PsychBytes with CCS

Partial Hospitalization and Intensive Outpatient Programs (PHP & IOP)

August 02, 2023 Josh Bailey, LPCC-S
PsychBytes with CCS
Partial Hospitalization and Intensive Outpatient Programs (PHP & IOP)
Transcript
Josh Bailey:

Hey, Psych Bytes with CCS is a weekly podcast hosted by Student Life Counseling and Consultation Service. This show is dedicated to discussing a wide range of topics pertaining to mental health commonly experienced in the college setting. It is important to note that this podcast is not a substitute for therapy. All of the topics on this show, while discussed by professionals are strictly psycho educational, and meant to inform listeners on available resources, skills and support. Topics on this show can be sensitive in nature. And should you find yourself needing additional support or resources, please visit ccs.osu.edu or call us at 614-292-5766. With that in mind, enjoy the show. What is up everybody and welcome to psych bytes. My name is Josh and today we are once again joined by Jennifer Lang, a licensed independent social worker with a supervisory designation and the Assistant Director of Clinical Services here at CCS. Welcome back. Jennifer, I'm back something special to point out is you are now the most featured member of CCS on Psych Bytes. Congratulations.

Jennifer Lang:

Thank you so much. Thanks for having me.

Josh Bailey:

So today you are back with us to talk about intensive outpatient and partial hospitalization programs or IOP and PHP. Let's go ahead and start with what are they?

Jennifer Lang:

Yeah, so I am aware that every time I've been here so far, I'm basically, you know, explaining what a bunch of letters string together are. And that's just part of being in this field, but happy to demystify it. So IOP stands for intensive outpatient program. And PHP stands for partial hospitalization program. And these are just big kind of fancy insurance terms. So we'll kind of break that down, you know, kind of for our use. But what I want to share really is these are just different levels of care. And when I say that, I think it's important just, because when students and clients are thinking about therapy or counseling, typically we're only thinking of it in one way, right? So it's like me sitting in front of a therapist for an hour, maybe once a week, talking about what my concerns are, getting some feedback and support, something like that.

Josh Bailey:

Right.

Jennifer Lang:

So a lot of folks aren't really aware that therapy can look a lot of different ways. So in intensive outpatient program, or partial hospitalization program, this is considered like a next level up from your traditional kind of like weekly, individual therapy. And individual— and intensive outpatient program and partial hospitalization programs are offered multiple days a week for multiple hours a day. Now, you might be sitting at home thinking, holy cow, like what am I going to be doing in therapy for multiple hours a day, multiple days a week. But there's a lot that this type of treatment can really help with. Traditionally, these are groups only. So you will be sitting with a group of maybe anywhere from 6 to 10 other folks who may be dealing with some very similar concerns or stressors. And you're going to be doing things like sharing what those stressors are with the group, getting support and feedback. You might even be challenged by some of these group members. It's certainly something that is still run by a therapist, but you have the mutual benefit of also having other clients and peers in the group who can really speak to similar experiences and concerns. So that I think is one really vital part of IOP and PHP. Another vital part of IOP and PHP are that you will probably be working with a psychiatrist. So these programs offer weekly psychiatric management appointments. The nice thing about that is that your group therapist and your psychiatrist are able to communicate about your concerns, what's going on, what are you benefiting from medication-wise, if there are any concerns around having side effects. So that is really helpful. So you're basically part of a treatment team while you're doing a program like this. Another aspect of IOP and PHP is that you're typically learning a lot of skills, right? So folks who are going into IOP, or PHP, might really be struggling with how their, I don't know, depression is impacting them on a day to day basis. And so when you're in a program like this, you're getting a lot of intensive skill building from a lot of different therapies, CBT, DBT, schema therapy, mindfulness, and we're looking at all those different types of therapies, and how you can start practicing skills to better improve your symptoms. So those kind of three pieces, right? The group— getting the feedback and support. The psychiatry— getting that collaborative wraparound approach to your treatment. And then that other piece, the intensive skill building, are what I would say are the three main components of doing an IOP or PHP program.

Josh Bailey:

So I have a couple of questions from that. First off, we're talking about group settings. That can sound a little bit alarming.

Jennifer Lang:

Yeah.

Josh Bailey:

It's enough for me to go and sit down and talk with my therapist about what's going on inside my head.

Jennifer Lang:

Yeah.

Josh Bailey:

How do you approach the group dynamic with people trying to discuss with them the benefits or the impact of having their peers involved in this process?

Jennifer Lang:

Yeah, no, that's a good question. And I often talk to folks about saying, you know, it's not like what you maybe are thinking of, or what you've seen on TV, or something like that. I'm not gonna, you know— these programs aren't going to expect you to walk in day one and share your whole life story, right? Like, it happens a lot more organically and kind of naturally than I think folks initially think. So a lot of times, I'll send students to one of these programs, and they'll come back and say, you know, it was so wild, it was like the second day, and there were two other people in that group. And their moms are struggling with similar things, what's going on in my family. So it just kind of comes up naturally, where a lot of folks are finding a connection, a shared experience, even a shared emotion or stressor as somebody else in the group.

Josh Bailey:

And I imagine that can be really validating to kind of take yourself off the island you've presumed yourself to be on for such a long time with whatever it is you're struggling with, then all of a sudden, someone that's around my age, or looks like me sounds like me, talks like me, might have a similar experience can really, maybe help me move forward, then?

Jennifer Lang:

Absolutely. I mean, right. We're never happy that somebody else is dealing with what we're dealing with, right? But it can be just a reminder that this might be an unfortunate, but typical kind of experience or stressor. And it can be helpful to hear from other people who have been where you are, or are where you are, how are they moving through it? What's working for them, right, can give, maybe generate you, you know, some ideas for yourself. And also getting that, that support, that encouragement, from someone who gets it.

Josh Bailey:

All right, intensive outpatient, partial hospitalization? What's the difference? You said they're both, I'm going to be here for multiple hours, like, how do we differentiate between those two?

Jennifer Lang:

Great points. So yes, I shared kind of the common components of both programs. So now let's get down to the differences. So a partial hospitalization program is basically like, think about like mental health summer camp or something, right? You're there for the majority of the day, most days of the week. So there are a lot of these programs out there. So I'm speaking kind of generally, but it might be you're at the program from nine to four o'clock, Monday through Friday, but you go home, right? And you come back the next day. A lot of these programs that are partial hospitalization programs, you might do 40 hours of therapy in one week, and then kind of stepped down the next week to doing somewhere closer to 20 hours, but you're going every day of the week.

Josh Bailey:

Okay.

Jennifer Lang:

And with the partial hospitalization program, the intention behind that, right, is that we want to make sure we're checking in about any safety concerns, functioning concerns, every day. So it is kind of a higher level up than intensive outpatient. Intensive outpatient is maybe less frequent. So you're gonna have maybe three days a week that you're in treatment for three to four hours a day, but you're skipping days, right? So you might be there Monday, Wednesday, Friday.

Josh Bailey:

Okay.

Jennifer Lang:

And so these programs might be a little longer. So a partial hospitalization program, it's going to be about a month, right? Think four weeks doing it this intensively. IOP, you're probably looking at closer to five or six weeks, so it's not as frequent but it lasts a little longer.

Josh Bailey:

Putting myself in the shoes of a students, you're telling me, hey, there's a possibility you're going to be going to therapy for 40 hours a week, five days a week, Monday through Friday. Again, if I'm a student, I have class, I have things to do. Like, how am I going to do this and not get kicked out of school?

Jennifer Lang:

Sure. And we want to be able to walk you through this and thinking about balancing these two important pieces of your life, right? Your mental health, right? And your ability to be academically successful, I typically will sit with students who are thinking about these programs, or have these programs recommended to them. And honestly, they're kind of at a point where their mental health is starting to impact their ability to be academically successful. Right? So they're like, I can't miss class. And I'm like, you're already missing class, because you're so depressed, or that you haven't left your your res hall or your, you know, your house and several weeks, right? So I encourage folks to think about your mental health is an important part of your ability to be academically successful. So how can we figure out how you can do the program, and salvage or support whatever other academic involvement you have? So we are really lucky, and have partnered with the office of disability services on campus. And they actually developed a type of academic accommodations specifically for students who are doing IOP and PHP correct, which is pretty incredible. So I think that really speaks to how many students have done a program like this and have benefited from it, that they've needed to develop this. So this can look like taking classes or materials asynchronously, or getting some flexibility around attending every single class or turning in assignments a little bit later. So it's building in some kind of buffer and wiggle room, so that you're able to hopefully stay in the class if you're able while you're doing the treatment.

Josh Bailey:

Okay, so the long and short of it is I will be supported, there are resources in place, I'm not going to flunk out of school, if I go into this to take care of myself.

Jennifer Lang:

Yeah I know, we definitely have a lot of support from multiple offices. And quite honestly, a lot of professors, you know, they're— they want to be understanding and supportive, you know, doing treatment. It's not necessarily a guarantee, that everything will just automatically fall into place. It does take some conversations and some intentionality. But we see students do this all the time.

Josh Bailey:

So let's talk about resources. Where do I find in IOP, or a PHP program? What's, what's around?

Jennifer Lang:

So in the Columbus area, we are really, really lucky. And there are multiple hospital systems that offer a program like this. So you can look on our CCS webpage, there's actually a tab that says the Young Adult IOP Referral Support Team, and then has some information on that page about a program here at OSU Wexner Medical Center. And that program is actually specifically for young adults. So we're looking at 18 to around 26, 27 year olds in that program. So that's one really fantastic program. There's also a listing of other programs in the area on that site as well. And that might be helpful for you to just take a look at, click through some of the programs, see which ones maybe speak to you, feel like they might be more helpful for you. But just gathering your information can be a really good place to start.

Josh Bailey:

Any parting words or any final highlights before we wrap up today's episode?

Jennifer Lang:

So I think the biggest takeaway I have on this topic is that when I see students leave a program like an IOP, or PHP, having successfully completed it, I see students who are walking away with way more confidence and having skills to navigate their concerns and their stressors. So it doesn't mean that they'll never get anxious again, right?

Josh Bailey:

Right.

Jennifer Lang:

Or they'll never have an issue with their sister who they've been struggling with their whole life. But it means that they have the skills and concepts in them to navigate those things in healthier ways.

Josh Bailey:

Right.

Jennifer Lang:

So that inherently builds confidence and competence. And that, I think, inherently improves our mental health and well being.

Josh Bailey:

As always, Jennifer, it's great to have you with us. Thank you so much for this information. Hopefully some people out there can find it really useful and really helpful if they're trying to make some important decisions for their mental health. So again, thank you very much for the time.

Jennifer Lang:

Yeah, thanks for having me.

Josh Bailey:

To all of our listeners: Thank you again for joining us. Keep your eyes peeled for our next episode. And until next time, my name is Josh and this has been Psych Bytes with CCS.