When people think about behavioral healthcare, they usually consider the two ends of the continuum of care spectrum: inpatient and outpatient.

Inpatient treatment is reserved for the acute cases, where a client needs stabilization with around the clock care. Typically, a hospital stay can last anywhere from a couple of days up to several weeks.

Outpatient care includes periodic appointments with psychotherapists and medication providers. The former, talk therapy, is more frequent and is often done once a week. Medication management is generally on a monthly basis.

Many adolescents and young adults suffering from stress, anxiety, depression, and mood swings benefit greatly from bi-weekly or monthly outpatient services.

Yet, for some, a more concentrated form of therapy – both in terms of content and frequency– is needed in order to restore psychological stability. This is where the intermediate level of care comes in.

When clinicians speak of this intermediate level of care, they are referring to intensive outpatient and partial hospitalization programs (IOPs and PHPs). These concentrated two to eight-week outpatient programs are designed to reestablish psychological stability and safety, reduce anxiety and mood symptoms, restore daily life activities impeded by a recent mental health decline, and engage support systems and relevant channels of client care.

Below are the top five questions parents ask me about these programs:

1. How do I know if my child is a good candidate for a PHP / IOP?

   If your child has been seeing a behavioral healthcare provider for several months and has not shown signs of improvement or symptoms have started to become more acute, he or she might benefit from a more intensive level of care. Additionally, PHP / IOP is also often recommended for those ‘stepping down’ from inpatient care, as it serves as a helpful and sometimes necessary transition back to daily routines.

2. There are several of these programs in my area. How do I select the one that is right for my child?

   In researching programs, the first items to look at are the age groups and conditions treated. For example, not every center will have services for children. Furthermore, certain conditions such as eating disorders or substance abuse may be best suited for treatment at a center specializing in their care.

   Ideally, the program selected will have been designed with more than immediate stabilization as its intended outcome. It will also help clients achieve meaningful breakthroughs in stuck patterns of intra-psychic and interpersonal conflict, repair emotional wounds, and equip them with the lifelong social, emotional and cognitive skills necessary to become balanced, resilient, and happy individuals.

   Additionally, programs that emphasize family involvement tend to offer more durable results. Family therapy fosters successful outcomes and sustainability of positive changes cultivated during the program.

   

3. Some of the programs we are looking into offer experiential therapy. What is the concept behind experiential therapy?

   Psychotherapy has been referred to as cyclo-therapy, an allusion to the focus on feelings in therapy. During a session, the classic pattern is the experience of a certain, often previously neglected or hidden, feeling followed by the examination of this emotional experience. Repetitions of these events – experiencing feeling and reflecting on it – create the cycle.

   Talk therapy can sometimes generate the emotional content that gets ‘worked through’ but a more direct and perhaps authentic route is to non-verbally express or enact the emotional sequences being explored in the room. Techniques of therapy focused on the body and action can generate the experience of unarticulated, felt meaning.

   Then, immersed in this emotive experience, the client can construct – or co-construct with the therapist’s support – a narrative formulation which seems to fit the experience. Since the emotional episode has been brought into the ‘here and now’, the client is able to check-in with it, comparing the description against the surfaced feelings.

4. Will my child fall behind academically if we enroll him or her into a PHP / IOP?

   These programs are designed with life balance in mind and allow for a continuation of academic progress. Typically, IOPs meet for three hours a day, allowing for partial school attendance. Some offer evening programming, so no school has to be missed at all. PHPs meet for approximately 6 hours a day, but supervised academic time is included in the daily curriculum. In each instance, a school liaison will work with parents and teachers to facilitate the process and keep your child on track.

5. Will my child need to continue with outpatient care after being discharged from a PHP / IOP?

   Yes, a return to outpatient care is recommended. A PHP / IOP program might jump start or reignite progress being made on the outpatient basis; PHP / IOP participation does not replace outpatient care.

Tim Yovankin, MD
Medical Director, Greywood Health Center
www.greywoodhealthcenter.com

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your symptoms and conditions.