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Partial Hospitalization Program

flowerlady3The River Centre Clinic’s Partial Hospitalization Program for adults combines 35 hours per week (5 days a week, 7 hours a day) of partial hospitalization treatment with the option of independent living arrangements in dormitory-style rooms in or near the main facility.  Partial hospitalization is the most appropriate level of care for the vast majority of women and men who suffer from serious eating disorders. It provides a higher level of structure and support than is possible during outpatient treatment, but is also an effective, safe, and economical alternative to inpatient treatment.

The Partial Hospitalization Program (PHP) is a 35-hour per week program that provides a high level of intensity, structure, and monitoring to meet the needs of most female and male adults who suffer from serious eating disorders. The PHP provides many therapeutic services of inpatient treatment at a fraction of the cost, which encourages treatment to have a sufficient duration and increase its likelihood of success. Treatment is individualized and includes individual, group, and family therapy, with emphasis on meal planning, symptom reduction skills, and relapse prevention. It also offers training on emotional skills, social skills, assertiveness, and stress management techniques. River Centre Clinic offers independent living arrangements for PHP participants during non-program hours.

The PHP is certified by the Ohio Department of Mental Health as a partial hospitalization program and includes a multidisciplinary staff including board-certified/eligible physicians, licensed psychologists, psychology fellows, psychology aides, licensed independent social workers, licensed professional counselors, a registered dietetic technician, and other staff members who have been trained to perform specific duties under appropriate supervision. Licensed clinicians are available on-site or on-call 24 hours per day. Staff physicians are on-site at regular times each week and on-call at other times. River Centre Clinic’s staff-to-patient ratio far exceeds requirements at all times.

Partial Hospitalization Program Overview

Program Hours

5 days per week —Monday through Friday
7 hours per day —11:30 a.m. to 6:30 p.m.

Typical Daily Schedule

11:30 a.m.: Weigh-in and lunch preparation
12:00 p.m.: Supervised meal
1:00 p.m.: Group (either psycho-educational or psychotherapy)
2:30 p.m.: Break
2:45 p.m.: Supervised snack
3:15 p.m.: Group (either psycho-educational or psychotherapy)
5:00 p.m.: Dinner preparation and supervised meal
6:00 p.m.: Post-dinner wrap-up group and activities
6:30 p.m.: Program ends (Participants move to independent living areas)

Summary of Program Components

  • Psychological assessment and medical evaluation.
  • Education about biological and metabolic changes that occur with eating disorders.
  • Individual counseling to identify the emotional, psychological, and interpersonal factors that led to the development and maintenance of the eating disorder.
  • Individualized treatment planning designed to identify treatment goals.
  • Group counseling by specially trained staff members who understand eating disorders.
  • Nutritional counseling to provide education about healthy eating and nutritional myths.
  • Structured eating (two meals and one snack daily) to facilitate the development of healthy, nutritious, and appropriate eating patterns.
  • Monitoring of diet, weight, and medical status.
  • Support from other program participants who also have eating disorders.
  • Support and information for relatives of program participants.

Initial Assessment

Before admission to PHP, River Centre Clinic conducts a comprehensive clinical assessment to gather information regarding the patient’s current symptom picture, history of eating problems, health history, family history, current and prior medications, and various questions about overall emotional and physical health. The clinic also obtains information forms and questionnaires completed by each patient. Patient information from both interviews and questionnaires is essential to ensure that we do not overlook important details of each patient’s current situation or history. Before admission to PHP, patients must receive a medical evaluation to determine their general health status. In most cases, patients receive the medical evaluation from their personal physician.

Individualized Treatment Plan

In the first week after admission to PHP, patients receive an individualized treatment plan tailored to meet their unique needs, based on our ongoing assessment of problems and progress. This plan is developed based on the initial assessment, then applied within the framework of evidence-based treatment principles and protocols, and continually revised as changes occur during treatment. The treatment team works closely with each patient to set realistic treatment goals, and staff members are available to patients to explain the rationale behind various aspects of treatment. While in the program, patients learn how to address the main symptoms of their eating disorder. They also learn how to identify and start resolving the emotional issues that have contributed to the development and maintenance of symptoms. Patients and their families are encouraged to participate in the treatment plan’s development and evolution as changes occur throughout the treatment process.

Nutritional Rehabilitation

PHP treatment includes complete nutritional rehabilitation to help patients achieve and maintain a healthy body weight, and develop appropriate eating patterns that will lead to true control of the eating process. Since food and meal planning are key elements of nutritional rehabilitation, each patient has a food plan tailored to meet individual needs under a dietitian’s or physician’s supervision, and specially trained staff members supervise meal planning and meals. PHP provides two meals and a snack daily, Monday through Friday. Staff members assist each patient in developing a food plan for weekends and other times outside of program hours.

Medical and Medication Services

One aspect of the PHP treatment plan is evaluating and addressing each patient’s ongoing medical needs, and is provided by our staff psychiatrist and consulting physicians. River Centre Clinic’s medication/somatic service provide medical interventions including physical assessment, prescription, or supervision of medication(s). This service is aimed at educating patients who require medication so they may develop an understanding of their medication regimen and other health issues.

Psychological Therapies

The PHP treatment plan involves a mix of individual, group, and family therapy. The plan also encourages family visitation that is prearranged with clinical staff members.

Individual Therapy:  Each PHP participant is assigned to one or two staff members for individual therapy meetings. One of the aims of individual therapy is to help these patients overcome some of the fears and inhibitions they might experience in a group setting.

Group Therapy:  The PHP treatment plan places strong emphasis on group therapy because it provides an opportunity for patients to learn by interacting with other people who suffer from eating disorders. The group therapy format also plays a valuable role in recovery by providing hope, reassurance, and understanding. Nevertheless, our approach is very flexible. We recognize that some people take longer than others to feel comfortable in groups. We encourage patients to express any concerns that they have about our treatment format so that our staff members can explain the rationale behind various aspects of treatment.

Family Therapy:  River Centre Clinic encourages each PHP participant’s family to be involved as part of treatment. We can schedule family meetings or therapy sessions regularly or periodically, according to the patient’s individual treatment plan. Each patient’s individual treatment plan may change over the course of treatment.

Discharge Planning and Aftercare

Discharge planning is an ongoing process that begins upon admission to PHP. The PHP treatment team works closely with each patient to set realistic treatment goals and develop an aftercare (continuing care) plan for applying the behavioral management, communication, and problem solving skills that have been effective in treatment. Aftercare involves a range of options, including weekly aftercare groups, relapse prevention therapy, or phone follow-up to provide safeguards against relapse. River Centre Clinic also assists patients and their families who need referrals for additional treatment or support in their home communities.