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Is PHP a Good Fit After Residential? Planning Step-Down Care

Cheryl Kehl, LCSW

CEO Co-founder and partner

Cheryl has been working in the private Mental Health and Addiction treatment world for 30 years, as a clinician, clinical director, program founder, program administrator, and facility decorator! Corner Canyon Health Centers is the result of this experience, her education, and her own experiences in treatment. Corner Canyon’s focus on comprehensive and innovative assessment, advanced and validated clinical practices, and implementation of the most effective new technologies and research are due to her desire to help others gain full health quickly and effectively in a comfortable setting. Cheryl completed her education at Brigham Young University where she received her Bachelor of Science in Psychology and Sociology in 1991 and her Master’s Degree in Social Work in 1993. She pursues interests in science, technology, and mental and physical health, and is fascinated by the overlap that is increasing between these with their ability to help clients heal faster. Cheryl is the oldest of ten children and has three adult children, two daughters and a son. Her interests include water sports, photography, interior design, creative projects, and spending time with her family and friends. She loves house boating on Lake Powell, but her favorite pastime is spending time with her 6 wonderful grandchildren.
 
Cheryl Kehl, LCSW

CEO Co-founder and partner

Cheryl has been working in the private Mental Health and Addiction treatment world for 30 years, as a clinician, clinical director, program founder, program administrator, and facility decorator! Corner Canyon Health Centers is the result of this experience, her education, and her own experiences in treatment. Corner Canyon’s focus on comprehensive and innovative assessment, advanced and validated clinical practices, and implementation of the most effective new technologies and research are due to her desire to help others gain full health quickly and effectively in a comfortable setting. Cheryl completed her education at Brigham Young University where she received her Bachelor of Science in Psychology and Sociology in 1991 and her Master’s Degree in Social Work in 1993. She pursues interests in science, technology, and mental and physical health, and is fascinated by the overlap that is increasing between these with their ability to help clients heal faster. Cheryl is the oldest of ten children and has three adult children, two daughters and a son. Her interests include water sports, photography, interior design, creative projects, and spending time with her family and friends. She loves house boating on Lake Powell, but her favorite pastime is spending time with her 6 wonderful grandchildren.
 
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A Partial Hospitalization Program (PHP) is a structured, intensive outpatient level of care running five or more days per week for several hours per day, sitting directly below residential care on the treatment continuum. 

After leaving a residential program, many people face an abrupt drop in clinical support. PHP fills that gap. It preserves the therapeutic intensity of residential treatment while allowing clients to sleep at home and rebuild real-world life. 

Research shows that longer engagement in a connected continuum produces better long-term outcomes than abrupt transitions to low-intensity services [1].

What Is a Partial Hospitalization Program?

The American Society of Addiction Medicine (ASAM) classifies PHP as Level II.5, the most intensive form of outpatient care. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines it as more than six hours of structured programming per day [2]. 

Most programs run Monday through Friday for 25 to 35 hours per week, with clients attending during the daytime and returning home each evening.

PHP sits between residential care (Level III) and intensive outpatient (IOP), which typically runs nine or fewer hours per week. The recommended step-down path runs: residential, then PHP, then IOP, then standard outpatient, reducing intensity as the person gains stability.

The table below shows where PHP falls on the ASAM continuum.

Level of CareSettingTypical Hours Per Week
Residential (Level III)24-hour live-in facility168 (on-site)
PHP (Level II.5)Outpatient, home at night25 to 35
IOP (Level II.1)Outpatient, evening often9 to 19
Standard Outpatient (Level I)Outpatient, flexibleUnder 9

Choosing the right step-down level is a clinical decision based on the severity of the substance use disorder, co-occurring conditions, home environment, and support system.

Why PHP After Residential Makes Clinical Sense

The early weeks after leaving residential treatment are among the highest-risk periods in recovery. Real-world stressors return quickly, and cravings or emotional triggers that felt manageable in a protected setting can overwhelm a person in the community. PHP maintains a clinical safety net during this window.

Clinicians following ASAM criteria recommend PHP when someone has stabilized medically but still needs daily structure [1]. A good candidate typically shows:

  • Medically stable with no need for 24-hour supervision

  • Has a safe home environment to return to each evening

  • Still needs daily clinical contact to prevent relapse

  • Has a co-occurring mental health condition requiring regular monitoring

  • Motivated to engage in treatment and build recovery skills

Research on post-discharge care shows that follow-up within 7 to 30 days of leaving an intensive setting is critical for preventing relapse and readmission [3]. PHP provides that continuity without requiring someone to restart their life from scratch.

What Happens in PHP: Therapeutic Approaches and Services

PHP delivers many of the same evidence-based treatments as residential care in a day format, building the coping skills clients will need after formal treatment ends. Common therapeutic approaches include:

  • Cognitive Behavioral Therapy (CBT) to identify and change thought patterns that drive substance use. Large-scale clinical trials support CBT’s effectiveness for substance use disorders [4].

  • Dialectical Behavior Therapy (DBT) skills training for emotional regulation, distress tolerance, and interpersonal effectiveness

  • Group therapy builds peer support and accountability in a structured clinical setting.

  • Individual therapy with a licensed counselor or therapist.

  • Psychiatric evaluation and medication management for co-occurring conditions such as depression, anxiety, PTSD, or bipolar disorder.

  • Relapse prevention planning, identifying personal triggers, and building a crisis response plan.

  • Family therapy and psychoeducation to help loved ones understand recovery and reduce patterns that can fuel relapse.

PHP and Co-Occurring Mental Health Conditions

Most people entering PHP after residential treatment have at least one co-occurring mental health condition. NIDA research confirms that integrated treatment for co-occurring disorders consistently produces better outcomes than treating each condition separately [5]. 

When depression, anxiety, or trauma drives substance use and substance use worsens those conditions, treating only one leaves the cycle intact.

PHP programs specializing in dual diagnosis offer on-site psychiatric care and coordinate medication management with therapy. Clients do not need separate providers for mental health and substance use treatment. 

Research shows that access to dual diagnosis services and trained staff leads directly to better treatment engagement and outcomes [6].

What to Expect When You Start PHP

Your first day in PHP begins with a clinical intake or review of your residential records. Your treatment team, which includes a therapist, psychiatric provider, and case manager, confirms your individualized treatment plan. 

Days follow a predictable structure: group sessions in the morning, individual therapy or skills groups in the afternoon, and psychoeducation or family sessions as scheduled.

That structure is intentional. Loss of routine is one of the biggest relapse risks after residential. PHP rebuilds it in a supported way, preparing you for independent living. 

Your team assesses progress regularly and recommends a step-down to IOP when you are ready.

Key Takeaways

  • PHP is the highest-intensity outpatient level of care, running five or more days per week, and is the recommended next step after residential treatment for most people.

  • Staying connected to structured, intensive care in the weeks after residential discharge is one of the most protective choices for long-term recovery.

  • PHP treats the whole person, including co-occurring mental health conditions, through integrated psychiatric and therapeutic care in one program.

  • Recovery is not a sprint. Choosing the right step-down plan now lays the foundation for durable change. You do not have to navigate this alone.

Frequently Asked Questions

Is substance use disorder treatable, and can PHP help?

Yes. Substance use disorder is a treatable chronic condition. PHP provides daily clinical support through evidence-based therapies with strong research backing for long-term outcomes.

What therapeutic approaches are used in PHP?

PHP uses Cognitive Behavioral Therapy, Dialectical Behavior Therapy skills, motivational approaches, relapse prevention, group and individual counseling, and psychiatric medication management.

How many days per week and hours per day does PHP meet?

Most PHPs run five days per week for five to seven hours per day, totaling 25 to 35 clinical hours weekly, depending on the program and individual needs.

Can PHP treat depression, anxiety, or trauma alongside addiction?

Yes. PHP programs offering integrated or dual diagnosis care treat co-occurring mental health conditions at the same time as substance use disorder, producing better outcomes than treating them separately.

Does insurance cover PHP?

Most private insurance, Medicaid, and Medicare cover PHP when medically necessary. Coverage details and authorization requirements vary by plan.

Why transition to PHP instead of going straight to IOP or standard outpatient?

Dropping from residential directly to low-intensity outpatient removes most clinical support at once. PHP preserves daily structure and reduces relapse risk during the most vulnerable period of recovery.

What happens on the first day of PHP?

Your team reviews your history and confirms your care plan. You meet your treatment group and begin scheduled therapy sessions on day one.

Trauma-Informed Treatment in Salt Lake County

Treatment for mental health conditions and trauma is available in Utah. Are you or a loved one looking for a compassionate space to heal from OCD, anxiety, trauma, PTSD, CPTSD, other mental health conditions, or addictions? 

Our licensed trauma-informed therapists and counselors at Corner Canyon Health Centers can provide compassionate help using a range of therapeutic and holistic techniques. We also offer ketamine-assisted psychotherapy for treatment-resistant depression.

Reach out to our admissions team at Corner Canyon now. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.

Sources

[1]Substance Abuse and Mental Health Services Administration. (2006). Intensive outpatient treatment and the continuum of care. In Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. NCBI Bookshelf.
[2]Substance Abuse and Mental Health Services Administration. (2024). Types of treatment. U.S. Dept. of Health and Human Services.
[3]Ojo et al. (2024). Ensuring continuity of care: Effective strategies for the post-hospitalization transition of psychiatric patients in a family medicine outpatient clinic. Cureus, 16(1), e52263.
[4]McHugh, R. K., & Barlow, D. H. (2010). Cognitive-behavioral therapy for substance use disorders. Psychiatric Clinics of North America, 33(3), 511-525.
[5]National Institute on Drug Abuse. (2021). Common comorbidities with substance use disorders research report. National Institutes of Health.
[6]Levin, F. R., et al. (2019). Treatment for substance use disorder with co-occurring mental illness. Focus, 17(2), 88-97.

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