A Partial Hospitalization Program (PHP) is a highly structured and intensive form of care for individuals recovering from an eating disorder. PHP offers a level of support that is less restrictive than a full hospital stay but more robust than traditional outpatient therapy. For many, PHP serves as a necessary step in the recovery process, helping to stabilize behaviors and bridge the gap between higher and lower levels of treatment.
Defining Partial Hospitalization
PHP for eating disorders is often referred to as Day Treatment. This level of care involves attending a specialized facility, hospital wing, or clinic for 5 to 7 days per week, typically ranging from 6 to 12 hours each day.
The primary goal of this setting is to provide a safe, supervised environment where patients can practice new coping skills and receive immediate support for interrupting harmful behaviors. Patients return home or to transitional housing each night, allowing them to maintain contact with their support system while accessing intensive, professional care. This hybrid structure stabilizes the patient’s condition while beginning the process of reintegration into daily life.
Criteria for Admission and Discharge
Admission to PHP is determined by clinical need, balancing symptom severity with medical stability. PHP is appropriate for individuals who are not in immediate medical danger, meaning their vital signs do not require 24/7 medical supervision. However, they must be unable to maintain adequate nutrition, stop eating disorder behaviors, or manage co-occurring mental health conditions in a less structured outpatient environment.
PHP is often utilized as a “step-down” from residential treatment once a patient has achieved medical stability but still requires significant structure to prevent relapse. It can also serve as a “step-up” from intensive outpatient care (IOP) when a patient’s symptoms have worsened or when they need daily monitoring and meal support that outpatient services cannot provide.
Discharge occurs when the treatment team determines the patient has met their goals and is ready for a less restrictive level of care. This transition signifies that the patient has demonstrated consistent behavioral stability, made progress in weight restoration if necessary, and successfully integrated coping and meal preparation skills. The goal is to move the patient to the next step, typically an Intensive Outpatient Program, where they continue to practice these skills with reduced professional oversight.
Core Components of PHP Treatment
PHP treatment focuses on three main areas: therapy, nutritional rehabilitation, and medical oversight. Group therapy is the primary therapeutic format, offering a supportive environment where patients share experiences and develop interpersonal skills with peers. These groups cover topics like relapse prevention, communication skills, and body image, often incorporating evidence-based treatments.
Therapeutic Modalities
Specific therapeutic modalities include Cognitive Behavioral Therapy (CBT) to challenge distorted thoughts about food and body, and Dialectical Behavior Therapy (DBT) to teach emotional regulation and distress tolerance skills. Individual sessions with a primary therapist and family therapy are also integrated to address underlying issues and build a strong support system at home. Family-Based Treatment (FBT) is often incorporated for adolescents to empower parents in the recovery process.
Nutritional Rehabilitation
Nutritional rehabilitation is central to the PHP experience, revolving around structured, supervised meals and snacks. A registered dietitian works with the patient to create an individualized meal plan and provides education on balanced nutrition, helping to normalize eating patterns and challenge food fears. Meal support sessions are facilitated by staff who help patients manage the anxiety and behaviors that arise before, during, and after eating.
Medical Monitoring
Medical monitoring provides a layer of safety throughout the program, though it is less intense than in a hospital setting. This includes daily checks of vital signs and weight, as well as access to psychiatric care for medication management and mental health support. This integrated approach ensures that both the physical and psychological consequences of the eating disorder are addressed simultaneously by a multidisciplinary team.
The Continuum of Eating Disorder Care
The Partial Hospitalization Program occupies a distinct middle ground within the full spectrum of eating disorder treatment. At the most intensive end is Inpatient or Residential care, which provides 24-hour medical and psychiatric supervision for patients who are medically compromised or acutely unstable. PHP acts as the typical step-down from this highest level, offering necessary structure and monitoring once a patient has achieved initial medical stabilization.
Immediately below PHP is the Intensive Outpatient Program (IOP), the next step toward independence. IOP is less intensive, requiring attendance for a few hours per day, 3 to 5 days per week, and is for patients who are medically and psychiatrically stable.