By Jodi Jaspan, MS, LPC
When people think of mental health treatment, they usually picture either a psychiatric hospital (an inpatient setting) or a therapist’s office (an outpatient setting). Few think of structured outpatient programs that provide intermediate levels of care. These programs offer great value in managing mental health conditions.
Unlike outpatient therapy sessions, structured outpatient provides a more comprehensive treatment experience. These programs have detailed schedules that use a variety of therapeutic techniques, such as cognitive behavioral therapy, group process therapy and even holistic practices, like yoga or meditation.
Structured outpatient involves more treatment hours as well. While traditional outpatient sessions may take place once a week and last around an hour, structured outpatient lasts anywhere from six to 35 hours each week. Clients often attend structured outpatient programs three to five days each week.
There are two main types of structured outpatient treatment: intensive outpatient (IOP) and partial hospitalization (PHP). They are distinguished by the number of treatment hours:
● IOP consists of at least six hours each week for adolescents and nine hours each week for adults.
● PHP consists of at least 20 hours each week.
There are certain core services that are offered in IOP and PHP. These include a variety of group therapies, individual counseling, psychoeducation (educating a patient on their condition and how to effectively manage it), medication management and psychiatric care. Complementary services, such as art therapy, yoga or music therapy, can also be part of the treatment experience.
Although IOP and PHP are often used for the treatment of substance use disorders, they are also beneficial for most mental health conditions, particularly when outpatient settings are not enough.
Structured outpatient is often used as the next step after inpatient treatment or as a preventative measure before a person needs a higher level of care. Take, for example, a woman who is hospitalized for a suicide attempt or a teen who is experiencing suicidal thoughts. The woman might seek out a partial hospitalization program as the next step in her recovery after her hospital stay, while the teen might try intensive outpatient to manage his suicidal thoughts before they lead to a crisis or full hospitalization.
If a person is at immediate risk of harming themselves or others, structured outpatient is not the right level of care. Generally, individuals are a good fit for IOP or PHP if they are:
● Motivated to participate in programming
● Able to learn and apply recovery skills
● Comfortable in a group setting
● Driven to improve their condition and work towards recovery
● Willing to verbally express their thoughts and feelings
Mental health treatment can be thought of as a continuum, with patients moving up or down in levels of care as needed. One major advantage of structured outpatient is that it allows individuals to receive an intense level of programming (much like inpatient) without entirely disrupting their current situation in life, such as work, school or family responsibilities. Clients in IOP or PHP are able to return home each night. The home environment can be beneficial for recovery, provided that it is a healthy, stable environment.
Structured outpatient also provides more direction in an individual’s treatment. With traditional outpatient counseling, it is the client’s responsibility to complete assignments between sessions and apply recovery skills they’ve learned. In IOP or PHP, the individual has extra support from clinicians and fellow participants. They spend more time at the treatment center, which allows them to focus their attention on recovery.
For individuals who are not managing a condition effectively at the outpatient level, or who do not meet the criteria for inpatient, structured outpatient can be the ideal treatment situation. They can receive a higher level of care than weekly outpatient sessions while still maintaining their normal living situation. Structured outpatient is opening up new possibilities and better treatment outcomes for those who have tried other levels of care and are looking for the next step.
Jodi Jaspan is a licensed professional counselor and serves as the director of business development for The Light Program, an outpatient mental health treatment program with several locations in eastern Pennsylvania.
We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.
Check out our Submission Guidelines for more information.
In a crisis? Call or text 988.
Find Your Local NAMI