What if I need more than once a week? Let’s talk levels of care

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One of the things I mentioned briefly in the Therapy 101 series was if more than one session a week is needed. That deserves a bit more description and attention.

When we think about counseling, there’s one of two things most people seem to consider: either a weekly appointment or going every single day (like you’re laying on a couch and free associating). Those are pieces of what could be possible. Part of it is based on something called levels of care.

Levels of care are just that – different levels of support or care of treatment that you can receive. In today’s post, we’ll talk about most restrictive to least (by restrictive, I mean how much support you’re getting, usually determined by number of hours you’re receiving care of different kinds). Depending on what’s going on, someone can move up in levels of care (more support) or down (less support).

These levels of care are determined by what you’re experiencing, what levels of care you’ve already done, and circumstances. What’s below is general information; check with your counselor or health care professional for more information. (I can’t answer questions about someone I don’t know, as an FYI.)

Hospitalization/inpatient – This level of care of often through hospitals and is a 24/7 level of care, usually including medical and therapeutic. This level of care requires someone to stay in the treatment location for a period of time (this varies based on need). This is a good option if someone is in imminent danger for harming themselves (or someone else), because there is always someone around (medical personnel, therapeutic). In this level of care, there are often group and individual treatment opportunities.

Residential – This level of care is supported living and can mean that there is staff available 24/7 all the way down to multiple visits by support staff multiple times per week. It depends on the location, services, needs of the client. The person lives in a residence owned by an agency/company from whom they are receiving services. (This may vary by provider.)

Partial Hospitalization Program (PHP) – PHP programs are often a step-down from hospitalization or inpatient services. This means that they’re a good option after a 24/7 option because they are often 6-8 hours a day, up to five or six days a week. They provide a lot of support but not living at the program. There’s a combination of group and individual work in PHP.

Intensive Outpatient (IOP) – IOP is another good step down option after inpatient or PHP (some programs have IOP meet during parts of the PHP, if the location has both services). IOP is generally about 3 hours a day, generally between 9 and 12 hours a week. Again, you aren’t living on site, but you still have a lot of support. There is a combination of individual and group treatment.

Outpatient – This is the level of care I provide here at An Intentional Pause. Outpatient is traditionally one hour a week; sometimes, if needed for a short time, a therapist and client may choose to work with one another for longer sessions or multiple times a week, no more than 9 hours a week (at that point, someone would be referred to IOP). There are times I’ve worked with people I’ve recommended both group work (usually an hour to 90 minutes a week) and one individual session (one hour). It definitely depended on what was going on, needed support, as well as other factors discussed with my client.

Brief note: Groups are often scary to think about as a client. I used to run a number of groups at previous agencies I worked for, and I was always amazed at how people learned from one another and grew as individuals in group work.

Aftercare – Some clients aren’t quite ready to stop counseling; many places and therapists have the option for aftercare, which are check-ins at a pre-determined length of time between sessions. That length of time is dependent on policies for the provider, insurance requirements, etc. It would be something to discuss with the provider, as there may be additional (non-therapy) supports to build into your after care plan!

What questions do you have about levels of care?

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