What is a Partial Hospitalization Program (PHP)?

This article is about Partial Hospitalization Programs (PHP), explaining what they are, why they exist, and what sort of mental health conditions benefit from treatment in this format.

If you or a loved one are considering treatment within a PHP, this article will help you understand what to expect from this program. It will also look at some of the research into PHPs to give you a sense of how the mental health community views them.

What type of treatment program is a Partial Hospitalization Program (PHP)?

Partial hospitalization, also known as a Partial Hospitalization Program (PHP), is a treatment program designed to address mental illness and substance abuse.

PHPs differ from other types of treatment programs in that they offer a middle ground between out-patient treatment (in which patients visit a facility for one-off or weekly treatments but return home as soon as this is complete) and in-patient treatment (whereby patients remain in a hospital or other treatment facility round the clock for the duration of their treatment).

Partial hospitalization programs can be provided in a hospital setting, healthcare facility, or by a Community Mental Health Center (CMHC).

Patients in PHPs continue to reside at home or in nearby housing options but travel to a treatment center up to seven days a week. The purpose of PHPs is to provide comprehensive treatment while avoiding or minimizing in-patient hospitalization.

Decisions about what type of treatment program is best for an individual are made according to the severity of their symptoms and level of functioning.

Research^[1] suggests patients benefit when they experience the least restrictive treatment model, determined according to the circumstances and severity of their condition.

Studies suggest that Partial Hospitalization Programs are a good fit for patients experiencing moderately severe distress^[2].

What is special about Partial Hospitalization Programs?

PHPs are designed to work around three fundamental treatment principles, working based on the following types of care:

Providing treatment in the least restrictive setting
Maintaining patients in their home or home-like communities
Offering care in normalizing environments

In addition to the above, a PHP can be considered a particular type of ‘therapeutic holding environment.’ This refers to how treatment can benefit patients in multiple ways, including how treatment is carried out.

The American Psychological Association defines a holding environment as:
“any therapeutic space that allows an emotionally fragile or insecure person to deal with effects that might potentially be overwhelming.”

In other words, when patients feel adequately ‘held,’ they are less likely to find the therapeutic process intolerable and more likely to make progress in treatment.

Within the scientific research exploring the PHP model, academics have gone one stage further in outlining specifically what conditions are offered to patients within PHP facilities. These conditions include containment, support, structure, involvement, and validation^[3].

In more detail, these five conditions can be described in the following ways:

1. Containment: By prioritizing each client’s physical and interpersonal safety, containment fosters trust and security, forming the foundation for all other treatment efforts.
2. Support: Staff must provide different types of support to promote hope and growth-oriented attitudes and behaviors in clients.
3. Structure: Creating an environment that is predictable and a routine that patients can understand. Structure is established through the daily schedule, rules and consequences, and behavior management practices.
4. Involvement: Every patient is expected to participate in the program. Involvement is encouraged through activities that promote the value of therapeutic community membership and reaching individual care goals.
5. Validation: Mental health professionals develop and implement a problem-oriented individual treatment plan to validate each client’s unique treatment needs.

What types of treatments are typically offered in Partial Hospitalization Programs?

Treatment in PHPs may include:

• Psychopharmacological assessments
• Check-ins
• Group therapy
• Individual therapy
• Family therapy
• Psychoeducational groups
• Skills building

Programs are available for the treatment of various mental illnesses, including:

• Alcoholism
• Substance abuse
• Eating disorders, including anorexia and bulimia
• Depression
• Bipolar disorder
• Anxiety disorders
• Trauma

PHP care is often a more successful level of care than outpatient treatment for those who are suffering from depression, anxiety, an eating disorder, or trauma.

PHP is suitable for those who can complete everyday tasks such as cooking, grocery shopping, and laundry and do not need 24-hour-a-day supervision.

Programs within PHPs may also be tailored to specific age groups, such as geriatric patients, adult patients, adolescents, or young children. Adolescents and children in PHPs may also receive academic sessions and supplementary lessons to ensure they can continue their education during treatment.

How successful are Partial Hospitalization Programs?

While it isn’t always straightforward to research the advantages and disadvantages of specific therapeutic environments, the evidence into PHPs has found this type of treatment program to be broadly successful.

One study^[4] looked specifically at sudden gains (SGs), referring to rapid symptom improvement among adults undergoing treatment for depression in a partial hospitalization program.

Sudden gains have been observed in some individuals receiving treatment for depression and other psychological disorders. Studies have demonstrated that SGs are linked to better treatment outcomes. SGs have been identified in both adult and adolescent populations receiving traditional outpatient psychotherapy, as well as for other disorders such as binge eating.

Unlike traditional outpatient therapy, PHPs offer brief and intensive group-based psychotherapy, typically lasting two to four weeks with four to eight hours per day of treatment. Generally, they are used for individuals who have not responded to standard outpatient treatment or are transitioning from inpatient to outpatient care. Studies have primarily focused on SGs in traditional outpatient treatment, which usually involves therapy once or twice a week.

The study mentioned above aimed to determine the proportion of individuals who experience SGs in a PHP, the timing of SGs during treatment, and the impact of SGs on treatment outcomes.

Results showed that over 40% of the 664 participants experienced SGs, most SGs occurring by the second week of treatment. SGs were linked with significant improvements in depression and quality of life scores at the end of treatment. Although depression scores decreased for the entire sample, the SG group demonstrated greater improvement compared to the group without SGs.

Although the findings suggested that the proportion of SGs in a PHP is similar to those observed in traditional outpatient psychotherapy, results indicated that the timing of SGs in a PHP means there may be a connection with the dosage of treatment received.

Another paper^[5] reviewed the literature evidencing treatment outcomes and client satisfaction within PHPs, referring to the following five studies.

A naturalistic assessment of 13 partial hospital units showed overall effectiveness in treating chronic and acute psychotic and affective disorders but less effectiveness in treating adjustment disorders.

Another study of 20 patients at a single partial unit found significant positive effects in reducing acute symptoms, improving patient morale, and facilitating community readjustment after discharge. There were also improvements in skill deficits, orientation to community support, and resources, but no improvement in long-standing symptoms or physical problems.

In a third study, patients in a partial program reported significant symptom reduction after six weeks, with sustained treatment gains revealed at the follow-up four months later.

Researchers in France conducted a naturalistic study and found that a French partial hospitalization program was effective, with patients reporting increased autonomy, lower symptom severity, and reduced subjective distress after an average of 4.8 months in the program.

Finally, an outcome study of 114 child and adolescent patients showed that partial hospitalization improved general functioning, family functioning, and the use of community-based mental health resources after discharge, with sustained improvements at the follow-up one year later.

How are Partial Hospitalization Programs funded and monitored?

In the United States, PHPs are funded by private insurance, Medicare, and, in some states, Medicaid. Many providers now offer more acute short-term services, using PHPs to treat acutely ill patients who can better understand their illness, adjust to medication regimes, develop coping skills, and set recovery goals to function effectively in society as recovered individuals.

PHPs must pass comprehensive reviews by national, state, and insurance bodies and adhere to specific guidelines for assessment, treatment, facility maintenance, performance improvement, and client outcome studies. The Association for Ambulatory Behavioral Healthcare is the leading national group that publishes the Standards and Guidelines for Partial Hospitalization Programs and Intensive Outpatient Programs (2021).

About Partial Hospitalization Programs at The Center • A Place of HOPE

At The Center • A Place of HOPE, we provide a Partial Hospitalization Program level of care.

PHP at The Center • A Place of HOPE involves supervised care from approximately 8 am to 6 pm Monday to Friday and 8 am to 5 pm on Saturdays.

The treatment approach at The Center is rooted in the Whole Person Care model, developed by Dr. Gregory Jantz, The Center’s founder, in the 1980s. This model focuses on treating the whole person, including the mind, body, and spirit, which can be more easily achieved through Partial Hospitalization.

Whole Person Care addresses every aspect of an individual’s life, including physical, emotional, nutritional, intellectual, relational, and spiritual factors, to facilitate healing. Through this approach, patients work through areas that have contributed to their current condition. The outcome is a more profound, long-lasting, and comprehensive recovery.

Our treatment programs are award-winning, and we are recognized as a Top 10 Center for Depression Treatment. We treat those struggling with:

• Depression
• Anxiety
• Eating disorders
• Emotional & Sexual Abuse
• Trauma & PTSD
• OCD
• Relationship issues
• Spiritual renewal
• Anger Management
• Addiction

To inquire whether treatment at The Center • A Place of HOPE is right for you or your loved one, please get in touch with our admissions team, who is here to help you.

We can take your call every Monday to Friday, 8 am to 5 pm PT. Outside of these hours, please complete the form on the admissions page or schedule a call back on the admissions page at a convenient time for you.

1. Garfield R. L., Love J. R., Donohue J. M. (2010). Health reform and the scope of benefits for mental health and substance use disorder services. Psychiatric Services, 61, 1082–1086.
2. Lenz, A. S., Conte, G. D., Lancaster, C., Bailey, L., & Vanderpool, E. (2014). Evaluation of a Partial Hospitalization Program for Adolescents. Counseling Outcome Research and Evaluation, 5(1), 3–16. https://doi.org/10.1177/2150137813518063
3. Gunderson J. G. (1978) Defining the therapeutic process in psychiatric milieus. Psychiatry, 41, 327–335.
4. Drymalski, W. M., & Washburn, J. J. (2011). Sudden gains in the treatment of depression in a partial hospitalization program. Journal of Consulting and Clinical Psychology, 79(3), 364–368. https://doi.org/10.1037/a0022973
5. Granello, D.H., Granello, P.F. & Lee, F. Measuring treatment outcomes and client satisfaction in a partial hospitalization program. The Journal of Behavioral Health Services & Research 26, 50–63 (1999). https://doi.org/10.1007/BF02287794