IOP vs PHP questions for bipolar

I've been thinking about doing IOP, but I have some questions for you guys. Wildflowerchild25 and falcon09 gave me some advice in the check-in thread, but I don't want to spam that thread. And I apologize if this post is too long.

(1.) Are most IOPs meant for substance abuse or detox?
People have told me that I can go to IOP despite not having a substance abuse problem, which would be good for me, but my concern is that they will focus too much on substance abuse and detox. (I don't have a substance abuse problem.) However, I admittedly don't know how IOP therapy, psychiatry, etc. work.

(2.) Would PHP be more suitable if IOPs focus on substance abuse and detox?
The only problem I have with PHP is that every day is long according to what I've been reading. Basically, we're talking about 9am until 3pm or something like that. I just want a therapist to talk to everyday, and possible med changes with supervision. I like that IOPs meet everyday from like 6pm until 9pm because I don't know if I could benefit from going to PHP everyday for such long periods of time. I also don't think I am borderline needing IP.

(3.) What kind of things do you learn in IOP and PHP?
I am just curious about what they're like. I want to know what I can expect to see if either PHP or IOP matches my needs.

My experience is limited. Here's what it was like in my area.

1. I don't think so. I think the programs are meant to serve both because they are deeply intertwined in many cases. When I went to IOP for 6 weeks it was a mixed bag. The people who primarily had substance abuse issues also struggled emotionally with trauma and other issues that patients without substance issues had. Most of the people in my group had a bipolar diagnosis. We also had one schizophrenic woman, one man with schizoaffective disorder, a bipolar hoarder and one with a mix of BPD, bipolar and gambling issues.

The focus was never on substance abuse. For each exercise the therapist would talk us through it and then encourage certain people to be sure to include thought and answers for their specific special blend of whatever brought them in.

2. PHP and IOP were basically the same in my area. The programs offered similar therapies, but went by different names. The hours for each program varied and the days of week varied depending on insurance. My program was 9-1 every day, but my insurance only allowed MWF for me. Call your insurance to see what they cover or ask the program the specifics for your insurance.

3. Mostly we learned coping skills and dug into our triggers. We shared our answers and others would chime in with encouragement, similar experiences etc. We were also educated about the symptoms and how our specific disorders manifest.

For me, the value changed depending on the therapist. They facilitated all of the discussions and I had one great one who challenged us and dug into the truth of why we were all there. She helped us all make strategic plans to deal. The other lady I had just kept everything surface level and accepted BS responses that were easy for everyone.

I saw a nurse every day for vitals and saw a pdoc every week. That helped while I was adjusting to new meds.

Overall, it was a good experience. It helped me see some of the more common patterns people with these types of experiences have. Hearing someone else's experience made it essier to recognize some of the same things in myself.

One thing was true through that you'll want to keep in mind regardless of the therapist or the other people in the group. You will get out of it what you put into it. If you hide details or just go surface level, it won't help as much as it could otherwise. I got a lot more out of it once I shed my discomfort and just let it all out. Everyone was cool and supportive. I just needed to trust that I needed to be there and that it could help if I did the work.

ETA: there was a program in my area for professionals with mental health issues. That might be a good fit for you if you have one of those as they would also cover coping skills in the workplace and issues specific to handling both. Most of the people in my group were on disability. I was working at the time I got sick and it would have been nice to include that perspective as well.

Hi bluebicycle. I can only speak about the ones in my area, but all had a "psych IOP/PHP", a dual diagnosis/addictions IOP/PHP", a "Women's group IOP/PHP", and one focused on helping the elderly with elderly issues. I participated in all of the first three (I'm not elderly) at different times. If you do not have substance abuse issues, you would not participate in that track. If I had to go to an IOP/PHP today, I would attend the co-ed psych one, only since substance abuse has not been an issue for me in years. I would, personally, not need a women's only group now.

Fern hinted that insurance companies may play a part in determining if you start in IOP or PHP. And if you start in PHP, it is common to eventually be cut down to IOP after a period of time. Sometimes it starts M-F. Sometimes fewer days, or eventually reduces to fewer days.

In my IOPs/PHPs, there were a couple hours of process group in the mornings (general group therapy with others in your track). Then a variety of either coping skills groups, stuff like art therapy, meditation, anger management, or any of many other topic groups, which changed daily. We could usually choose between two or three options per given hour. Only then might I have been in a group with people that were from a different track or a different group but the same track. For people with addiction issues, there was usually an addiction-related option in the afternoon (PHP) beyond the dual diagnosis process group. Those without addictions did not attend that, usually. The difference between the IOP and PHP of any track boiled down to leaving before lunch (IOP) or eating lunch there and then attending additional options (PHP). If you have no addiction issues, you would not have to attend anything related to addictions at the facilities I went to.

As Fern wrote, vitals are taken frequently. Maybe daily, or a little less often. Visits to the outpatient psychiatrist may be once or more times per week (depending on facility or your mental state). At my outpatient facilities, some patients may even get private therapy once or more times per week, but that usually depended on the severity of my mental state.

Add On: I just looked and the place near me even recently added a men's program and young adult program. Maybe not relevant to you, but I thought perhaps of interest to others. I am glad to see the men's program added. I thought having a co-ed and women's only psych was sort of... you know.

Hey Blue!

I have not attended either type of program. I cannot give you first hand experiences.

I have had a couple of close friends do both types. They'd found the PHP more intensive, of course. This was a good choice when they were in severe distress and really needed help with being safe during most of the day.

The IOP had allowed them to work some each day.

Both programs were for psych and/or substance abuse issues.

I have a copy of the extensive manual used in both PHP and IOP. The manual is so large they could not cover all of the material.
They were taught mostly DBT, CBT and Mindfulness.

They had found they did have a lot in common with people attending for substance abuse. All were seeking coping skills.

One of your considerations might be whether or not your insurer covers both types of programs.

Think carefully about how you'd like to handle any choice re: your employer.
One of my friends talked with the intake person re: attending. She had filled out the forms and had emailed them to the intake person, as directed for the interview.. My friend was still considering her options. The intake worker contacted her employer's personnel department, disclosing everything needed to gain approval for "leave" in order to attend PHP. She was going to need medical leave in order to attend. She had NOT authorized the intake worker to schedule leave with personnel.

In some cases, people take vacation time. Others are able to work and attend IOP. In this cases, there is no reason for personnel to get involved.(as far as I know.)

I am glad you're looking into these options.

IN my experience IOP and PHP both focused on mental health. I don't have a substance issue. I think substance abouve has its own IOPs and pops away from mental health groups. have there own IOP/PHP for those issues. IOP is just a less intense usually a step down from a PHP program. In my experience PHP pick you up drive you to the program and you are there all day and get served lunch. They are like hospital but you sleep at home. IOPs are a further step down and you have to get yourself to the program and its only a couple hours of mainly group talk. It can be mornings or afternoon s so there's an option to work. Phps have more information groups and coping skill groups along with the talk therapy.

I don't really have a thing to add to what has been written by my wise friends above. I have done both, for,. oh, maybe a total of fiveish years or so. All focused on mental illness, though lots of folks, of course, have coexisting substance issues.

For me, I wasa mostly in post-mania and post-psychosis depression then and the extra support really helped me stay alive, for sure. Coping skills were the focus. CBT, a little bitty bit of DBT, REBT, etc.

I am sure you have been all through this, but I would just add that I would personally not reveal my diagnosis or illness or treatement to the employer. They almost always discriminate in some way, at least, this was my experience.

Hugs and love!!!

I would look up individual programs in your area, perhaps ask your treatment team. A lot of IOPs in my area are focused on substance abuse, but PHPs are for everyone. I have been to IOPs that are for everyone, however. We learned all sorts of things that others have mentioned, like anger management, sobriety maintenance, coping skills, DBT, setting boundaries, and so on. I know of two PHPs one is for adolescents and is noon-6pm and one is 9am-2pm and two IOPs one is 3pm-6pm (also for adolescents) and one 6pm-9pm (for substance misuse).