Residential vs PHP

How a program approaches dealing with treatment needs is almost as important to the recovery process as the question of what issues a patient is dealing with. Some people need to work in a setting that provides constant support and even 24/7 monitoring. Others may be able to visit a facility on a regular basis and go home each day at the end of sessions. For those who need a lot of support, residential treatment programs are often the preferred option. Patients who may benefit from less monitoring often prefer to explore the PHP model, meaning going into a partial hospitalization program.

It’s a good idea to appreciate what approach each option entails before you decide what type of treatment is appropriate for you or a loved one. Let’s take a closer look at what each program offers and how either one might apply to your situation.

The Basics of Residential Treatment

The core idea behind residency at a rehab facility is that you will have an opportunity to address major medical concerns that often arise due to addiction and withdrawal in a setting where there will be constant supervision. For example, someone who is experiencing withdrawal from cocaine may develop issues with their appetite, sleeplessness, exhaustion and physical pain. It can be helpful to have a professional present to oversee a person going through cocaine withdrawal in order to ensure the client is sleeping and eating well enough for their body to recover.

In the above example, it should be noted that while there are few documented deaths tied to cocaine withdrawal, they do happen. Someone trying to kick a cocaine habit in a treatment program may:

  • Attempt suicide
  • Experience depression
  • Become paranoid
  • Act violently
  • Go through cardiac episodes

Knowing that an individual in such circumstances will be monitored can be a huge relief to friends and family members. It also allows the patient to focus on recovery while professionals address some of their day-to-day concerns.

Residential treatment options are technically a type of inpatient care. This is because a full admission into the program is required. Most facilities that describe themselves as offering residential care, though, attempt to replicate as close to a home environment as possible under the circumstances.

How Long Does a Residential Program Take?

Living in residence at a facility is usually set up to work on a 30-, 60- or 90-day basis. Program lengths can be adjusted to address:

  • How bad a person’s physical condition is
  • If they’re dealing with multiple addictions
  • Any co-occurring mental health concerns
  • Worries about them relapsing

The initial goal is to get a person detoxified. This means getting the substances that they’ve been abusing out of their systems. It is hard to commit to a specific length for a stay until a professional has seen what a client is like at the end of the detox process.

Some individuals prefer to visit programs that are outside the states they live in. This allows them to unplug from personal relationships that may have played roles in their addiction issues. Others like to stay at facilities that are close to home in order to maintain support from family members. It’s a good idea to think about these concerns and the way you came to the conclusion that you have addiction problems. This will allow you to make a choice that reflects your circumstances better.

The Basic of the PHP Approach

Partial hospitalization is aimed at people who have been judged to be capable of sticking with a treatment path while going back to their own homes or those of friends or family members at night. The goal is to find a happy medium between inpatient and outpatient care. People have access to programs and resources that are equivalent to what a hospital can offer, and they have the benefit of not feeling like they’ve “checked in.”

Notably, patients do come in each day for several hours of intensive sessions with staff members. A lot of treatment options can be handled in a PHP setting, including:

  • Individual counseling
  • Group therapy
  • Family therapy

This approach is suited to those who aren’t experiencing extreme withdrawal symptoms. In some cases, they may require minimal medical intervention, such as the prescription of benzodiazepines for dealing with addiction and withdrawal-related concerns from drugs like opiates and opioids. As long as the client appears to be functioning well with minimal medical help, they can go home and come back on a regular basis.

How Long Does a PHP Take?

Overall treatment tends to follow the same 30-, 60- and 90-day structure that residential programs follow. People often start out in a residential setting and transfer to a PHP one once they’ve become stabilized, so the exact amount of time that might be spent in one program or the other often depends on how long the residency lasted.

A lot of this boils down to what drugs were being used. Amphetamine users, for example, may take weeks to see their cravings abate, often making them poor candidates for a PHP facility. Conversely, people with alcohol use disorders may see the worst of their withdrawal symptoms abate after days, although they do face a higher risk of mortality during the process.

Following Medical Advice

A major challenge that patients face in choosing between the two options is confronting their own limitations. Especially in situations where a person voluntarily enters a program, a lot of the decision-making is theirs. That means the most anyone can hope for is that they will hear the advice of doctors and drug counselors and heed it.

For most people, the biggest questions in the process are:

  • Will I go through a difficult withdrawal process?
  • Do I have specific medical conditions that call for closer monitoring?
  • What are the chances I will experience a relapse?

Evaluating withdrawal issues is fairly straightforward for the majority of clients. Each drug has a well-documented profile, and that means we know which drugs entail difficult withdrawal symptoms.

Those who choose residency are often trying to kick habits that present mortality risks. By far, the greatest risk that a patient will die while trying to quit abusing a substance comes from alcohol. Within three days of getting their last drink, people with alcohol use disorders may begin to experience:

  • Auditory and visual hallucinations
  • Heart rhythm problems
  • Retching, nausea, anxiety, and sweating
  • Convulsions
  • Seizures
  • Confusion

It’s understandable why someone would want a professional on standby in the middle of the night if they’re worried that any one of those might happen, let alone potentially all of them.

On the flip side, a person who is trying to quit alcohol will begin to see a number of physical improvements after a week. They’ll generally have more energy both physically and mentally. They’ll sleep better and even see their skin begin to clear up. At that point, there’s some argument that acting on the advice of a qualified professional, the individual may want to transfer from residency to partial hospitalization.

Available Support

One factor that has to be examined in making the choice to transfer to a PHP is just how much support a person can expect at home from friends and family members. It has been estimated that about 50 percent of addiction factors are hereditary, and going home every night may mean being in a setting where there are other people with addiction issues. Romantic partners often provide the wrong kind of support, too. Under those kinds of circumstances, it might be better to enter residency to ensure that you’ll be in a supportive setting throughout the recovery process.

Conversely, if you know there will be support at home, there’s a lot of upside in sleeping in your own bed. This is, of course, contingent on the idea that other potential relapses risks won’t be present. A counselor will evaluate some of these factors, which may include asking questions about:

  • Your propensities to sneak out
  • Your partying behaviors
  • The chances that drugs are still hidden in the home
  • Who comes and goes at the house

This sort of evaluation calls for you to not only take a close look at yourself but also those around you. One reason seeking professional counseling can be beneficial is that an outside party can discuss with you in detail how addiction came into your life. They can make notes about things like how a specific family member might have introduced you to drugs. From there, they can help you identify patterns. You can then make a more fully informed decision about whether residential or PHP treatment suits your needs.

Flexibility

It’s worth noting that residential and PHP models of treatment do not always completely exclude each other. In fact, regardless of how you start the recovery process, you’ll be working toward a less supervised approach with time. Someone who starts treatment in residency might get to the end of a 30-day program and decide that an additional 60 days in a PHP would be a good idea. At the end of that stretch, they may begin more intermittent counseling sessions either on-site or with a counselor who has a relationship with the facility.

Similarly, if someone tries a PHP and ends up needing closer monitoring, that’s an option. A PHP is not desirable if a person is at risk of undergoing major withdrawal symptoms, but not everyone presents with serious symptoms until they begin detoxifying. It may turn out, for example, that a person was self-medicating for depression and anxiety and didn’t even really know it. Take away drugs, and you may suddenly see a high-functioning addict become a person who has completely untreated mental health issues. In such cases, it’s good to know that more intensive options are available.

Making the Choice

It’s important to remember that the very first choice isn’t between residential and PHP care. The very first choice is to get help. Picking between residential and PHP treatment is a problem that comes after the biggest choice is already made.

You should be fully informed about both ways of dealing with drug treatment programs. It’s also wise to take the time to hear what a counselor has to say about whether you might be a good fit for residency or partial hospitalization. Take all of your circumstances under consideration and try to value what the counselors have to say, too. Recovery is possible, and PHP and residential drug programs offer hope for people while giving them the flexibility to adjust their care to what’s going on in their lives.