in before can set you up for a relapse. You need to begin applying the skills that you’ve learned to the “real world” with support, and for most, that support needs to come from professionals who understand addiction, as well as fellow participants in group therapy or a support group setting.
Partial Hospitalization Programs (PHP)
A partial hospitalization program (PHP) is often the second treatment stage for people struggling with substance addictions. For some people, they are the first stage. This might be the case if you have obligations that prohibit your stay in a residential facility. You might also go into a PHP if you relapse but do not require inpatient care.
With a PHP, you must report to the facility on an agreed-upon schedule. Most commonly, you’ll go to treatment five full days per week. There are often varying hours offered, so you might be able to go in the evening or on weekends. The benefit of going through a PHP after a residential program is that you will begin to acclimate to being at home on a part-time basis.
During your PHP treatment, you’ll receive counseling and therapy sessions. If you are on medication for your addiction or other mental health conditions, you might have your medication intake monitored. PHP offers much of the same supervision you had during your residential treatment, but you’re allowed to sleep at home and spend some time with people outside the treatment facility.
Intensive Outpatient Programs (IOP)
Another midway stepping-stone is sometimes an intensive outpatient program (IOP). This can be a step after being in a PHP, or it can be the step after residential treatment. In a few cases, it’s the first step of rehabilitation treatment, particularly for a relapse. This is also the case if you cannot take time off work for addiction treatment (but realize that addiction treatment is covered under the Family Medical Leave Act (FMLA), so don’t discount a residential program without investigating this).
If you are in an IOP, you will be expected to report to the facility most days of the week. You won’t have to spend the whole day; you might spend only a few hours. You’ll receive counseling and attend private and/or group therapy during these appointments. It’s similar to what you’d expect from a PHP but a bit less intensive. You’ll also have more time to do things outside of the program, such as work, spend time with your family, and begin socializing with community members.
Discharge Planning & Aftercare
Once you are done with all phases of your intensive treatment, it’s very important that you continue with an aftercare program. This can include weekly visits to your counselors, group therapy, and/or support group participation. Dropping your support system can make it more likely that you will have a relapse. Having mentors can help you make good choices when faced with difficult situations, which will happen once you are out of the intensive phase of your treatment. If you are tempted to relapse, having someone to talk to who knows where you have been and understands how to help is an invaluable resource.
If you relapse, getting in touch with someone who can help is vital. Most of the time, particularly if you catch it early, you will not have to go back into residential care. You might be able to go back to the intensive outpatient program or, in some cases, the partial hospitalization program. If your addiction specialists feel you need residential care again, try not to look at it as anything more than a temporary setback. You already know that you’ve gotten through treatment and will get through it again. Relapses are often part of the process.
Learning to live without relying on your addiction is a lifelong journey. It’s important to give yourself the time and support needed to get through the intensive phases of the treatment plan. Also, be open to returning if necessary. Talk to your mental health care provider and addiction specialists to get the care you need. They will have good suggestions on where you can start and how long you should be in each type of treatment. Have faith in the system and don’t give up; you will likely see success in the form of an addiction-free life.
- National Institute on Drug Abuse. Treatment Approaches for Drug Addiction DrugFacts. National Institute on Drug Abuse. Published January 17, 2019. Accessed October 15, 2022. https://nida.nih.gov/publications/drugfacts/treatment-approaches-drug-addiction
- Hartney E. 5 Triggers of Relapse and How to Avoid Them. Verywell Mind. Published November 28, 2020. Accessed October 15, 2022. https://www.verywellmind.com/why-did-i-relapse-21900
- Department of Labor. elaws – Family and Medical Leave Act Advisor. Accessed October 15, 2022. https://webapps.dol.gov/elaws/whd/fmla/10c9.aspx
- Johnson B. Psychotherapy: Understanding group therapy. https://www.apa.org. Published October 31, 2019. Accessed October 15, 2022. https://www.apa.org/topics/psychotherapy/group-therapy
- Lash SJ. Increasing Participation in Substance Abuse Aftercare Treatment. The American Journal of Drug and Alcohol Abuse. 1998;24(1):31-36. doi:10.3109/00952999809001697
- University of Pennsylvania Health System. Stairway to Recovery: Can Addiction be Cured? Accessed October 15, 2022. https://www.uphs.upenn.edu/addiction/berman/treatment/
Last medically reviewed October 15, 2022
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