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There Are Levels to This

When you hear the terms "Mental Health" or "Therapy" what do you think? These terms often evoke pictures in the mind of asylums, hospitals, and straight jackets. But all behavioral health options are not quite that intense. There are levels to this. Let's chat about Levels of Care.

Someone mentions the word "counseling" and you're already afraid of being locked away in a psychiatric facility. That way of thinking is what we call catastrophizing. There are a few other levels before inpatient hospitalization.

Level 1- Community Resources and Self Help

Peer Support Group

The first level of care is the DIY version of emotional wellness. Community resources and self help resources can serve as an entry point on the journey to a better you. Many local church, community centers, and non-profit organizations offer support groups and education. Self help, inspirational/ motivational, and spiritual books and study guides can also help to gain insight into mental and emotional unrest. If you've tried to navigate through this level and feel as though you need a little more, you may be ready for the next step.


Level 2 - Individual Therapy/ Counseling and Support Groups



Counseling one on one with your therapist.

Individual Therapy occurs at the outpatient level of care. You may attend therapy in a setting such as an independent office, at an agency, or group practice. Typically, individual therapy occurs on a one to one basis, with just you and your therapist for 45 - 90 minuets, once per week. You will work collaboratively with that therapist to decide upon a treatment plan with specific goals and interventions toward which you will work.


Your therapy may be supplemented with process or support groups at this level. These groups typically meet once per week and are composed of people with similar demographics and presenting concerns. Process groups and support groups allow for exploration of personal issues in a supportive environment, with other individuals who share similar experiences. They can be very beneficial, offering differing perspectives and peer learning, while reducing feelings of isolation and loneliness. It is of note that maintenance groups such as Alcoholics Anonymous (and other variations) or Al-Anon groups would also fall into this category.


Level 3 - Intensive Outpatient Program (IOP)


Intensive Outpatient Programs are a step up in care. If you have begun to struggle to complete activities of daily living (ADL's) and notice impaired functioning in your household, at work or school, and/or socially at a moderate to severe level, IOP may be the appropriate level of care. At this level of care, people most often are experiencing depression, anxiety, struggles with substance use or other harmful behaviors. This level of care uses group therapy in the form of process and psycho-education groups for up to 3 hours per day, for three to five days per week. Individuals at this level of care live at home and are able to function independently, without the need for medical oversight or restriction. Many programs also offer medication management with psychiatric medical professionals as needed.



IOP or PHP group therapy

Level 4 - Partial Hospitalization (PHP)

Partial hospitalization is exactly as the name states, a step down from hospitalization or inpatient care. If after attending IOP, your symptoms continue to persist, to increase in frequency or duration, or you have an emergence of new symptoms, you may need a higher level of care. PHP is very similar to IOP but increases in duration in a treatment day (from 3 hours to 5-8) and frequency of treatment (from 3-5 days to 5-7 days). Participants are still able to live at home and are able to proceed with life, otherwise, as normal. Other treatment modalities are often included in this more intense modality, such as holistic treatment (yoga, nutrition services, exercise, physical activity), art therapies, animal assisted therapies, etc. For many, having a time set aside to focus on self and wellness, away from the stressors of work and home life can add a much needed layer of insulation in which they are able to improve.


Level 5- Inpatient Hospitalization and Residential Treatment

We have finally arrived at the inpatient level of hospitalization. This level is the preferred level of care when a need for stabilization or safety concerns have arisen and the individual needs around the clock care. Thoughts of active suicide or homicide, and /or experiencing intrusive thoughts or sensations that do not come from you, are reasons to seek treatment at this level of care. The aim for treatment in this setting is to assist you with achieving a balanced and manageable mood and ways of thinking and behaving and to eliminate any threat to self and others by means of medical and therapeutic interventions.


Residential treatment typically lasts 21+ days and is one of the top of levels of care. Individuals in this level of care are living in quarters on the property of the facility for the duration of their stay. Participants will engage in many treatment modalities, many of those previously listed in lower levels of care, in addition to groups and activities that have a more long term process focus moving toward a goal that builds over the duration of the treatment stay. Most often, residential treatment is associated with substance use related struggles, but persistent behavioral health concerns are also treated at this level of care.

Hospital Floor

If you're not sure where to start, a local counselor can help you to determine what level of care you need. Click the couch below to schedule your first appointment with me today and we can discuss your options and find the solution that best fits your needs today!



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