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Guidance and Resources for Connecting Clients to Higher Levels of Care
When a client needs more support than weekly outpatient therapy can offer, the next question is rarely just “inpatient or not.” There’s a full continuum of care in between, and programs differ in whether they treat psychiatric conditions, substance use disorders, or both. This guide walks through that continuum and explains how to use the regional directories on this site to find an appropriate referral across Texas.
Inpatient Treatment
– Structure: 24-hour medically supervised hospital-based care, usually short-term (days to about two weeks).
– Setting: Locked or supervised hospital unit, sometimes including medical detox.
– Best fit: Acute safety risk (suicidality, homicidality, severe psychiatric decompensation) or medically complex withdrawal requiring stabilization before stepping down to a lower level of care.
Residential Treatment
– Structure: 24-hour supervised care in a non-hospital setting. Length of stay commonly ranges from 30 to 90+ days depending on the program and payer.
– Setting: Client lives on-site full time in a structured, substance-free therapeutic environment.
– Best fit: Needs a fully structured environment to stabilize — often after an inpatient stay, or when the home environment isn’t safe or supportive enough to sustain recovery at a lower level of care.
Partial Hospitalization
– Structure: Typically 5–6 hours a day, 5 days a week; often includes psychiatric medication management and daily clinical contact.
– Setting: Client returns home or to supportive/sober housing each evening — not under 24-hour supervision.
– Best fit: Significant symptoms that need daily monitoring, but no imminent safety risk requiring round-the-clock care.
Intensive Outpatient Treatment
– Structure: Typically 9–12 hours per week of group-based programming, often 3 hours a day, 3–5 days a week.
– Setting: Client lives at home and continues work, school, or other daily responsibilities.
– Best fit: Stepping down from PHP, or stepping up from weekly outpatient when symptoms or substance use are escalating but don’t require daily medical oversight.
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