When Therapy Isn’t Enough
Whitney is a Licensed Professional Counselor in Colorado, specializing in working with women with Borderline Personality Disorder, Bipolar Disorder, and women navigating matrescense, infertility, pregnancy loss, pregnancy, and the postpartum journey. Whitney is the founder of The Rylie Center for Hope and Healing.
In the face of a global pandemic, many individuals realized that their mental health was shaken and needed to become a priority. According to the Centers for Disease Control and Prevention, 20.3% of adults over the age of 18 sought counseling, and 16.5% of adults over the age of 18 took medication for their mental health in 2020. Since the COVID-era, 30% of adults continue to see a therapist for their mental health on a regular basis. In 2021, 42 million Americans received some form of treatment for their mental health. When we examine these numbers, most of these numbers are reflective of outpatient, individual therapy provided in a community mental health center or private practice setting that provides an outpatient level of care.
This is a setting that provides weekly, bi-weekly, or monthly individual therapy that’s typically 45 to 55 minutes long. This level of care is sufficient for those wanting to work on many issues, such as increases in feelings of depression, anxiety, daily stressors, postpartum issues, stress in the workplace or at home, relational issues, childhood trauma, adjustment issues, and many other issues that may present in one’s life. This was a tool that many were able to utilize virtually during the COVID pandemic and are still able to access virtually that opened many doors that many had never utilized, especially those living in rural communities and those with hectic work schedules. However, in the face of a crisis or tragedy that increases one’s perception of chaos, loss, panic, or even existential loss, an outpatient level of care that is utilized once a week or even bi-weekly is not always sufficient for helping to cope or mitigate symptoms. For many folks, weekly therapy in an outpatient setting is not enough as they navigate the depths of their mental health struggles and a higher level of care can be necessary and immensely helpful.
There are multiple options when it comes to navigating mental health to a higher level of care: there is an intensive outpatient or IOP, this option can be completed virtually at home, in an outpatient clinic, or at a hospital. This type of care typically requires you to participate in individual therapy as well as group, skills-based therapy. An IOP is typically 3-9 weeks and requires a 3-4 hours commitment a few days per week. A PHP or partial-hospitalization program is more intensive than an IOP program. This type of program is typically completed at an outpatient clinic or at a hospital. A PHP requires daily meetings for 4 for 6 weeks and as a participant, typically will have individual therapy and skills-based group therapy. Most PHP programs offer medication management as well. The daily time commitment is typically around 6 hours. Most PHPs are in-person and participants return home at the end of each day.
What are some reasons that someone might enter into a higher level of care? Once a week therapy or support may not be enough support for their mental health needs at the time. Their current struggles with depression, anxiety, OCD, trauma, mood dysregulation, or substance use may be too acute or better managed in a more intensive setting. They may be experiencing persistent, intense intrusive thoughts, they may be experiencing persistent suicidal ideation, they may be experiencing limited ability to complete activities of daily living like work, hygiene routines, or daily household tasks. They may be experiencing daily distress and moderate or severe symptoms of their mental illness that impair their ability to function or live independently or successfully.
There are many types of IOP and PHP specializing in different clinical needs, varying from trauma, substance use, Dialectical Behavioral Therapy, depression, and anxiety to perinatal mental health and more, as well as a program geared to serve adults, teens, and even children. Most IOP and PHP programs will utilize “evidence-based practices” as their modality of treatment exclusively or in conjunction with other modalities. This simply means that their modalities of therapy have been widely studied and applied in varied settings and studies and have been clinically proven as effective over multiple scientific and peer-reviewed studies; it has been proven with research multiple times to improve symptoms.
Having a conversation with your care team about your mental health needs is the best way to explore your options for entry into a higher level of care and course of treatment. Every program has its own admission process, and some will require a referral from your current treatment providers.
*If you or someone you know are experiencing a mental health crisis, reach out to the national mental health crisis hotline by calling or texting 9-8-8. You can also find additional resources by visiting NAMI.org, mentalhealthfirstaid.org, going to your nearest crisis center, or by visiting 988lifeline.org. If you are experiencing a mental health emergency, go to your nearest emergency room.
Read more from Whitney Frost
Whitney Frost, Mental Health Therapist and Clinical Director
Whitney is a mom, wife, therapist, business owner, author, mental health advocate, and champion for policy change for all women and moms in the US, and serial entrepreneur. Whitney is an advocate for women navigating motherhood by creating equitable, quality mental and physical health care for all women and those identifying as women. Whitney is the founder of The Rylie Center for Hope and Healing, Colorado's largest perinatal collective.
