Eating disorders are complex mental health conditions requiring structured, multi-faceted treatment to address psychological, nutritional, and medical aspects. Care is organized into a spectrum of intensity, ranging from standard outpatient therapy to 24-hour residential and inpatient hospitalization. A Partial Hospitalization Program (PHP) is a highly organized step within this spectrum, designed to offer intensive daily support without requiring round-the-clock residence at a facility.
Defining Partial Hospitalization Program Structure
A Partial Hospitalization Program is an intensive day treatment option for individuals with eating disorders. Patients attend the program typically five to seven days a week, for six to ten hours per day, before returning home overnight. This structure is sometimes referred to as a Day Treatment Program. The schedule provides clinical and medical monitoring during the hours when structure and support are most needed, particularly around mealtimes. The PHP model allows the patient to practice new coping skills in a less restrictive, real-world setting each evening. This intensive environment serves as a bridge, either stepping down from residential care or stepping up from insufficient outpatient treatment.
Criteria for Admission to PHP
Admission to a PHP is determined by a patient’s medical and psychological status, placing it between residential and intensive outpatient levels of care. Individuals must be medically stable, not requiring continuous 24-hour nursing supervision, meaning they have stable vital signs and manageable lab work. They require more structure than standard outpatient care provides to interrupt eating disorder behaviors.
Typical candidates have significant psychological preoccupation with food, weight, or body image, or are unable to stop harmful behaviors without daily support. Their symptoms are often too severe for an Intensive Outpatient Program (IOP), but their physical health does not require immediate inpatient or residential admission. A functioning and supportive home environment is often a prerequisite, as the patient returns home each night.
Essential Therapeutic Components of PHP
The PHP environment is characterized by a multidisciplinary team approach, involving specialists including therapists, registered dietitians, and psychiatrists. This team collaborates to provide comprehensive care that addresses the medical, nutritional, and psychological facets of the eating disorder. A core component of the daily schedule is structured meal support, where patients eat meals and snacks under the direct supervision of a clinician. This supervision helps patients practice normalized eating patterns, adhere to their meal plans, and process the anxiety that often accompanies eating.
The majority of the day is filled with various forms of group therapy, which can include evidence-based modalities like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). These groups focus on developing coping skills, challenging distorted thoughts, and processing underlying emotional issues. Psychoeducation groups are also offered to teach patients and their families about nutrition, body image, and relapse prevention strategies.
Individual therapy is provided weekly, allowing for one-on-one work on specific psychological issues contributing to the eating disorder. Nutritional counseling with a dietitian is frequent, focusing on developing a personalized meal plan and establishing a healthier relationship with food. Regular medical monitoring and psychiatric management are also integrated, ensuring physical health concerns are addressed and medication is managed effectively.
Stepping Down and Discharge Planning
The PHP is a time-limited phase of treatment, focused on achieving clinical stabilization so the patient can move to a less intensive level of care. Goals for discharge typically include a significant reduction in eating disorder behaviors, the ability to manage emotional distress without relying on symptoms, and, if medically necessary, weight stabilization. The patient must have demonstrated consistent progress in applying skills learned in the program to their life outside the facility.
The process of moving to a lower level of care is known as “stepping down.” This transition most commonly involves moving from PHP to an Intensive Outpatient Program (IOP), which offers fewer hours and days of programming per week. A comprehensive discharge plan is developed well before the end of the PHP stay, outlining appointments with outpatient providers, such as a therapist, dietitian, and physician. This detailed aftercare plan ensures continuity of care and provides a supportive framework for long-term recovery, preventing a sudden loss of structure that could lead to relapse.