Partial Hospitalization Programs for Bulimia

When dealing with eating disorders like bulimia nervosa (BN), there are several levels of care designed to address the different needs of people at different points in recovery. From most to least intensive, these levels of care include:

• Inpatient hospitalization
• Residential treatment
• Partial hospitalization programs
• Intensive outpatient programs (IOPs)
• Standard outpatient care

Among those levels, a partial hospitalization program (PHP) is almost a middle-ground, giving you support and care most days of the week while allowing you to still live at home.

The goal of this type of eating disorder treatment program is to help you learn to better control your disordered thoughts and behaviors to the point where you can begin taking on more personal responsibilities while continuing to pursue recovery.

What is Partial Hospitalization?

Partial hospitalization programs are a type of care designed for eating disorder recovery. While PHPs are about halfway down the ladder of care, they remain an intensive care option.

During partial hospitalization, you as a patient are expected to show up for treatments anywhere from 5-6 days per week. These programs are also typically lengthy, as you attend treatment for 6-7 hours a day or sometimes more.¹

Many facilities also offer you food or snacks to take home.

Still, PHP eating disorder treatment is generally more flexible than residential programs. As time goes on and you continue to work towards recovery, schedules and types of treatment may be adjusted to better reflect your progress.

What to Expect at a PHP

After an initial intake process to check your physical and mental health and ensure you’re a good fit for a partial hospitalization program, your treatment team will develop a regimented treatment process. This will include your daily, personalized therapy schedule, group meetings, and other forms of care.

It’s important not to miss scheduled appointments, as this can affect your insurance coverage and potentially result in getting discharged from the program, depending on the circumstances. Rare absences due to illness or family emergencies are typically fine, but make sure to call ahead to alert the relevant parties that you will be absent.

Different PHP Treatments

While the specifics of a program vary, you will likely be scheduled to talk with a mental health professional and a case manager one-on-one at least once a week or even more frequently. You will also regularly talk to a doctor about any medications you’re taking and continue to receive medication management and nutritional counseling. 

Group therapy sessions are also common. During these meetings, you’ll talk with a group of individuals who are also dealing with mental health issues or, more likely, eating disorders.

Sessions are led by mental health professionals who direct the discussion and keep things on topic. In group therapy, you can learn from other people’s experiences and exchange advice and support as the therapist guides discussions.

Occasionally, PHPs make room for eating disorders treated with other types of care, such as art therapy or exposure therapy. The type and length of treatment involved in a program will depend on your specific needs and care plan, along with what is allowed or provided for by health insurance.

How Long Is Partial Hospitalization Treatment?

When it comes to bulimia nervosa treatment planning, the details depend on your individual needs and the recommendations of your medical team. This includes the length of time you are recommended to stay at a partial hospitalization program.

Often, different types of programs are available for adolescent and adult patients, though both aim to help you practice the skills you’ve learned to deal with eating disorder behaviors. Still, there may be a difference in how long it takes to complete an adult partial hospitalization program compared to PHP treatment designed for adolescents.

Depending on these specifics, you may remain in partial hospitalization programs anywhere from several weeks to several months.

Partial Hospitalization vs. Outpatient Treatment

As you live at home throughout partial hospitalization treatment, PHPs can technically be considered a form of outpatient eating disorder treatment, albeit a heavily structured version of care. However, partial hospitalization programs for bulimia nervosa are much more intensive than typical outpatient treatment.

During outpatient care, you generally keep a regular appointment with a therapist, psychiatrist, and/or physician to stay recovery-focused, continue checking in on the effects of any medications you may be taking, and stay wary of potential triggers. At this point in recovery, you should have your disordered eating behaviors and thoughts under control and should be able to maintain regular social and familial responsibilities in your recovery.

An intensive outpatient program is a step up from this level of care. At this point, you attend treatment several days a week (typically between 2-4 days), and these sessions may be longer than typical therapy appointments. At this level of care, you may also supplement treatment with support group meetings or family therapy.

Still, partial hospitalization programs remain a more intensive form of care than IOPs. Treatment sessions generally occur more often and are far longer than intensive outpatient meetings. Many patients who progress throughout their PHP will “step down” to an IOP.

Virtual Partial Hospitalization Programs

If you aren’t able to attend partial hospitalization treatment in person, you may be able to partake in these programs virtually.

Studies on virtual or online eating disorder treatment are ongoing, as the technique is relatively new, but what analyses have been done have found that the quality of care offered through virtual eating disorder treatment is comparable to in-person treatment in many cases.²

Virtual care also has a number of more obvious advantages. You meet with your care team via online platforms like websites or apps or may even text or talk on the phone with them. That this can be done from anywhere means many more people can participate in treatment programs, including those in underserved areas or those with challenges around transportation or mobility.

Virtual meetings allow you to talk to a mental health professional from the comfort of your home or even talk with professionals who may not live in your area, increasing the odds of a favorable treatment response. Schedules are generally more flexible than in-person appointments, and virtual programs are also typically more affordable than in-person care, making them more accessible to many patients.

Who is a Partial Hospitalization Program Best For?

Partial hospitalization programs are helpful for anyone who is earnestly pursuing eating disorder recovery, but they’re especially helpful for some patients.

The level of care is a typical “step down” for those who have had favorable treatment outcomes in a residential program and are ready to take on more personal responsibility. They can also be a good option for those who need more intensive care and regimented guidance than is available through a standard outpatient program.

Sometimes, patients eligible for residential care instead attend a PHP, especially if there are concerns about leaving home or financial considerations. Those who are in an IOP or even in outpatient settings may return to a PHP if they experience a relapse in symptoms such as binge eating or purging.

Finding Help for Bulimia Nervosa

If you or a loved one are struggling with bulimia nervosa or other eating disorders, it’s important to seek help.

Speaking with a doctor or mental health therapist is a great first step on the road to recovery, as these professionals can offer advice on which types of programs may work best for you.

Whichever level of care works best for you, the key is to stay focused on your recovery and engaged in treatment. This helps you not just learn but truly internalize the new skills and coping mechanisms intended to help you overcome your disordered eating behaviors and guard against relapse.

Therapy benefits virtually every area of life, promoting overall well-being. But it can still be a scary or difficult first step to make. The most important thing to remember is that it’s a step that’s always available and that help is always out there if you seek it.