PHP/IOP & Ketamine Therapy: Coordinated Care Without Chaos
“PHPs and IOPs have a different subset of considerations. Ketamine and esketamine both take time — and that can impact a patient’s availability to participate in group-based programming.”
— Dr. Benjamin Yudkoff, Chief Medical Officer and Co-Founder, Lumin Health
Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) hold a vital space between stabilization and community: structured, relational, and rhythm-based. Patients often find consistency there after the chaos of crisis.
But adding ketamine therapy or esketamine (Spravato) to that rhythm requires careful consideration — in partnership with the patient, with the PHP/IOP program administration, and with Lumin Health as the ketamine facilitators. The medication’s timing, monitoring, and post-dose rest period can overlap with group hours or individual sessions. Without planning, that overlap risks fragmenting both treatments.
This article offers a practical roadmap for PHP and IOP teams who want to integrate or coordinate care with local ketamine therapy / esketamine (Spravato) clinics — maintaining therapeutic structure while expanding access to rapid-acting interventions.
Scheduling, Safety, and Outcome Tracking
Dose-day planning around groups
A typical ketamine treatment session lasts about two hours, including observation. That means dose days require protected time. Some people require additional time to recover and rest lasting several hours after the treatment session, itself.
Dr. Yudkoff explains:
“Working with a patient who’s receiving ketamine or esketamine may impact the availability of the patient to participate in the group-based programming available in both PHPs and IOPs — and that’s something to consider.”
A simple fix is anticipatory scheduling:
- Afternoon doses: allow patients to attend groups and therapy sessions, putting ketamine and esketamine treatment sessions later in the day.
- Clinician coordination: confirm with the patient’s psychiatrist or prescribing provider which days are ideal to minimize fatigue and cognitive fog.
For some programs, this coordination mirrors ECT scheduling — but with less physiological disruption and more rapid return to baseline.
Who calls whom for urgent changes
The most essential line in Dr. Yudkoff’s remarks is not about dosing — it’s about communication:
“If a PHP or IOP makes a referral for ketamine or esketamine, the importance of communication with the outpatient provider is paramount. An outpatient provider should never be surprised that a person is receiving or pursuing ketamine or esketamine.”
That principle applies in both directions:
- If the ketamine clinic notices destabilization — emergent suicidality, dissociation, or non-response — the PHP/IOP team should be notified immediately.
- If the program observes clinical change — sudden activation, agitation, or emotional flooding — communicate back before assuming discontinuation is necessary.
Shared safety notes, direct clinician contact, and predictable updates prevent both overreaction and oversight. The relationship between programs and prescribing clinics should feel like a handoff within one extended team, not a siloed referral.
After the PHP/IOP: Discharge and maintenance plans
Coordination doesn’t end when the PHP or IOP episode closes. For many patients, ketamine or Spravato treatment continues during or after step-down. To avoid gaps, teams should:
- Establish a maintenance rhythm before discharge — whether that’s weekly, biweekly, or as-needed dosing.
- Clarify point-of-contact for medication follow-up and crisis management post-discharge.
- Ensure handoff back to the outpatient psychiatrist or therapist who can continue meaning-making and behavioral support.
- Lumin Health is here to help with any disposition considerations.
For patients finishing both a PHP/IOP and ketamine course, that last piece is critical. Rapid relief without ongoing integration risks relapse; consistent psychotherapy ensures that neurobiological change becomes durable psychological change.
The Partnership Philosophy for Safe and Effective Ketamine Treatment
PHP and IOP treatment and ketamine / esketamine (Spravato) are synergistic: rapidly stabilizing, interventional modalities that help where other treatments have not sufficiently reached. When paired carefully, the two can reinforce one another: the medicine loosens old patterns, and the program provides the scaffolding that makes new ones stick.
Dr. Yudkoff’s framing captures the heart of this collaboration:
“Hospitals and structured programs don’t need a rigid protocol — they need communication and understanding of each patient’s trajectory.”
At its best, this is a therapeutic partnership designed to improve the life of shared patients. The medical intervention and the group-based therapy work side-by-side — different tempos, same goal: helping the patient return to stable function with safety, meaning, and confidence.
