Why would my provider recommend I try a higher level of care? What’s the difference?
In once-a-week therapy, you meet with your therapist one time every week, usually for about an hour. That can be really helpful! But sometimes, people need more support than that—especially if they’re feeling really sad, worried, or having a hard time staying safe.
That’s when your therapist might talk to you about something called an IOP or a PHP.
What is an IOP or PHP?
- IOP stands for Intensive Outpatient Program.
- PHP stands for Partial Hospitalization Program.
These are places (sometimes in-person, sometimes online) where you can go a few times a week or even every day for a few hours at a time. You’ll still live at home, but you’ll get more help, more often.
What Happens There?
- You’ll talk with therapists, maybe in a group with others who also want to feel better.
- You might learn new ways to understand your feelings and what to do when they get really big.
- People will listen to you and help you feel safe and cared for.
- Sometimes you’ll have activities, like drawing, writing, or learning how to calm your body and mind.
How Is It Different From Weekly Therapy?
- You go more often—instead of once a week, it might be 3 to 5 days a week.
- You get to talk to more people who want to help.
- You’ll have more time to practice what you’re learning.
- It’s like giving your brain and heart a little extra “boost” of care.
Getting this kind of help doesn’t mean you’ve done anything wrong. It just means you’re being really strong by asking for support when you need it.
🌱 Outpatient Care (Talk Therapy & Check-Ins)
What it is:
You see a therapist or doctor a few times a month.
What to expect:
✔️ Meet with a therapist once a week or every other week
✔️ See a psychiatrist or doctor for medicine if needed
✔️ Live at home and go to school or work
How long: Ongoing (as needed)
How intense: A few hours per month
👥 Intensive Outpatient Program (IOP)
What it is:
A few hours of therapy each week, more support than regular therapy.
What to expect:
✔️ Go to therapy 3–5 days a week
✔️ Each day is about 3 hours
✔️ Group therapy, and sometimes individual therapy
✔️ Medication management by a doctor or nurse
How long: 6–12 weeks
How intense: Low to medium support
🕒 Partial Hospitalization Program (PHP)
What it is:
Daytime program that feels like school or camp for your mental health.
What to expect:
✔️ Go during the day, home at night
✔️ Usually 5 days a week, 5–6 hours per day
✔️ Group therapy, individual therapy, and family therapy
✔️ See a doctor or psychiatrist for medicine
How long: 2–6 weeks
How intense: Medium to high support
🏠 Residential Treatment Center (RTC)
What it is:
Live in a safe place where you get help every day for mental health or substance use.
What to expect:
✔️ Live there full-time
✔️ Daily therapy, activities, and learning
✔️ Individual, group, and family therapy
✔️ Doctors or psychiatrists give and manage medicine
✔️ 24-hour staff for support
How long: Weeks to months
How intense: High support
🛌 Inpatient Hospitalization
What it is:
Short-term stay in a hospital for when someone is in crisis or unsafe.
What to expect:
✔️ Stay in the hospital full-time
✔️ Help to stay safe
✔️ Daily check-ins with doctors and nurses
✔️ Short therapy sessions, often in groups
✔️ Medicine started or adjusted
How long: A few days to 1–2 weeks
How intense: Very high support, 24/7 care
🏥 Detox (Detoxification)
What it is:
Help to safely stop using alcohol or drugs. First step before other care.
What to expect:
✔️ Stay in a hospital or detox center
✔️ Doctors help with withdrawal symptoms
✔️ Rest and get stable
✔️ Some therapy and support, but focus is on the body
✔️ Medication may be used to ease symptoms
How long: 3–7 days
How intense: Highest level of care – 24-hour medical help
💬 Who helps me?
| Level of Care | Therapy | Medication Help |
| Outpatient | 1:1 therapy (weekly/monthly) | Psychiatrist visits (as needed) |
| IOP | Group + some 1:1 therapy | Regular check-ins with doctor |
| PHP | Daily group + 1:1 + family | Frequent med management |
| Residential | Daily group, 1:1, family | On-site doctors and nurses |
| Inpatient Hospital | Crisis-focused therapy | Daily doctor visits |
| Detox | Supportive check-ins | 24/7 medical supervision |
FAQs
Will my insurance cover this level of care?
Insurance often covers higher levels of behavioral health care, like intensive outpatient or inpatient treatment—but coverage can vary by plan. An insurance representative or admissions person at the program can help you understand your specific benefits and any costs you might have.
Is this a permanent level of care?
Not at all. Higher levels of care are usually temporary and are designed to give you the support you need right now. As things stabilize, you can often step back down to routine care—sometimes with the same provider you’ve already been seeing.
Do I have to follow through with the referral?
No—it’s your choice. We’ll offer referrals based on what seems like the best fit for your current needs, but you’re always in control of your care decisions. We’re here to support you either way.
Am I able to go back to my provider?
Yes, absolutely. Many people return to their original therapist or prescriber after completing a higher level of care. Your provider can be part of your support team as you transition in and out of different types of care. You can contact our support team at support@rula.com or visit this help center article which will walk you through the steps of resuming care with your previous provider.
Can I go to part of the program?
Most programs are structured to be attended in full so you get the most benefit—but it’s okay to ask about flexible options. Some programs offer evening or part-time tracks. Care Coordination can help you explore what might work best for your schedule.
Do I have to take time off of work or school?
Sometimes, yes—depending on the level of care. But many programs offer flexible schedules, and some are in the evenings or weekends. We can help you find options that minimize disruption while still getting you the support you need. If attending the program conflicts with your work or school schedule and you need assistance with taking time off, the program administrators can usually provide documentation to help support your request.
Are all programs in-person?
Not anymore! Many programs now offer virtual or hybrid options—especially intensive outpatient programs (IOPs). This can make it easier to get care without having to travel or take time away from home.
What if I cannot afford this level of care?
Cost is a real concern, and you’re not alone. Some programs offer sliding scale fees, payment plans, or financial assistance. Care Coordination can help you identify treatment options that accept your insurance or offer a sliding scale. Your actual cost share estimate will be provided by the program where you choose to seek treatment.
What if I’m in a crisis situation right now?
Rula has a dedicated crisis hotline staffed 24/7 by professional crisis support counselors. If you are experiencing a crisis, you can call (877) 371-5488 to receive immediate assistance.
Anyone who is experiencing a suicidal crisis, is in emotional distress, or is concerned about a loved one’s mental health can call or text 9-8-8 to be connected with a trained crisis counselor who is there to listen and offer support. The 988 Suicide and Crisis Lifeline provides completely free and confidential support 24 hours a day, 7 days a week. As an alternative to a phone call or text, you can also chat via your computer or phone with a counselor at https://988lifeline.org/chat/.
Patients who are covered by Kaiser Permanente and experiencing a behavioral health emergency or having a mental health crisis (possible inpatient care) should contact the Kaiser Permanente Behavioral Health Care Helpline (BHCL) at 800-900-3277 or contact the National Crisis & Suicide Hotline at 988. Both are available 24/7 at no charge 24/7.
Do I have to stop seeing my current therapist or psychiatrist?
Most of the time, no. Your provider might pause sessions while you’re in the program, but you can often return to them afterward. Many providers stay in touch with the program to help with a smooth transition.
How long will I be in the program?
It depends on your needs. Some people attend for a few weeks, while others stay longer. The treatment team will check in with you regularly to see how you’re doing and help decide when you’re ready to “step down.”
Will I be in a group with other people?
Yes—IOP and PHP programs usually include group therapy. You’re not alone, and many people find it comforting to connect with others who are going through similar things.
What kind of therapy will I get?
You’ll likely get a mix of group therapy, skills-based classes (like CBT, DBT, or coping skills), and possibly individual sessions or medication support, depending on the program.
What if I start and decide it’s not for me?
That’s okay. You always have a voice in your care. If something doesn’t feel like a good fit, your provider or care coordinator can help explore other options.
Is this the same as being hospitalized?
No. IOP and PHP are outpatient programs. You don’t stay overnight, and you continue living at home. But you get more support than in regular therapy.
What if I’m not sure I need a higher level of care?
That’s totally normal. Your provider is recommending it because they think it could help, but you’re encouraged to ask questions, learn more, and be part of the decision. Your therapist may consider alternative options such as:
- Connecting you to a more specialized provider who best fits your needs.
- Increasing the frequency of your sessions to twice weekly, and incorporating additional services such as group therapy or medication support.