Knowing which treatment level is right for you means knowing the different level options at treatment centers. Intensive outpatient program (IOP) and partial hospitalization (PHP) are different options from which a person can choose. Goals can vary by program, but typically goals for levels of care are too medically stabilize, decrease and cease destructive eating disorder behaviors, and address and treat mental health issues .
Partial hospitalization (PHP) is typically required when a person is medically stable but still requires the structure to continue treatment. PHP can last anywhere from 3-12 hours per day, up to 7 days a week, depending on the person’s needs.
In PHP a person typically will stay for a majority of the day, receive all meals and snacks, as well as attend all group therapy, individual therapy, nutrition and psychiatry sessions. In a PHP program, the participant will go home at night.
Typically duration of treatment in PHP depends on a person’s insurance coverage limits, and the ability for treatment, the severity of disorder and history, any other mental health issues, as well as current mental health status .
During an assessment with the facility of choice, the evaluation team will talk with and coordinate your level of care with insurance.
When determining if a person is in need of PHP, a person needs to be medically stable, but the eating disorder impairs a person’s mental and emotional functioning, and a person will need daily assessing and support to not engage in eating disorder behaviors.
Another factor is that a person is not able to function in their everyday occupation, school, or individual life. They will continue to engage in eating disorder behaviors without regular monitoring or structure of care.
In PHP individuals are not responsible for bringing meals or snacks. Those are provided by the facility and are made according to the participant’s meal plan requirements.
Most of the day is designed around group therapy and individual appointments.
As the eating disorder person moves through the program, they may be allowed to attend yoga sessions within the facility or obtain passes for eating outside of the facility for a meal.
These techniques help the person stay supported but still practice how to navigate in real life as they step down in treatment levels.
Intensive Outpatient Programming
Intensive outpatient programming (IOP) is typically for individuals who are stepping down from residential or PHP levels of care and are still needing some support structure. Symptoms are generally under control at this point, and individuals are able to function within their daily lives with minimal support .
IOP can also be the first step for people who are just starting in their eating disorder treatment. It can be a level that they may begin at but will step up quickly to a PHP or residential care. Determining this can depend on insurance needs as well as personal needs.
IOP typically runs 3-7 days a week for 3 hours per day. It involves group therapy, supportive meals, as well as individual therapy and nutritional sessions during the week.
IOP also offers family group therapy and psychoeducation for friends and family on eating disorder symptoms and treatment planning. Duration of stay also depends on insurance coverage and client needs.
IOP therapy groups are typically run by the facility staff, and each group has a different focus. It allows participants to be able to meet others who are struggling with similar behaviors as well as have a supportive structure to their day.
Supportive meals are also important during IOP. Often those who attend IOP may still struggle with getting all of their meals and snacks in on a daily basis.
Individuals are responsible for bringing their own meal and/or snack to IOP, but it is checked by a staff member to ensure it is equivalent to their meal plan.
Like other eating disorder treatment levels, in IOP participants are weighed several times per week to keep track of progress, as well as continue to adapt their meal plan as needed with the on-staff dietician.
Therapeutic goals are worked on between the treatment team, client, and individual therapist to establish realistic and necessary recovery goals.
Typically in IOP after discharge from the program, participants are able to attend aftercare groups where a person can meet once per week for approximately 1 ½ hours a week with other participants from the program.
Often groups will include a meal as well as peer support. A staff member from the eating disorder clinical team will be in the group to help participants stay on task and suggest topic discussions.
Determining Which is Right For You
A person’s needs, the severity of the illness, personal motivation for treatment, and insurance coverage all determine what level of care a person can attend. All of these factors can also influence how long a person is able to stay in treatment.
Both IOP and PHP programs are multidisciplinary in approach where clinical staff range in their specialties. Some programs offer therapists, nutritionists, and psychiatrists where others may include occupational therapists, yoga therapy, and other clinical staff trained in dialectical behavioral therapy and cognitive behavioral therapy .
Many programs will vary on their therapeutic approaches as well, regardless of the level. Some many market a DBT program focus, or a Family Based Therapy (FBT) model focus. Knowing which therapy is the best for treatment is dependent on which therapy practice sounds like an individual best fit.
In conclusion, there are multiple differences between IOP and PHP levels of care in eating disorder treatment. Knowing which level is right for you depends on several factors including insurance coverage and motivation level for recovery.
Researching your options, as well as facility, focuses on treatment can help a person determine which is the appropriate fit for their treatment needs.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
References: Treatment Settings and Levels of Care. (n.d.). Retrieved August 06, 2017, from https://www.nationaleatingdisorders.org/treatment-settings-and-levels-care
 The Benefits of Intensive Outpatient Treatment for Eating Disorders. (2017, July 27). Retrieved August 06, 2017, from http://casaserenaedp.com/benefits-intensive-outpatient-treatment-eating-disorders/
 A. (2016, July 28). What’s Working? Comparing Partial Hospitalization and Residential Treatment for Eating Disorders. Retrieved August 06, 2017, from http://www.scienceofeds.org/2016/07/28/whats-working-comparing-partial-hospitalization-and-residential-treatment-for-eating-disorders/
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on October 11, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on October 11, 2017.
Published on EatingDisorderHope.com