Partial Hospitalization and Intensive Outpatient Programs: Patient Guide

The Partial Hospitalization Program and Intensive Outpatient Program at Langley Porter Psychiatric Hospital offer a range of mental health services for patients with moderate to serious behavioral and emotional conditions. This guide includes information to help patients and their loved ones know what to expect and how to navigate our programs from admission to discharge.

We offer services based on provider-determined medical necessity, and care is provided in person only at our Mount Zion location. These are intensive short-term programs designed to be attended consecutively (without missing any sessions).

What to expect on your first day

When starting the Partial Hospitalization Program (PHP), you'll meet with your assigned psychiatrist and clinician for assessment and treatment planning. Your clinician is a master's-level therapist who helps coordinate your care with your treatment goals in mind. Your clinician will be your main point of contact for all questions regarding your treatment. You will meet with your clinician regularly. For the PHP, this generally means once or twice a week. For the Intensive Outpatient Program (IOP), this is generally once a week. On your first day, be prepared to let your psychiatrist and clinician know which medications you take and what you've taken in the past.

The PHP and the IOP are group therapy programs. The majority of your time in these programs will be spent attending group sessions focused on developing skills to manage your symptoms.

Feeling nervous on your first day is normal. Don't hesitate to approach a staff member with concerns or questions. After a couple of days, most participants feel more comfortable and adapt to the routine of their program. Eventually, most participants come to value and enjoy their time in the programs, and we hope this will be your experience, too.

Hours and schedule

Participants attend PHP and IOP sessions Monday through Friday, excluding holidays. The duration of each program is usually two weeks.

The PHP program consists of four therapy-group sessions with a one-hour break for lunch in the UCSF Health cafeteria.

PHP daily schedule (M-F)

• Psychotherapy group: 10 - 10:50 a.m.
• Skills group I: 11 - 11:50 a.m.
• Lunch: 11:50 a.m. - 1 p.m.
• Skills group II: 1 - 1:50 p.m.
• Skills practice and review: 2 - 2:50 p.m.

The IOP program consists of three therapy-group sessions.

9 a.m. IOP Daily Schedule (M, W & Th)

• Psychotherapy group: 9 - 9:50 a.m.
• Skills group I: 10 - 10:50 a.m.
• Skills group II: 11 - 11:50 a.m.

10 a.m. IOP Daily Schedule (M, W & Th)

• Psychotherapy group: 10 - 10:50 a.m.
• Skills group I: 11 - 11:50 a.m.
• Skills group II: 12 - 12:50 p.m.

TAY (Transitional Age Youth, ages 18 – 26) Daily Schedule (M, W & Th)

• Psychotherapy group: 1 - 1:50 p.m.
• Skills group I: 2 - 2:50 p.m.
• Skills group II: 3 - 3:50 p.m.

Optional Friday IOP Schedule

• Psychotherapy group: 10 - 10:50 a.m.
• Skills group I: 11 - 11:50 a.m.
• Lunch break: 11:50 a.m. - 1 p.m.
• Skills group II: 1 - 1:50 p.m.

Psychotherapy and skills groups

Each treatment day consists of three to four therapy groups. Group therapy at Langley Porter Psychiatric Hospital is grounded in mindfulness and acceptance-based therapies, including dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), and acceptance and commitment therapy (ACT). Participants learn techniques to improve their mindfulness (nonjudgmental awareness of thoughts and emotions), interpersonal skills, emotional regulation and distress tolerance, with the goal of enhancing their abilities to cope and manage their symptoms on a daily basis.

Psychotherapy group

The purpose of this group is to help you prepare for the day, so you can approach it with presence of mind and purpose. The psychotherapy group session begins with a mindfulness exercise, a review of the day's schedule and skills focus, and a brief structured check-in.

Following the check-in, there may be time for group discussions around common themes that were raised, focusing on skills to address problems in life.

Skills groups

With the goal of reducing psychiatric symptoms, each group works on teaching participants therapeutic skills, coping strategies and useful concepts.

Areas of focus include:

• Helping you balance your emotions, thoughts and behaviors
• Increasing your ability to be present in the moment
• Expanding your capacity to accept things as they are without judgment
• Improving your abilities to cope with emotional pain and increase positive emotional experiences in your life
• Learning crisis management skills
• Developing or improving relationships and communication skills

Other PHP groups

You may attend other groups in the PHP, including one called "Week in Review," "Weekend Planning" and "Sustaining Change." Talk to your clinician about which sessions support your treatment goals. The last day of each week often features groups devoted to discussing and reviewing the skills covered that week, especially those of particular importance in your treatment. During this group, you'll develop a plan for your activities and safety over the weekend or you'll continue working on ways to sustain what you've learned during treatment.

Expectations for group participation

Program and group ground rules include but are not limited to:

• On-time arrival. The program day and each group start promptly on the hour. Please don't disrupt the experience of other participants by arriving late.
• Mutual respect. To create a safe place for self-reflection and exploration of our relationships, we aim to establish an environment of mutual support and respect. With those goals in mind, we practice the following:
  • Active listening. Pay attention to the person who is speaking, and show you are engaged through good eye contact.
  • Participation. Contribute to the group to the best of your ability. You may decline to speak, but we encourage participation even when you don't want to. By practicing the opposite action skill (choosing to react differently from habitual ways), you may find you feel better.
  • Consent for feedback. If you want to offer feedback to another group member, practice asking for their permission. Avoid offering unsolicited advice.
  • Open body language. Assume postures that indicate you are present and willing to participate.
• Avoiding absences. Whenever possible, schedule personal appointments outside of treatment hours. If you need to arrive late or be absent on any scheduled treatment day, call your clinician or leave a message at the main line, (415) 476-7400, as soon as possible. Given the nature of the program, we may initiate a welfare check for a PHP participant who has a "no-call, no-show."
• No verbal or physical threats or violence. This is grounds for immediate dismissal from the program.
• No acts of theft. This is grounds for immediate dismissal from the program. Langley Porter Psychiatric Hospital is an open building and we cannot be responsible for lost or stolen goods, so keep your personal belongings with you at all times.
• No drugs or alcohol. We encourage you to abstain from drugs and alcohol for the duration of the program. This helps ensure that your assessment, treatment and long-term planning are based on the clearest views of yourself and your situation.
• Technology-free sessions. All mobile electronic devices must be turned off during group sessions. Groups should be as free from distractions as possible. Taking pictures of the treatment area or other program participants is prohibited.
• Confidentiality. Protecting the privacy of other participants is a crucial part of creating a safe therapeutic environment. This includes:
  • Group confidentiality. Anything said between two or more group members at any time should not be shared with anyone else. What is said in the group stays in the group. At no time should you use group members' names outside of treatment areas or disclose their personal or identifying information.
  • No posting pictures on social media. Sharing photos of the treatment area or other program participants on social media is prohibited.
• Respect relationship boundaries. We encourage expressing and accepting support during group sessions, but we recommend that participants refrain from developing relationships outside of the groups before completing the program. This maintains a safe boundary between you and your peers, creating a space where everyone can focus on their own goals and needs. Furthermore, we strongly advise against developing romantic or financial relationships during the program, as they can interfere with treatment.
• Respect group discussion boundaries. Sharing in group sessions is important, but some topics and details are better suited for one-on-one discussions with your clinician. Topics involving safety (such as self-harm), trauma, or alcohol and drug use are best shared in these private meetings. In the PHP groups, you will be prompted to communicate your safety status each day without providing details. If you have questions about what is acceptable to share in groups, talk with your clinician.
• No fragrances. Some people are sensitive to scent, and the group rooms are closed environments where strong smells don't easily dissipate. For the comfort of other participants, refrain from using perfume or cologne.
• No eating during groups. To avoid distracting others, don't bring food to sessions. Beverages are allowed. If you have an urgent need to eat, use the planned breaks, such as the time between sessions or lunch. You may excuse yourself from the room to take medications.
• Take medications appropriately. Please don't take any medications (whether prescribed or over-the-counter) during group sessions, as the sight may distress other group members. If you need medication during the course of the treatment day, try to take it during planned breaks, such as the time between sessions or at lunch. If necessary, you may briefly excuse yourself from the room.

Punctuality and attendance

The PHP and the IOP are intensive short-term programs designed to be attended consecutively, without absences. To maximize the benefits of treatment, avoid arriving late and try not to miss any groups or program days.

We monitor absences. If you are late or absent, we will work with you to identify barriers to your attendance and evaluate whether you can commit to the program. We understand that unavoidable issues sometimes occur.

If you miss more than three groups or program days, you may be discharged from the program.

What to expect at discharge

While the PHP and the IOP help participants cultivate the capacity and skills to remain safe in a less structured environment, mental health recovery takes longer than a few weeks. Having a plan for your mental health care after the program is an important part of continuing your recovery.

Your clinician will help you develop an aftercare plan. A typical aftercare plan includes seeing a psychiatrist and therapist on a regular basis. If you need to find a new mental health provider, expect that it may be a few weeks before your first appointment. We can provide resources and information on providers, clinics, group therapy and support groups in your community.

Shortly before or on the day of discharge, your clinician will review your treatment progress with you. You will also be asked to complete symptom questionnaires and a perception-of-care survey. This information helps us learn how to improve our programs. We take participants' input seriously and read all submitted comments. Thanks in advance for helping us to better meet our patients' needs.