What to Expect in Your First Week of PHP or IOP

Starting a Partial Hospitalization Program (PHP) or an Intensive Outpatient Program (IOP) can feel like a big step. Many people arrive with the same questions:

• What will my first day look like?
  
• How many hours will I be there?
  
• Will I be pushed too hard, or not enough?
  
  

In the wider treatment system, PHP and IOP are classified as ASAM Level 2 services. Partial hospitalization (Level 2.5) usually means 20 or more hours of treatment per week, while intensive outpatient (Level 2.1) usually means 9 to 19 hours per week of structured programming.

If you want a deeper overview of these levels of care before or after reading this article, you can explore:

• Understanding Partial Hospitalization Programs (PHPs)
• Intensive Outpatient Program (IOP): What Is It, Programs, and More
  
  

PHP vs IOP: What Your Week Will Generally Look Like

Before talking about day one, it helps to know roughly how much time you will spend in treatment.

Based on ASAM and payer guidelines, along with state and Medicare policies:

• Partial Hospitalization Program (PHP)
  
  • Often 4 to 5 days per week
    
  • About 20 hours or more per week of structured treatment
    
  • Sometimes described as a “day program” that bridges inpatient and outpatient care
    
    
• Intensive Outpatient Program (IOP)
  
  • Often 3 to 5 days per week
    
  • Usually 9 to 19 hours per week of group and individual services
    
  • Sessions may be mornings, afternoons, or evenings, depending on the program
    
    

Both levels typically include:

• Group therapy
  
• Individual counseling
  
• Education on addiction, mental health, and relapse prevention
  
• Medication management where appropriate
  
• Ongoing assessment and treatment planning
  

Research on intensive outpatient care for substance use disorders shows that IOPs can be as effective as inpatient treatment for many people, especially when they include evidence-based therapies and sufficient weekly hours.

You can also connect with the intake team at Mainspring Recovery, they can help you decide which level of care is safest to start with, using a structured criteria 

Day One in PHP or IOP: Orientation and Assessment

The first day is usually the longest emotionally, because everything is new. Most programs focus on two big pieces:

1. Getting to know you in detail
   
2. Helping you understand the structure and expectations
   
   

Check-In and Paperwork

You can expect:

• Sign-in and basic registration forms
  
• Review of consent forms, privacy policies (HIPAA), and program rules
  
• Explanation of attendance expectations, drug/alcohol policies, and what happens if you miss sessions
  
  

Staff should tell you who to talk to if:

• You feel unwell
  
• You need to step out
  
• You are struggling with cravings or distress during the day
  
  

Medical and Psychiatric Evaluation

Evidence-based PHP and IOP standards emphasize a thorough assessment at the start so treatment is not “one size fits all.”

On day one, you will likely have:

• A medical review (history, current medications, allergies, past hospitalizations)
  
• Screening for withdrawal risk, chronic conditions, or urgent medical problems
  
• A psychiatric evaluation to assess mood, anxiety, trauma history, psychosis, and suicidality
  
• Standardized screening tools or questionnaires about symptoms and substance use
  
  

This is also where medication plans are discussed, including options like medication-assisted treatment (MAT) for opioid or alcohol use disorders, where appropriate and supported by guidelines.

Psychosocial and Substance Use History

You will usually meet with a therapist, counselor, or social worker to talk about:

• Your substance use history (what you use, how often, previous attempts to cut down)
  
• Impact on work, school, relationships, housing, legal issues
  
• Mental health history (depression, anxiety, trauma, self-harm, hospitalizations)
  
• Support system (family, friends, recovery communities, safe people)
  
  

This information feeds into an individualized treatment plan, which is a requirement in most PHP and IOP standards.

Safety and Crisis Planning

On day one, staff will also ask:

• Whether you have current thoughts of self-harm or suicide
  
• Whether there is violence, abuse, or unsafe situations at home
  
• What your high-risk times and triggers tend to be
  
  

If at any point your answers suggest you are not safe in this level of care, the clinical team may recommend a higher level (such as residential or inpatient) instead of PHP/IOP. That re-assessment is part of good practice.

The Rest of Your First Week in a PHP

Once assessments are done, the rest of your first week in PHP usually settles into a repeatable daily structure.

A Typical PHP Day in Week One

Many PHPs for addiction and co-occurring disorders follow a pattern similar to this:

• Morning
  
  • Check-in group (how you are feeling, cravings, safety check)
    
  • Educational or skills group (for example, understanding addiction as a chronic disease, grounding techniques, or relapse warning signs)
    
    
• Midday
  
  • Skills-focused therapy group (CBT skills, emotion regulation, communication skills)
    
  • Breaks and lunch
    
    
• Afternoon
  
  • Process group (talking through current stress, recent use, triggers)
    
  • Individual session or case management as needed
    
  • Brief wrap-up, goal setting for the evening, and safety check

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What You Will Probably Notice in Week One

Common experiences during the first week of PHP:

• Feeling tired from focusing intensely on your recovery for several hours a day
  
• Realizing you are not alone when you hear others with similar stories
  
• Some emotional ups and downs as you talk about topics you may have avoided for a long time
  
• Relief at having a predictable daily structure
  
  

It is very common to worry, “Am I doing this right?” Your team’s job in week one is to help you settle in, understand the routine, and feel safe asking questions.

The Rest of Your First Week in an IOP

An Intensive Outpatient Program has many of the same components, but with fewer hours per week and more flexibility.

A Typical IOP Week

• Time commitment
  
  • Usually 3 to 5 days per week
    
  • Each session often 3 hours or so, totaling 9 to 19 hours per week
    
    
• Common structure
  
  • Group therapy as the core
    
  • Individual sessions at set intervals
    
  • Psychoeducation about addiction, mental health, coping skills, and relapse prevention
    
  • Medication management visits as needed
    
    

Some programs offer evening IOP, which is designed for people who work or attend school during the day.

How Week One in IOP Often Feels

In the first week of IOP, you are usually:

• Learning how to fit treatment into your existing schedule, rather than pausing everything
  
• Balancing family or work responsibilities with session times
  
• Starting to identify triggers in real time and bringing those experiences back to group
  
  

Because IOP participants spend more hours outside the program, there is often a strong focus in week one on:

• Planning sober evenings and weekends
  
• Building or reconnecting with support networks (family, friends, mutual help groups)
  
• Practicing skills between sessions and reporting back on what worked
  
  

High-quality IOPs encourage you to be honest if the current level of structure is not enough. Sometimes, your first week reveals that you need PHP or residential care first, and that adjustment is part of good clinical care, not a failure.

Program Rules You’ll Hear About Early

Common expectations in the first week:

• Substance-free attendance, often with random or scheduled drug/alcohol testing
  
• Confidentiality agreements, including what you may and may not share outside group
  
• Respectful communication guidelines in group settings
  
• Policies about phones, lateness, and absences
  
  

These are not just “rules.” They exist to protect safety, privacy, and group trust, especially during early, vulnerable weeks.

Getting the Most Out of Your First Week

A few practical tips to make that first week count:

• Show up, even if you feel unsure. Early consistency matters more than saying the perfect thing in a group.
  
• Be as honest as you can about use, cravings, and safety. Treatment plans only work if they match reality.
  
• Ask questions about medications, schedule, or rules. Clarity reduces anxiety.
  
• Bring a notebook to jot down skills, phrases, or insights you want to remember.
  
• Plan for rest. PHP and IOP can be emotionally tiring. Try to keep evenings simple in week one.
  
  

Over time, many people find that what felt intimidating on day one starts to feel like a predictable, supportive routine.

Final Thoughts

Your first week in a Partial Hospitalization Program or Intensive Outpatient Program is about getting oriented, being assessed properly, and starting to build trust with your treatment team and peers.

If you are unsure whether PHP, IOP, or another level of care is right for you, talking directly with a treatment team can help you take that next step with more confidence.

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Disclaimer: This article is for general information only and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. Always talk with a qualified clinician about your specific symptoms, safety concerns, and treatment options.