Potential Challenges of PHP and Cognitive-Behavioral Therapy

Megan Newton

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monday.com

Introduction

An estimated 20% of adults in the United States struggle with some form of mental health issues. This staggering number highlights the need for effective mental health treatment options.1
PHP and cognitive-behavioral therapy act as beneficial treatments tailored to the unique needs of each patient. This article will explore the benefits and applications of PHP and cognitive-behavioral therapy in mental health treatment.

What is Cognitive-Behavioral Therapy (CBT)?

Cognitive-behavioral therapy is a widely recognized and effective psychological approach. It aims to address and change patterns of thinking and behavior. CBT operates on the premise that thoughts and actions are interconnected.
CBT helps people understand the way they perceive and respond to situations. It targets unhealthy thought patterns and behaviors and focuses on fostering more constructive and positive alternatives.
This therapy is practical and goal-oriented. It focuses on the present and future rather than delving into the past. This helps equip people with skills to manage challenges and enhances mental well-being. One study found that CBT resulted in long-term improvement in 43% of survey patients.2
Cognitive-behavioral therapy is beneficial across a spectrum of therapeutic programs. It may be beneficial in various mental health treatment settings, including:
Outpatient counseling
Residential treatment centers
Community mental health centers
Employee assistance programs (EAPs)
School-based counseling services
Telehealth and online therapy platforms
CBT may also aid in partial hospitalization programs. Within these programs, it’s a common treatment modality.

The Role of Cognitive-Behavioral Therapy in Partial Hospitalization Programs (PHP)?

In a PHP setting, patients receive care during the day and return home in the evenings. Because of this, CBT serves several crucial functions, including:
CBT addresses and modifies maladaptive thought patterns that may contribute to mental health challenges.
CBT empowers them to develop healthier cognitive patterns that foster a constructive mindset. This is especially effective in managing depression, anxiety disorders, and other mood disorders.
CBT is instrumental in equipping people with practical coping strategies and behavioral skills. Through targeted interventions, people in a PHP can learn to:
Manage stress
Navigate challenging situations
Develop effective problem-solving techniques
CBT in a PHP setting serves as a structured and goal-oriented therapeutic tool. It helps people gain insight into their thoughts and behaviors. This also helps them learn skills for daily life and fosters positive changes.

How Does It Complement Other Therapeutic Approaches Often Used in PHP Treatment?

Cognitive-behavioral therapy works well with other therapies often used in partial hospitalization programs. It works with dialectical behavior therapy (DBT) to help manage thoughts and emotions. In group therapy, CBT supports individual progress and encourages learning from others.
It also works well with medication management by addressing thoughts while taking medication. When combined with psychodynamic therapy, CBT provides a practical focus on the present. In all, CBT blends well with various approaches, creating a comprehensive strategy for mental health treatment.

How CBT is Integrated into Partial Hospitalization Programs

Partial hospitalization programs incorporate cognitive-behavioral therapy through a structured and collaborative process that addresses each person’s needs.
Here’s how CBT is often woven into PHP care:
When someone enters a PHP, they undergo an initial assessment. During this time, the therapists identify specific challenges and goals for treatment. CBT is then tailored to address these goals. The focus is placed on practical strategies for improvement.
Participants engage in one-on-one sessions with a CBT-trained therapist. These sessions delve into the person’s thought patterns, behaviors, and emotions. Together, they work on recognizing unhealthy cognitive patterns.
CBT principles reinforce learning and provide a supportive environment when applied to groups. Group therapy allows people to:
Share experiences
Practice new skills
Receive feedback from peers
PHP treatment often includes skill-building workshops where people learn and practice specific CBT techniques. These workshops cover topics such as:
Stress management
Problem-solving
Emotion regulation
CBT equips patients with crisis intervention and coping strategies. Participants learn how to:
Manage challenging situations
Identify triggers
Use effective coping mechanisms

Homework Assignments

Therapists may assign homework between sessions to reinforce CBT concepts. This can include practicing new skills, journaling, or reflecting.
Progress is regularly monitored in a PHP. Feedback is then provided to help patients track their advancements. Adjustments to the treatment plan are made as needed, ensuring a dynamic and responsive approach.
As mentioned above, CBT is often used alongside other therapeutic approaches within a PHP. This fosters a holistic treatment plan. The collaboration between therapies also ensures that patients receive comprehensive treatment.

Primary Goals of PHP And Cognitive-Behavioral Therapy

The primary goals of PHP And cognitive-behavioral therapy are multifaceted. They focus on providing comprehensive mental health support.
Some of the goals include:
PHP and cognitive-behavioral therapy seek to stabilize those in crisis. This is done by offering intensive therapeutic interventions. The goal is to manage acute symptoms and prevent further deterioration of mental health.
CBT integrated into a PHP focuses on skill development, teaching patients practical coping strategies to:
Manage stress
Regulate emotions
Navigate challenging situations effectively
The combined approach sets specific and achievable goals for patients in a PHP. This promotes a goal-oriented treatment plan. CBT helps define and work toward these objectives, enhancing the patient’s sense of progress.
A PHP with CBT serves as a transitional step between more intensive care, such as inpatient hospitalization, and lower levels of outpatient care. The goal is to facilitate a smoother transition by building necessary skills and support systems.

Holistic Well-Being

The integration of CBT in a PHP aims at addressing the holistic well-being of each patient. It considers both the cognitive and behavioral aspects of mental health. This comprehensive approach supports participants in achieving lasting positive changes.

Preventing Relapse

CBT plays a crucial role in preventing relapse by empowering people with the tools to:
Recognize potential triggers
Manage stressors
Maintain healthy thought patterns

Assessment of Suitability for PHP and Cognitive-Behavioral Therapy

Assessing people for the suitability of participation in PHP and cognitive-behavioral therapy involves a comprehensive evaluation process that includes:
Participants undergo screening to determine their mental health needs. This may involve an assessment of:
Current symptoms
History of mental health challenges
Any previous treatment experiences

Clinical Interviews

Mental health professionals conduct in-depth clinical interviews. These interviews explore the person’s mental health history. This includes current symptoms and psychosocial factors contributing to their challenges.

Diagnostic Assessment

A diagnostic assessment helps identify specific mental health diagnoses and co-occurring conditions. This allows professionals to tailor treatment approaches to the patient’s needs.
The severity of symptoms is evaluated to determine if the person needs the intensity of care provided in a PHP.
This assessment considers factors such as:
Level of distress
Impairment in daily functioning
Risk of harm to self or others
The extent of functional impairment is assessed to understand how mental health challenges impact the patient. This includes their daily life, relationships, and well-being.
Assessments include evaluating the presence of suicidality or safety concerns. Patients at immediate risk may need more intensive care, such as inpatient hospitalization.
The person’s motivation and readiness for treatment are considered. This includes their willingness to:
Engage in therapy
Take part in the PHP
Actively work toward positive change
For CBT, the assessment includes determining the suitability of cognitive-behavioral interventions. This involves evaluating the person’s
Cognitive style
Willingness to engage in practical skill-building
Openness to exploring the connection between thoughts, feelings, and behaviors

Collaborative Decision-Making

The assessment process is collaborative. It involves open communication between the patient and the treatment team. The person’s preferences, goals, and treatment expectations are all considered.

Ongoing Evaluation

Assessment is an ongoing process throughout treatment. Regular check-ins and evaluations ensure the chosen interventions align with the person’s evolving needs and progress.

What Conditions Can PHP and Cognitive-Behavioral Therapy Treat?

Both combined and alone, PHP and cognitive-behavioral therapy can be valuable tools for a variety of health conditions. However, because much of the influence of treatment depends on the person, these forms of treatment may not be the best course of care depending on the severity of the condition.
This isn’t to say that PHP and cognitive-behavioral therapy aren’t useful, though. In fact, one study found that self-harming actions decreased from 94.7% to 5.3% over the duration of treatment.
With that in mind, some of the conditions that PHP and cognitive-behavioral therapy are often used to treat include:3
Mood disorders (e.g., major depressive disorder, bipolar disorder)
Anxiety disorders (e.g., generalized anxiety disorder, panic disorder)
Psychotic disorders (e.g., schizophrenia, schizoaffective disorder)
Personality disorders (e.g., borderline personality disorder)
Substance use disorders (SUD)
Eating disorders (e.g., anorexia nervosa, bulimia nervosa)
Obsessive-compulsive disorder (OCD)
Phobias
PHP and cognitive-behavioral therapy can serve as highly effective treatment options. But, they may also include some potential challenges, including:

Resource Limitations

Partial hospitalization programs may face challenges related to resource availability. This includes staffing, funding, and facility capacity. These resources can impact the quality and accessibility of care.

Coordination of Care

PHP and cognitive-behavioral therapy often involve several different healthcare providers working together. Coordinating care between different healthcare providers and ensuring seamless transitions can be challenging.

Insurance Coverage

Some people may encounter difficulties in securing adequate insurance coverage for a PHP. This may potentially limit their access to this level of care.

Stigma

Despite being an outpatient program, there can be stigma associated with attending a partial hospitalization program (or receiving mental health support in general). This may influence someone’s willingness to participate.

Treatment Engagement

Maintaining consistent engagement and attendance in a PHP and cognitive-behavioral therapy can be a challenge. This is especially true if someone faces external stressors or has difficulty adhering to the program schedule.

Time and Commitment

A PHP often takes a significant time commitment. Because of this, patients may find it challenging to:
Attend regular therapy sessions
Complete homework assignments
Actively take part in the therapeutic process

Access and Availability

Access to qualified CBT practitioners may be limited in certain geographic areas. People may also face challenges finding therapists with expertise in specific areas. This includes those with expertise in areas such as certain types of trauma or rare conditions.

Resistance to Change

Some people may resist the cognitive and behavioral changes encouraged by CBT. This may make it challenging for the therapy to be effective.

Cultural Considerations

CBT may not always align with the cultural beliefs and practices of all people. Therapists need to be culturally sensitive to ensure the approach is well-received and effective.

Severity of Symptoms

In cases of severe mental health conditions, patients may find it difficult to engage in CBT if their symptoms are particularly debilitating. Additional interventions or support may be needed. These treatments may be combined with PHP and cognitive-behavioral therapy.

How Can Continuum Outpatient Center Help?

Navigating mental health challenges and treatment can be daunting, but you don’t have to do it alone. Continuum Outpatient Center is here to help.
PHP and cognitive-behavioral therapy can be highly beneficial in treating certain mental health challenges. It can also act as a bridge between inpatient and outpatient care. Because of this, Continuum strives to increase accessibility to these types of care.
Our PHP is scheduled for four weeks, Monday through Friday. For many, sessions begin at 9 a.m. and will end at 3 p.m., with breaks throughout the day. This allows people to navigate treatment while also considering responsibilities outside of the PHP.
Studies have shown that patients enrolled in a PHP experience significant positive changes. At Continuum Outpatient Center, our healthcare providers strive to make this option available to you.4
At Continuum Outpatient Center, our PHP provides community building and skill development. This occurs while focusing on the root of mental health challenges. Through both evidence-based and holistic treatments, our PHP provides an environment for growth.
To learn more about our four-week PHP and cognitive-behavioral therapy, contact us today at 210-405-5935. We’re here to support you.

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