This chapter discusses some of the unique challenges presented by the treatment of patients with chemical dependency (CD) and co-occurring disorders at the PHP and IOP level of care. The chemical dependency (CD) PHP/IOP is a specialized form of outpatient treatment that aims to help an addicted patient cease the use of his or her substance of choice, whether alcohol or illicit substances. The course of treatment in the CD cohort involves group therapy, education, and homework. A psychiatrist may supervise medical withdrawal issues and prescribe appropriate psychiatric medications. The education sessions may contain information about coping skills but will tend to focus on addiction, recovery, and relapse. The challenges for CD and co-occurring treatment at the PHP/IOP level are financial, milieu related, and psychiatric in nature. The financial issues have to do with the cost of treatment resources and managed care constraints.