PHP for Individuals with Co-occurring Substance Use and Mental Health Disorders

In this article, we discuss the use of PHP for dual diagnosis. This program caters to the unique needs of those with co-occurring disorders.

What is Dual Diagnosis?

Dual diagnosis, also known as co-occurring disorders, refers to the presence of both a substance use disorder (SUD) and a mental health disorder in an individual.

In some cases, mental illness can drive individuals to use substances as a form of self-medication. Conversely, prolonged substance use can exacerbate or trigger mental health challenges. Chronic drug or alcohol misuse may lead to the development of anxiety, depression, or even psychosis.

This cycle can make recovery challenging but not impossible. A partial hospitalization program (PHP) for dual diagnosis integrates various therapeutic approaches to break this cycle.

PHP for Dual Diagnosis

What is a PHP for Dual Diagnosis?

A PHP for dual diagnosis is a structured and intensive level of care that falls between inpatient hospitalization and traditional outpatient therapy. This allows individuals to receive treatment while still living at home, enabling them to maintain daily responsibilities.

A PHP for dual diagnosis is a specialized program that addresses both substance use and mental health disorders concurrently. It typically involves daily treatment sessions that can range from 4-6 hours, 5 days a week.

What Are the Benefits of PHP for Dual Diagnosis?

PHP for dual diagnosis offers several advantages that make it effective for treating dual diagnosis:

Seamless Transition Between Levels of Care

The gradual transition from inpatient to outpatient care offered by PHP for dual diagnosis allows individuals to ease back into normal routines at their own pace. This approach reduces the risk of relapse and helps adapt to life after treatment.1

Enhanced Accessibility

A PHP for dual diagnosis is more accessible to a wider range of individuals. It primarily benefits those who might not require or cannot afford full-time inpatient care. This increased accessibility ensures that more individuals with dual diagnoses can receive specialized care.

Real-World Skill Application

Participants in PHP for dual diagnosis can immediately apply the coping strategies and skills they learn in therapy to their daily lives. This real-time application can reinforce learning and enhance the effectiveness of therapy.

Continuity of Care

These programs often provide continuity of care with the same treatment team involved throughout different phases of treatment. This consistency can promote a sense of trust and safety for individuals with dual diagnosis who often struggle with feelings of abandonment or rejection.

Reduced Stigma

Any form of mental illness can be stigmatizing. PHP for dual diagnosis reduces the stigma by providing a less sterile treatment environment that feels closer to everyday life, compared to inpatient treatment.

Flexible Scheduling

A PHP typically offers more flexible scheduling compared to inpatient programs. This flexibility can be particularly beneficial for anyone who has work, school, or family obligations. It allows them to receive treatment while maintaining their other commitments.

Customization of Treatment Intensity

The dynamic approach of PHP for dual diagnosis adjusts the intensity of treatment based on individual progress and needs. This ensures that individuals receive the right level of support at different stages of their recovery journey.

Community Integration

Returning to the community after treatment can be challenging. PHP for dual diagnosis has a strong focus on community integration through various activities and interventions. This helps individuals feel more comfortable and confident in social settings.

Assessment and Eligibility for PHP

Before entering a PHP for dual diagnosis, clients are assessed to determine the severity and extent of their substance use and mental health disorders.

This assessment may include:

  • A thorough physical examination
  • Psychological evaluation and diagnostic interviews
  • Substance use history and patterns of use
  • Mental health symptoms and history

When Might an Individual be Referred to a PHP?

Based on the results of this assessment, an individual may be referred to a PHP if:

  • They have a dual diagnosis or co-occurring disorders of substance use and mental health issues
  • Their condition is severe enough to require intensive treatment but can still be managed in a community setting
  • They have adequate support and structure at home to attend daily treatment sessions
  • They are medically stable and do not require 24-hour medical supervision

The Role of Comprehensive Assessment in Treatment Planning

The comprehensive assessment serves as the foundation for your individualized treatment plan in the PHP for dual diagnosis.

This process involves:

Identifying Specific Needs

Identifying specific needs is about understanding the unique combination of substance use and mental health issues you are facing.

The assessment aims to uncover:

  • Specific mental health conditions present and their severity.
  • How each condition affects the other.
  • Any underlying factors contributing to both conditions, such as trauma or chronic stress.

Risk Assessment

Risk assessment in a PHP for dual diagnosis involves evaluating the potential risks in the treatment process.

This includes assessing:

  • Relapse Potential: Determining the likelihood of returning to substance use. Factors like the duration and intensity of past substance use, previous attempts at recovery, and current stressors are considered.
  • Risk of Self-Harm or Harm to Others: Assessing any history or current risk of self-harm or aggressive behavior. This is to ensure that the program can provide the appropriate level of monitoring and support.
  • Environmental Risks: Understanding your living situation and social environment to identify any factors that might impede recovery or increase the risk of relapse, such as access to substances or lack of support.

Determining Treatment Goals

Goal setting is an integral part of PHP for dual diagnosis. The comprehensive assessment helps set realistic and achievable goals for your recovery journey. These goals are usually specific, measurable, attainable, relevant, and time-bound (SMART).

They might include:2
  • Short-term goals like attending all therapy sessions for a month or learning specific coping strategies
  • Long-term goals such as maintaining sobriety for a year or achieving stable mental health
  • Personal goals related to improving relationships, returning to work, or pursuing educational opportunities.

Treatment Planning

This plan outlines the specific interventions and activities offered to assist individuals in achieving their treatment goals. It also considers the duration, frequency, and intensity of treatment sessions.

PHP Structure and Therapeutic Components

PHP for dual diagnosis integrates various components to provide comprehensive care. These components include:

Structured Therapy Sessions

These are the backbone of PHP for dual diagnosis. Group therapy, led by trained therapists, offers a safe space to explore issues related to substance use and mental health. These sessions often involve discussions on coping strategies, relapse prevention, and emotional regulation.

Individual Counseling

One-on-one sessions with a therapist provide a more personal approach. These sessions allow individuals to delve deeper into their personal experiences, challenges, and progress. It’s an opportunity for tailored therapy that addresses their unique needs in recovery.

Educational Groups

Knowledge empowers individuals to make informed decisions about their health and recovery. These groups focus on teaching people about the nature of substance use disorders, the impact of mental health conditions, and how they interact.3

Peer Support

Interacting with others who are facing similar challenges can be incredibly supportive. Peer support groups within PHP for dual diagnosis offer a sense of community and understanding. It also provides a platform to share experiences, receive feedback, and build connections.

Integrated Treatment Approach

Traditionally, mental health and substance use were treated separately, often leading to fragmented care and less effective outcomes. PHP for dual diagnosis focuses on addressing both disorders simultaneously.

Integrated care means consistent messaging and strategies across all aspects of treatment. Treating mental health and substance use simultaneously helps develop a better understanding of how they interact.4

The Role of Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) combines medications with counseling and behavioral therapies to treat substance use disorders.

In dual diagnosis treatment, MAT can be particularly beneficial in:

  • Managing Withdrawal Symptoms: Medications can help manage withdrawal symptoms and cravings. This makes it easier for individuals to engage in therapy and other treatment components.
  • Addressing Mental Health Conditions: Certain medications are effective in treating underlying mental health conditions, such as depression or anxiety, which may contribute to substance abuse.
  • Supporting Long-Term Recovery: MAT can be an ongoing part of your recovery plan. This provides continued support even after completing the PHP for dual diagnosis.

Range of Therapies and Support in PHP

Therapy ensures individuals have the tools and skills needed to manage their concerns. Support activities offer ways to stay focused on your recovery and help you develop new habits.

In PHP for dual diagnosis, treatment is based on scientific research and has been proven to be effective in managing co-occurring disorders.

Cognitive Behavioral Therapy (CBT)

CBT is the first-line treatment for many mental health conditions and substance use disorders. It focuses on identifying negative thoughts and behaviors and replacing them with positive ones.

Dialectical Behavioral Therapy (DBT)

DBT is a specialized form of CBT that helps individuals manage intense emotions and improve relationships. It includes skills such as mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Holistic Therapies

Activities like yoga, meditation, and art therapy can help reduce stress and promote relaxation. These holistic therapies also encourage self-reflection and provide a healthy outlet for emotions.

Family Involvement

In a PHP for dual diagnosis, there are opportunities for family members to be involved in treatment and receive support. This can help improve communication, establish healthy boundaries, and repair relationships.

At Continuum Outpatient Center, we believe that a family system approach is best for holistic and sustainable recovery. We believe that supporting not only the individual struggling with dual diagnosis but their loved ones as well leads to the best chances for continued health and healing.

Nutrition and Exercise

A healthy mind and body go hand-in-hand. PHP for dual diagnosis teaches about the importance of proper nutrition and exercise in managing mental health and substance use. Individuals may also have access to a nutritionist or fitness classes as part of their treatment plan.

Developing healthy mind-body habits can enable people to refrain from their unhealthy coping mechanisms, such as substance use. This will help individuals to prevent relapse and continue sobriety.

Daily Structure of a PHP

A typical day in a PHP for dual diagnosis is carefully structured to provide a balance of therapy, education, and personal time. Here’s what a typical day might look like:


The day usually starts by 9:00 a.m. These activities often begin with a group therapy session or a check-in meeting. This is a time to set goals for the day and share any challenges or progress. Each session lasts between 30 and 60 minutes.

Therapeutic Activities

A significant portion of the day is dedicated to engaging in diverse therapeutic activities. These activities are carefully selected based on individual treatment objectives. Immediate mental and physical health requirements are also considered.


Clients have a lunch break before afternoon sessions to recharge and socialize with other participants. This is also an excellent time to process experiences from the morning sessions. After that, individuals continue with more group or individual therapy sessions.

The day usually concludes by 3:00 p.m. with a wrap-up session or a check-in meeting. This is an opportunity to discuss the day’s progress and set intentions for tomorrow.


After treatment concludes, clients have personal time. This is a time to relax, practice self-care, and reflect on the day’s therapy sessions. It’s best to use this time to participate in pleasurable activities, such as journaling, meditation, or exercising.


Generally, sessions occur during the work week, Monday through Friday. Exceptions are sometimes granted if there are any special events or planned outings.

Weekends are usually reserved for participants to spend time with their families and friends or engage in community events. It’s essential to keep a healthy balance between therapy and other aspects of life.

Aftercare and Relapse Prevention Following PHP for Dual Diagnosis

After completing PHP for dual diagnosis, aftercare planning begins. This involves creating a strategy to help further the recovery journey outside of the treatment setting.

The key is to establish a routine that supports your ongoing recovery. This might mean regular check-ins with a mental health professional, participation in community support groups like AA or NA, and activities that promote mental and physical wellness.

Relapse Prevention Methods

Relapse prevention is an ongoing process. Long-term methods for preventing relapse in PHP for dual diagnosis often involve a combination of strategies.

Recognizing Triggers

Aftercare planning involves identifying specific things or situations that might lead to relapse. Individuals learn to notice these triggers early and learn how to handle them better.

Lifestyle Changes

Regular exercise releases feel-good chemicals in your brain. A balanced diet provides the necessary nutrients for your body and brain.

Proper sleep is essential for your brain to process emotions and information. These habits help individuals keep their body and mind in good shape, reducing the chance of falling back into old patterns.

Building a Support Network

Social support plays a significant role in psychological resilience. Engaging with friends, family, therapists, and support groups provides a social buffer against stress. These relationships can offer practical support, advice, and emotional comfort.

Developing Coping Skills

PHP for dual diagnosis equips clients with various coping skills to handle stress, emotional distress, and cravings. Aftercare reinforces these skills, ensuring that individuals feel confident in applying them in real-life scenarios.

Regular Monitoring and Check-ins

Regular check-ins with therapists or counselors help monitor progress and address any emerging issues. These sessions can provide crucial support and guidance, especially during the early stages of aftercare.

PHP for Dual Diagnosis

Choosing Continuum for Dual Diagnosis PHP

Finding quality care for both mental health concerns and substance use disorder can be daunting. If you’re juggling the challenges of both a substance use disorder and a mental health condition, our PHP for dual diagnosis is tailored to each individual’s needs.

What We Offer

Our San Antonio, Texas, PHP offers individually tailored treatment by providing a variety of therapies to address a multitude of concerns. Treatment plans are developed with the participant to determine what approach best suits their needs.

We offer a supportive and compassionate environment where clients can heal physically, emotionally, and mentally.

Our goal is to equip you with the tools and strategies you need to break free from your struggles. No matter where you are in your recovery journey, know that there is hope and help available at Continuum.

Start Your Journey to Wellness Today

Start your journey toward long-term recovery by reaching out to us today. Let us help you achieve lasting wellness and resilience in the face of dual diagnosis challenges.

Questions About Treatment?
Reach out to our knowledgeable and compassionate Continuum Outpatient Center team for the guidance and support you need for sustainable recovery. We’re here to help you build a foundation for long-term happiness, wellness, and healing.