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Assessing the level of support a client needs is essential. When we receive a referral at our practice, our first step is to determine if we can meet that individual's needs. Essentially, we ask, “Is this the right level of care for them?” At Think Happy Live Healthy, we provide individual psychotherapy services and are an outpatient setting. Let’s explore this in more detail.
Outpatient Therapy: Individual therapy is classified as the lowest level of care for mental health services and is considered to be an outpatient service. While reasons for referral vary, it typically consists of clients starting off meeting with a therapist on a weekly basis for 50-60 minutes. Therapists work collaboratively with clients on their goals, helping clients with managing symptoms, and discussing tools and strategies for coping. Clients sometimes are assigned therapeutic “homework” so that they can practice skills learned in sessions. Therapy can take place virtually or in-person, depending on the client’s preference, and can occur through private practice settings, county mental health departments, non-profit organizations, and online therapy platforms. At times, however, whether this occurs during the intake appointment or once therapy sessions have begun, a therapist may learn additional information that could determine that a higher level of care would be needed for a particular client. Listed below are the remaining levels of care that an individual may need, which range from least restrictive to most restrictive.
Intensive Outpatient Program (IOP): An IOP is a structured non-residential program for individuals who need more intensive services than weekly therapy sessions. Support may involve individual, group, and family therapy and occur a few hours a day for multiple days per week. These programs are time limited and often range from 8 to 12 weeks. Individuals attend IOP’s to treat various conditions, such as mental health, substance use, and eating disorders. While a person may start off with this level of treatment they also may enter an IOP after participating in a PHP, which stands for a Partial Hospitalization Program.
Partial Hospitalization Program (PHP): This level of care is still considered to be a non-residential outpatient mental health program, however, it is even more structured and time intensive than an IOP, with individuals often spending the majority of their day in therapy and sessions occurring more frequently during the week. The overall length of treatment is shorter, however, with programs usually lasting a few weeks to a couple months. Individuals attend PHP’s for similar referral concerns as IOP’s, however, symptom severity and having significant difficulty functioning in daily life may lead people to choose a PHP. Individuals may also participate in a PHP after they have been in residential treatment.
Residential Treatment: People who participate in residential treatment are living outside of their home while they are receiving comprehensive services in a community environment. Intensive services are provided, such as regular individual therapy, group therapy, and psychiatric care. Individuals may go directly to a residential treatment facility or begin attending a program after having been hospitalized. The focus of this level is to help people with healing, with stays often occurring between 1-3 months. This level of care is not for crisis management, which occurs at the highest level of care on the continuum: inpatient hospitalization.
Inpatient Hospitalization: This level of care is the most restrictive. Individuals are determined to need hospitalization when they are experiencing a mental health crisis that poses a safety risk to themselves or others. The primary purpose of this level of care is ensuring safety and stabilization, with these individuals being monitored 24 hours a day. Stays are brief, typically ranging from a few days to a month.
These levels of care are all on a continuum and individuals can “step up” or “step down” based on need or they may have to go directly to the highest level of care due to safety concerns. If a client expresses thoughts related to suicide during a therapy session in an outpatient setting, a risk assessment will be conducted during the session to determine client’s level of risk. From that assessment, if it is determined that the client is at imminent risk for suicide, the therapist will recommend that the client goes immediately for a mental health evaluation to ensure safety. This evaluation will take place at a local hospital emergency room (ER) or in the emergency services department at a community health center. After this evaluation is completed, a recommendation may be given for a client to be hospitalized if they pose a safety risk to themselves or others. If the person is not at imminent risk, a safety plan will be established, and the recommendation may be that the individual continues with current outpatient therapy and adheres to their designated safety plan. It also may be determined that a higher level of outpatient treatment is needed and that weekly therapy sessions are not sufficient.
If you or someone you know is experiencing a mental health emergency, please contact Mental Health 24-Hour Emergency Services (703) 573-5679, CrisisLink Suicide Hotline (703) 527-4077 or 1-800-Suicide.
For more information on levels of mental health care, you may wish to check out the following resource from the Anxiety and Depression Association of America. If you have questions about the levels of care, talk with your therapist, who can help share additional guidance. At Think Happy Live Healthy, we also offer consultations if you are unsure what level of service you or your child may require. These consultations are available to those who are current clients and those who are not clients at the practice. If you are interested in making a referral for yourself or your child for individual therapy or to schedule a consultation, please feel free to reach out to us here.
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