Partial hospitalization

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Partial hospitalization programs (PHPs) for eating disorders are structured day treatment programs that individuals attend several days a week for several hours as a step down from 24-hour inpatient hospitalization. PHPs can include medical care, nutrition counseling, structured eating sessions, and group, individual, and family therapy. (1)

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How are eating disorders treated with PHP?

Also known as a day treatment program, a partial hospitalization program provides a structured, nurturing environment for people who are stepping down from inpatient care to help them transition back into their normal daily routines or those who may not need 24-hour hospitalization but still need significant support. 

PHP patients are medically and psychiatrically stable but:

  • Require daily assessment of mental and physical status
  • Struggle to function in normal social situations, such as in school or at work
  • Still engage in harmful eating behaviors, such as binging, purging, fasting, limiting food intake, or other weight control techniques

What to expect in partial hospitalization programs?

Every individual goes through a thorough case management evaluation to determine length of treatment and specific programs needed. 

A typical treatment team may include a dietician, psychiatrist, counselor, and movement therapist. 

Types of PHP programs for eating disorders

Every PHP program is different and tailored to each person’s needs with daily and weekly monitoring for the program’s duration. Treatment can include group and individual therapy sessions, expressive and creative arts therapies, medication management, as well as nutritional and meal support. Length of treatment depends on each individual’s needs and goals.

Evaluating PHP as an effective eating disorder treatment

As with any other type of treatment, the level of support needed depends on each person’s individual circumstances.

What are the benefits of partial hospitalization? 

The partial hospitalization program has many benefits. These include lower costs than full 24-hour hospitalizations and more flexibility. Individuals typically go for treatment during the day and go home at night. 

Another benefit of a partial program is having the support of highly-skilled professionals to guide the recovery process. 

What are the limitations of partial hospitalization? 

Partial hospitalization means individuals will not be monitored 24 hours a day, which may result in relapses. Some individuals may revert to old habits once they return home. 

Partial hospitalization can also be very expensive for patients, especially without insurance coverage. It could lead to the discontinuation of the program before the end goal is achieved. 

Efficacy of PHPs in healing eating disorders

Studies have found PHPs to be effective in treating eating disorders. One study comparing the outcome of both a residential full-time hospitalization and partial hospitalization program on patients with eating disorders found a high efficacy for PHP over full hospitalization in maintaining symptoms of remission. (1)

In another study, adult patients with a long standing course of illness and high levels of psychiatric comorbidity from eating disorders were observed after following a PHP program. Results proved the effectiveness of PHP in improving eating disorder outcomes, even in severe cases, through long-term follow up. (2)

Further, another study concluded eating disorders, when left untreated, can severely impair a patient’s wellbeing and life. Their observations made it clear that PHP treatments are highly effective in treating any type of eating disorder and improving the patient’s quality of life. (3)

PHP for eating disorders at Within Health

Within Health has developed a completely unique type of care. We operate with both PHP and residential practices, while being a completely virtual treatment program. Our team believes there is a gap in the traditional PHP and intensive outpatient programs (IOP) that we are currently filling. Through this model, Within Health clinicians and nutritionists are able to provide up to twelve hours of care daily for each patient. 

Within Health also allows patients to receive both PHP and IOP levels of care from home where their eating disorder thrives. By treating the eating disorder in its native environment, our team can treat it differently than at a facility. Call our team today to learn more about the treatment programs available at Within Health, or to hear about how to get started.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Eating disorder treatment: Know your options. (2017, July 14). Mayo Foundation for Medical Education and Research.
  2. Friedman, K., Ramirez, A. L., Murray, S. B., Anderson, L. K., Cusack, A., Boutelle, K. N., & Kaye, W. H. (2016). A narrative review of outcome studies for residential and partial hospital-based treatment of eating disorders. European Eating Disorders Review, 24(4), 263–276. https://doi.org/10.1002/erv.2449 
  3. Brown, T. A., Cusack, A., Anderson, L. K., Trim, J., Nakamura, T., Trunko, M. E., & Kaye, W. H. (2018). Efficacy of a partial hospital programme for adults with eating disorders. European Eating Disorders Review, 26(3), 241–252. https://doi.org/10.1002/erv.2589 
  4. Hayes, N. A., Welty, L. J., Slesinger, N., & Washburn, J. J. (2018). Moderators of treatment outcomes in a partial hospitalization and intensive outpatient program for eating disorders. Eating Disorders, 27(3), 305–320. https://doi.org/10.1080/10640266.2018.1512302

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