When to Step Down From PHP to IOP: Signs You’re Ready for the Next Level of Care

Author:

Hayley Snelling

B.S. Psychology

Editor:

Emma Loker

B.S

Recovery isn’t about staying in one place – it’s about growing and adapting as you heal. If you’ve been in a Partial Hospitalization Program, stepping down to an Intensive Outpatient Program might be the next step in your journey.

Transitioning between the two treatments is a major milestone in your recovery. It means you’ve gained important skills and built a strong foundation that means you become more independent and take your mental health into your own hands.

In this guide, we’ll explore the differences between PHP and IOP, what the transition process is like, and the main signs that you are ready for this step. You’ll also discover how to prepare yourself emotionally for this change so that you can move forward feeling confident in your recovery.

Healing is never a straight line, but when you get the right support, you can continue to grow, heal, and thrive.

PHP vs IOP Mental Health Programs: What Are They?

Let’s explore each of these programs in a little more detail.

Partial Hospitalization Program (PHP)

A Partial Hospitalization Program (PHP) is an outpatient program that provides an intensive and structured level of support and supervised care during the daytime, whilst allowing you to return home for the evenings and night.

Daytimes are usually timetabled with four to six hours of treatment, including sessions of individual therapy, group therapy, medication management, and psychoeducation. You attend the program five to seven days each week, for several weeks or months. You receive a high level of support, care, treatment, and therapy, in a carefully structured and safe environment.

PHP is a great option for patients who need intense and structured support during the daytime, but who do not require full hospitalization or overnight care.¹ It’s a helpful way to transition from being an inpatient to an outpatient. It’s also an effective treatment program if you experience severe mental health symptoms that interfere with your daily functioning, or if you think you may be at risk of having a mental health relapse.

Intensive Outpatient Program (IOP)

An Intensive Outpatient Program (IOP) is also a structured, non-residential treatment program for people managing their mental health conditions who don’t require full-time care or supervision, but it does differ from PHP in several ways. It has less of a time commitment, usually two to three hours a day, for three to five days a week. This means that you can potentially carry on with most of your usual daily activities, like work or school, whilst getting a more intense level of support than standard outpatient therapy.²

Your treatment sessions will usually involve individual therapy, group therapy, medication management, and psychoeducation, aimed at stabilizing your symptoms and building up your coping strategies.

IOP can be a benefit if you need more support than traditional outpatient therapy, or if you are transitioning from a PHP. It’s a great option if you have a stable and supportive home situation and people you can talk to while being able to continue your daily routine.

Transitioning From Partial Hospitalization to Outpatient Care

So, what are the next steps after partial hospitalization? IOPs can be a great option for someone stepping down their care from PHP, but why would you want to transition in the first place?³

Well, an IOP is the natural next step in recovery. You’ve already built up some coping skills and are feeling more stable than when you started the PHP. You might be feeling more confident in how to manage your mental health outside of a full-day program for the majority of the week, but you still need and want structured support to help you heal. Perhaps you’re ready for more independence and less of a rigorously-timetabled day so that you can begin returning to work or school part-time.

You can gradually adjust to life outside of intensive treatment, while still having access to therapy and support resources that you may need. These are some of the main reasons that people begin creating a step-down plan for mental health care, moving from PHP to IOP.

What Happens When You Step Down From PHP?

Let’s look at how to tackle PHP to IOP transitions. Adjusting to life after partial hospitalization can be a daunting prospect for some people. You’ve grown used to the structure, the support, and the familiar faces, and the last thing you want is to be left feeling adrift and alone. Don’t panic – we’re going to walk through what this transition looks like practically so that you feel more prepared for the next step in your healing.⁴

1. Less Structure

You’ve grown used to having the majority of your day and week timetabled for you – this is about to change. Instead of spending a full day in treatment, you’ll only be spending a partial day. This could feel challenging at first, especially if you appreciate the structure, but it’s also a great opportunity.

You can start to make your own plans in the daytime again, whether that’s work, school, seeing friends for coffee, or doing online yoga classes. Just because you have less timetabled treatment time from the program doesn’t mean you can’t schedule some activities for yourself outside of IOP.

2. More Flexibility

There may be a few days during the week when you aren’t at the treatment centre at all. Rather than having these feel like empty days, you could make plans to do things you enjoy or want to do. If you’ve wanted to visit a park and have a picnic with friends and it’s a gorgeous sunny day, you can do that.

If you’ve wanted to stay in and binge the latest series of your favourite show with your partner, you can do that too. If there’s a course you’ve been wanting to take one day a week, you could start that now. If you want to go for a run, bring out some arts and crafts, or do some gardening, go ahead.

3. Coping Skills

You have more flexibility and time which is great, but what happens on the days when you aren’t in the program and something happens to trigger you? It’s not all going to be sunshine and roses every day. Thankfully, you have been learning coping skills and strategies in PHP to help you when this happens, and they are the perfect chance for you to practice them.

Whether it’s journaling your thoughts, breathing exercises, grounding practices, or something else; remember to keep practising these skills and be ready to bring out the strategies when you need them.

There’s the added benefit of knowing that tomorrow or the next day, you will be seeing your therapist or others from the program to share and get support for what has happened.

4. Maintaining Care

Transitioning out of PHP doesn’t mean that you’ll be cut off from your support or treatment. Transitions to IOP are planned to make the change feel smooth and seamless for you. The key is to avoid abrupt changes in the recovery process. Your case manager and support team will ensure that you receive support and help that feels comfortable and suitable for you by creating the best treatment plan for your personal care.

5. Relapse Prevention

IOP will help you to recognize the triggers for your mental health symptoms, and teach you coping skills and strategies to help you deal with them. It keeps your recovery moving along and will help you to develop your own healthy routines which work for you, whilst having the safety net of the program available to you multiple times a week.

Signs You’re Ready to Move From PHP to IOP

You might be wondering how to know when you’re ready for IOP? You’ll usually have some idea or feeling whether it’s the right time for you, but here are some of the signs of progress for stepping down care:

Managing Symptoms: You feel like you’re managing your symptoms better than when you started PHP, and are doing so with greater independence.
Less Intensive Support: If you feel like the amount of intense therapy and treatment you receive at PHP is no longer required, it might be the right time to work toward IOP.
Better Daily Functioning: You feel ready to take on some responsibilities again, or attend school or work part-time.
Support System: You have a good support network built up outside of PHP – friends, family, or support groups – who can help you as you transfer to a less intensive program.
Team Recommendations: Your treatment team feel that the time might be right for you to transfer to IOP.

Preparing Emotionally for Lower Levels of Care

It’s natural to feel nervous when faced with change, so we’ve brought together our five top tips for preparing yourself to progress to a less intense level of care.

1. Accept Mixed Emotions

You might feel excited at the idea of having more free time with an IOP. Maybe you’re worried that you won’t be able to cope without the level of support and structure you have become used to?

Perhaps you’ll feel annoyed or irritated by the fact that you are changing for the better, but people around you on the outside are still the same as they were. Whatever you feel is completely valid. It’s important to know that you might feel a complete mix of emotions and that it’s ok to feel this way.

2. Practice Your Coping Skills

You’ve learned a lot of new coping skills and strategies through PHP, and now it’s time to put it into practice. Even if you aren’t feeling stressed or triggered, the more you practice, the easier it will be to use these skills when you do need them. Practice makes progress.⁵

3. Build Up Your Support Network

A support network can help provide you with emotional support outside of the program, so it’s great to build your support up, whether it’s friends, family, or support groups. It’s an important link to moving from intensive structured support to a less intensive approach. Although your therapist and health professionals will still be involved in your care, it will become increasingly important for you to have people outside of the clinic that you can rely on.⁵

4. Create a Routine

Make a daily routine to help replace some of the structure that will lose from PHP. Have a regular wake up and sleep time, schedule your meals, and plan to do things that help your well-being, such as yoga, meditation, or crafting.⁵ Take what was useful to you from PHP, and bring it into your outside life.

5. Talk With Your Treatment Team

You can always ask your treatment team about potential resources and recommendations for preparing for the change in care. They will have helped people in your situation before, so pick their brains for suggestions.

Become an Outpatient and Feel Supported Doing So

At Mission Connection we’re committed to supporting you on your road to recovery. We understand that mental health conditions can affect every part of your life, which is why we offer compassionate, individualized care – because no two people are the same. Whether you are looking for short-term support during a crisis, outpatient therapy after PHP, or ongoing therapy, we have options available to fit in with your schedule and responsibilities.

Your well-being is our priority, and we believe that mental health care should be accessible to everyone. We provide flexible payment options to make sure that cost won’t be a problem.

Contact our team of friendly experts to find out how we can support you through your healing journey.

References

National Association of Private Psychiatric Hospitals & American Association for Partial Hospitalization. (n.d.). Definition of partial hospitalization. PubMed. https://pubmed.ncbi.nlm.nih.gov/10106610/
Amft, T. B. (2024, December 12). How an intensive outpatient program (IOP) works. Verywell Mind. https://www.verywellmind.com/what-is-an-iop-intensive-outpatient-program-5521766
Geng, C. (2023, March 1). What to know about intensive outpatient programs (IOP) and their uses. Medical News Today. https://www.medicalnewstoday.com/articles/intensive-outpatient-therapy
Helps, S. (2025, January 27). Making the transition from PHP to IOP: What to expect. Summit Behavioral Health. https://summithelps.com/blog/making-the-transition-from-php-to-iop-what-to-expect/
Life Adjustment Team. (2024, February 16). Making the transition from partial hospitalization to day-to-day living. https://www.lifeadjustmentteam.com/making-the-transition-from-partial-hospitalization-to-day-to-day-living/