The Difference Between IOP and PHP Eating Disorder Programs

Eating disorders are dangerous mental health conditions with various biological, psychological, and environmental causes. As such, these conditions often require comprehensive treatment. While it’s important for everyone struggling with an eating disorder to receive appropriate care, the level of care required will vary from case to case.

Partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) are two of the most common levels of care for eating disorders. Which one is best for you or your loved one will depend on a number of factors.

Different Levels of Care for Eating Disorders

Every eating disorder is considered dangerous, but the level of care recommended for someone will depend on the severity of their case. This is generally determined by how much control someone has over their disordered thoughts and behaviors, how long they’ve been dealing with the illness, and whether they’re at risk of any life-threatening complications, among other considerations.

Hospitalization and inpatient treatment are the most intensive levels of care. They both require someone to live full-time at a hospital or treatment facility, where they can receive 24-hour access to care and medical monitoring.

An outpatient program represents the opposite side of the spectrum. Patients at this point in recovery live at home and generally have some level of control over their disordered thoughts and behaviors. They may have routine visits with a therapist or team of health professionals, using treatment more as a regular check-in to stay recovery-focused.

A partial hospitalization program and an intensive outpatient program are between these two treatment options. They’re both well-suited for people who are far enough along in their recovery journey to live at home, but still want or need a lot of additional support, or for people whose symptoms have not yet escalated to the point where inpatient treatment is warranted.

Partial Hospitalization Programs

In the “hierarchy” of levels of care, partial hospitalization programs are below inpatient treatment. These programs are optimal for patients who are struggling with outpatient programs and those who are showing physical or mental symptoms that require closer monitoring. They’ve also proven effective alternatives to inpatient care in many cases.¹

PHPs are generally very intensive. Patients at this level of care live at home and commute to treatment, but sessions take place throughout the day for most of the week. Patients in an especially intensive treatment program may attend sessions up to seven days a week.

Partial hospitalization programs usually involve several treatment approaches—and similar options to many inpatient programs—including:

• Individual and group therapy sessions
• Meal monitoring
• Nutritional counseling and education
• Medical check-ins, including medication consultations for psychiatric and medical needs

The duration of treatment in PHP depends on a number of factors, including, unfortunately, a person’s insurance coverage limits. Optimally, someone will be in a PHP program for as long as needed, which can be several months. However, PHPs are also relatively versatile in terms of schedule. As patients progress through their recovery journey, sessions can be adjusted to reflect the level of support they need. Since the treatment is intense, it is usually shorter in duration compared to less intense levels.

Intensive Outpatient Programs

IOP treatment is a truly hybrid level of care—it’s not as rigorous as a PHP but a more intensive treatment program than traditional outpatient care.

During this phase of treatment, patients will live at home and commute to care, as with a PHP. But sessions are less intensive, taking place for fewer hours a day and fewer days a week. A typical IOP schedule includes:²

• Group therapy sessions
• Family therapy sessions
• Individual therapy sessions
• Meal support several times a week

At this point in recovery, patients are considered medically stable and generally do not require daily medical monitoring. Their eating disorder symptoms should also be sufficiently under control to the point where they can begin incorporating work, school, and other social responsibilities into their schedule.²

In many cases, people enter intensive outpatient treatment after “stepping down” from more intensive forms of care. But it’s also possible for a patient to begin their recovery journey at this point, so long as they are not showcasing severe mental health concerns. As with nearly all eating disorder treatments, the duration of a program will depend on a number of factors, including individual progress and insurance stipulations.

PHP vs IOP: Which Is Best for You?

There are a number of factors that go into determining the best level of care for an eating disorder patient, and nearly all of them are highly individualized and can—and will—change throughout the recovery process.

When making an initial assessment, a medical provider or treatment team will consider, among other factors:³

• The severity of the illness
• Personal motivation for treatment
• The duration of the illness
• An individual’s medical history
• The medical stability of a patient
• Insurance coverage

IOP and PHP programs are multidisciplinary, and clinical staff vary in their specialties. Some programs offer therapists, nutritionists, and psychiatrists, whereas others may include occupational therapists, yoga therapy, and other types of alternative care.

As with all mental health treatment programs, the best type of care for each person is subjective. As patients progress through the program, whether in an IOP or PHP, they should receive regular evaluations from their treatment teams, and alternate levels of care will be suggested when deemed appropriate.

It’s best to leave these determinations to trusted medical staff. If you or a loved one is struggling with an eating disorder and in need of treatment, it’s important to seek out help. A therapist, psychiatrist, or other licensed medical professional can help assess the issue and recommend the best course of action, including which level of care will be best for you.

It can feel scary to admit that this type of treatment is needed; getting appropriate care for an eating disorder is the best way to make a full recovery. It’s important to remember that recovery is always possible, no matter what level of care is required.