Addiction Recovery Management Service

The Addiction Recovery Management Service (ARMS) specializes in supporting teenagers and young adults between the ages of 14 and 26 and their parents as they deal with their substance use and related problems.

Overview

About ARMS

teen addiction treatment at arms
ARMS services young patients between 14 and 26 facing substance use issues and their families.

The Addiction Recovery Management Service (ARMS) is an outpatient, dual diagnosis clinic made up of a multidisciplinary team of clinical psychiatrists, psychologists and masters-level social workers who are trained to work with youth and their parents to provide an individualized plan for recovery. Learn more about the clinical team.

As part of Massachusetts General Hospital with links to the medical, clinical and addiction research resources within the Center for Addiction Medicine, ARMS offers a unique level of expertise. We evaluate each patient’s history and current symptoms in order to devise the treatment plan that is the most likely to succeed. We understand that substance use and mental health issues are closely connected. Our team is trained to assess and treat comorbid mental health problems such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder as well as other mental health issues.

Our Services

All are welcome at ARMS, and we meet each patient where they are. We can be a valuable resource for those who are unsure they even have a problem, those still thinking about making changes, those taking the first steps towards treatment, or those enrolling in ARMS to fully pursue their recovery and overall wellness. Patients are not required to be abstinent to engage in our program.

We are an outpatient program providing comprehensive outpatient individual therapy, group therapy, and outpatient psychiatry consultation and follow-up. Our services include assistance in the following areas:

  • Assessing the varied dimensions of potential substance use and mental health issues
  • Determining necessary treatment for related behavioral or psychiatric conditions
  • Connecting patients and families with the treatment services they need at ARMS or, if necessary, making a referral and helping families navigate the treatment system
  • Monitoring existing patients’ progress through their addiction treatment
  • Assisting with relapse when it occurs

Learn more about ARMS

Dr. James McKowen

Watch this video series featuring clinical director James McKowen, PhD to learn more about our program, staff and treatment options: Addiction Recovery Management Program.

Read our Frequently Asked Questions.

 

Approaches to Treatment

Treatment works when addiction is approached like any other chronic disease, which requires time, flexibility and a commitment to overcome the relapses that are likely to be a part of any behavioral modification. By targeting harm reduction approaches and avoiding the guilt and shame often associated with addiction, ARMS helps patients to achieve happy, independent lives without substances.

We help our patients choose positive behaviors instead of the destructive behaviors they have favored in the past and use the latest research evidence to inform our treatment.

Treatment Options at ARMS

  • Motivational Enhancement Therapy (MET): short-term program to increase readiness and motivation for treatment through goal setting
  • Cognitive-Behavioral Treatment (CBT): behavior is analyzed for vulnerabilities and new behavioral skills are taught
  • Adolescent-Community Reinforcement Approach (A-CRA): short-term approach to teach increased effectiveness skills to youth and parents
  • Community Reinforcement Approach and Family Treatment (CRAFT): approach focused on helping parents develop communication skills, problem-solving, self-care, and contingency management strategies to support their child’s recovery

Learn more about our approach to addiction recovery.

See treatment options

Our Research

ARMS conducts research to help improve our understanding of effective treatments for youth with substance use disorders, decreasing risky behaviors associated with substance use and identifying factors that support recovery.

Learn more about our research.

For Parents

We also provide evidence-based coaching, support, and services to parents of young people with substance-related problems who are not yet willing to seek treatment themselves.

ARMS works with the parent-child unit to address issues that coexist with addiction, such as how to improve communication and problem-solving skills, how to set appropriate boundaries around behaviors, and also help families address issues that may be present around the stigma, shame, worry, and anger that they may feel. Although we do not provide family therapy specifically or provide treatment options for siblings, we do facilitate referrals as needed in this regard.

We are dedicated to helping our patients and their parents face challenges and struggles as they arise and ease the process of achieving long-term recovery.

Learn more about parent services

Our Team

The members of the Addiction Recovery Management Service (ARMS) are specifically trained in addiction medicine. They have experience in helping youth and their parents navigate the often overwhelming process of seeking treatment for substance use and achieving the overall goal of greater health and well-being.

  • John F. Kelly, PhD

    ARMS Program Director

    Dr. Kelly is the Program Director of the Addiction Recovery Management Service and Associate Director of the Center for Addiction Medicine at Massachusetts General Hospital. He also serves as an Associate Professor in Psychiatry at Harvard Medical School. Dr. Kelly is a consultant to the White House Office of National Drug Control Policy, the Substance Abuse and Mental Health Services Administration, the Center for Substance Abuse Treatment and the U.S Department of Education. He also serves on the Executive Committee of the American Psychological Association, Division on Addictions, and as a scientific consultant to the National Institutes of Health.

    He has published more than 70 scientific articles, reviews and book chapters in the field of addiction. He has received several grant awards from the National Institute of Alcohol Abuse and Alcoholism and the Hazelden Foundation for his work on treatment process and outcomes, informal care utilization among adolescents and adults and mechanisms of behavior change in addiction recovery.

  • Martha T. Kane, PhD

    Mass General Clinical Director for Ambulatory Psychiatry

    Dr. Kane is a licensed clinical psychologist and the Clinical Director for Ambulatory Psychiatry at Massachusetts General Hospital. She spearheaded the initial development of the Addiction Recovery Management Service. Dr. Kane has expertise in treating clients with co-occurring chemical dependency and mental health disorders, particularly patients with character disorders and trauma histories.

    Dr. Kane completed a fellowship in Addiction Psychiatry at Mass General and has held positions as therapist, Director of the Perinatal Addiction Treatment program and Clinical Director of the West End Clinic Addiction Unit. In that role, she directed both the standard outpatient program and an intensive outpatient program, and maintained an active caseload of patient care. She continues to provide training to residents and fellows in both medicine and psychiatry, as well as numerous community groups. She provides consultation to staff and assists in program development.

  • Timothy E. Wilens, MD

    Director of Substance Abuse Services, Mass General Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD

    Dr. Wilens is the Director of Substance Abuse Services in the Clinical and Research Program in Pediatric Psychopharmacology and Adult Attention Deficit/Hyperactivity Disorder (ADHD) at Massachusetts General Hospital. He is also an Associate Professor of Psychiatry at Harvard Medical School. Dr. Wilens is among Boston Magazine's “Best of Boston” in Child/Adult Psychiatry and the “Best Doctors in America.” His research interests include the relationship among ADHD, bipolar disorder and substance abuse, and the pharmacotherapy of ADHD and juvenile bipolar disorder across the lifespan. He has published more than 130 peer-reviewed articles, 55 book chapters and 180 abstracts and given presentations at national and international scientific meetings. Dr. Wilens is a Distinguished Fellow of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.

  • James McKowen, PhD

    ARMS Clinical Director

    Dr. McKowen is a licensed clinical psychologist and Clinical Director of the ARMS Program. He is an Assistant Professor in Psychology and Instructor in Psychiatry within the Department of Psychiatry at Harvard Medical School and the Center for Addiction Medicine. He completed his pre- and postdoctoral training at Mass General in Child Psychology and Addiction Medicine. Dr. McKowen has expertise in working with adolescents and young adults with substance use and comorbid mental health disorders and their families. Dr. McKowen conducts research on the neuropsychological effects of substance use in youth. He has authored and co-authored several published research articles and presented at national and international conferences in these areas. He is also trained in cognitive behavioral therapy approaches to the treatment of mood and anxiety disorders in children, adolescents and young adults.

  • Amy Yule, MD

    ARMS Medical Director

    Dr. Yule is a psychiatrist and Medical Director of the ARMS program. She completed her training in Adult Psychiatry and Child and Adolescent Psychiatry in the Massachusetts General Hospital and McLean Hospital training programs. She completed her Addiction Psychiatry Fellowship in the Partners Addiction Psychiatry Program. She is Board Certified by the ABPN in Adult Psychiatry, Child and Adolescent Psychiatry and Addiction Medicine. In addition to her clinical work at ARMS, Dr. Yule has been involved in clinical research focused on identifying risk factors for the development of a substance use disorder and risky behaviors associated with substance use.

    She is currently an American Academy of Child and Adolescent Psychiatry Physician Scientist in Substance Abuse and is studying evaluating treatments for youth with substance use disorders and bipolar disorder.

  • Jessica Nargiso, PhD

    Licensed Clinical Psychologist

    Dr. Nargiso is a licensed clinical psychologist with expertise and training in substance abuse treatment and prevention with adolescents and young adults. She is trained in cognitive behavioral therapy and other evidence-based approaches for treating substance use and other co-occurring mental health disorders in these populations. Dr. Nargiso completed postdoctoral training at the Center for Alcohol and Addiction Studies at Brown University. In addition to her clinical interests, her interests include the effectiveness of community-based prevention and early intervention strategies for reducing substance use among youth. She has published articles in national and international peer-reviewed journals in these areas.

  • Lisa Cohen, PsyD

    Licensed Clinical Psychologist

    Dr. Cohen is a licensed clinical psychologist with an extensive history of training and treatment in the field of substance use and other co-occurring mental health disorders. She is trained in several evidence based treatment modalities including cognitive behavioral therapy, dialectical behavioral therapy, as well as short-term solution focused therapy. She completed her postdoctoral training in an outpatient substance abuse clinic in the Boston area and then went on to oversee the clinical program of an outpatient substance abuse treatment program. Her clinical interests include treating substance use and other mental health disorders in individuals as well as their effects on other members of the family.

  • Oriana E. Federico, LICSW

    Social Worker

    After completing her BA in Women's Studies from Wheaton College in Massachusetts, Oriana Federico served two years with City Year Boston (an AmeriCorps program) working with youth in Boston Public Schools, and served as a Team Leader during her second year. Oriana earned her MSW from Columbia University in New York City, where her year-long internships included the home-finding department of a foster care agency and a substance abuse treatment program. She has since gained further experience in the field of substance abuse both in her role as the Clinical Coordinator of a private ambulatory substance abuse program in New York, NY, and as a psychotherapist with NYU Lutheran in Brooklyn, NY.

  • Lisa Doherty Watt, MSN, PMHNP-BC, PPCNP-BC

    Nurse Practitioner

    Lisa completed her MS in nursing at the MGH Institute of Health Professions and is board certified as both a psychiatric mental health nurse practitioner and a pediatric primary care nurse practitioner. Lisa has expertise in working with adolescents and young adults with chronic illness including chronic pain, substance use and mental health disorders. She is trained as an adolescent community reinforcement (A-CRA) clinician and uses evidenced-based treatments designed for adolescents with alcohol or other drug use disorders. Lisa’s clinical interests include early identification of substance use disorders and increasing access to mental health services in primary care.

  • Chris Savage, Certified Recovery Coach, Certified Peer Specialist

    Recovery Coach

    Chris brings many years of lived experience with him to ARMS. Chris started in the field in a peer-to-peer role and eventually moved on to management. Chris has an extensive history working with and offering support to people and families struggling with substance use, homelessness and mental illness. Prior to joining ARMS, Chris worked as the senior substance abuse specialist at North Suffolk Mental Health. He joined ARMS to focus on supporting youth struggling with addiction. Chris has presented at conferences nationally on recovery and wellness and truly believes that recovery is possible no matter the circumstances. In his role as a recovery coach, Chris is always willing and happy to share a vast knowledge of support resources and personal experiences with youth to strengthen their own recovery from substance use.

  • Paige Estabrooks, MPH

    Practice Manager

    Paige Estabrooks is responsible for the operational and administrative management for ARMS. Paige’s undergraduate studies focused on health and wellness at Colby Sawyer College. Shortly after graduating, Paige earned her MPH with a concentration in community health at Massachusetts College of Pharmacy and Health Sciences. She has over four years of experience working in healthcare administration and is passionate about patient advocacy and improving patient experience in healthcare environments. Paige holds a professional interest in supporting youth and their parents striving to lead healthier, fulfilled lives while dealing with mental health and substance use related issues.

  • Chloe DeLoughery

    ARMS Patient Service Coordinator

    Chloe DeLoughery recently graduated with a Bachelor’s Degree in Sociology from Mount St Mary’s University in Emmitsburg, Maryland. Chloe’s undergraduate research focused on the impact of tattoos and self-perception on future financial success. Because Chloe has a professional interest in supporting those with substance use disorders, she hopes to pursue a career in social work in the future. Aside from her professional interests, Chloe enjoys playing sports and reading, and she is an avid lover of music.

Our Approach

teens at teen treatment center
The ARMS program helps young patients live healthier, more empowered lives.

The Addiction Recovery Management Service (ARMS) helps young people with substance-related problems to lead healthier, more empowered lives by crafting an individualized treatment plan for them.

The good news is that treatment does work. It just takes time and commitment, and an honest acknowledgement of the realities of addiction.

Zero Tolerance Doesn't Work

As chronic disease of the brain, addiction is much like diabetes. Behavior modification is at the core of treatment, and it’s a difficult process. Patients often don’t want to change, even after admitting they have a problem, and most patients undergo an average of five to seven relapses before they are able to maintain a stable recovery. Even then, lifelong vigilance is required.

Adolescents who enter treatment are more likely to achieve long-term sobriety than those who enter as adults, and the earlier they enter, the more effective treatment will be. However,  adolescents need specialized treatment that is tailored to their development level.

Sobriety should not be seen as the central aim for everyone. Rather, treatment is successful when it helps young people achieve greater stability and better functioning.

Positive goals for those with substance-related problems include:

  • Abstinence from substances associated with poor functioning
  • Reduced use or intensity of use
  • Improved functioning in school and better relationships
  • Improved physical health
  • Improved mental health

Key Elements of Good Treatment

We understand addiction as a long-term recovery process and know that relapse is a part of that process. Therefore, patients can receive treatment services as long as they are interested in receiving care and motivated to attend appointments consistently. If we feel that a patient needs more intensive treatment for a period of time, such as detox, residential or a partial hospital program, we help patients access that treatment and stay involved throughout that process. We are also available for step-down after-care treatment.

No one type of treatment will work for everyone, but some factors that can help to ensure a successful outcome include:

  • Services match patient’s age and needs
  • Staff trained in adolescent issues
  • An assessment of patient’s circumstances
  • Substance use monitoring
  • Family involvement
  • Life goals training
  • Careful aftercare planning and implementation

Getting Started at ARMS

Every enrollment begins with an evaluation that is completed by an experienced clinician with expertise in substance-related problems and conditions.

This appointment usually takes two to three hours, with the majority of that time spent with a licensed social worker or psychologist. The evaluation is used to determine each patient’s level of substance use and any other contributing factors that may be present, including mood and anxiety issues, ADHD or other comorbid mental health issues. We also review any pertinent records, in order to learn childhood history and current presenting symptoms.

During the initial assessment, we provide recommendations and feedback on an appropriate treatment plan dependent on each patient’s particular circumstances and needs. These recommendations will include:

  • Level of care determination (detox, inpatient, residential, partial, intensive outpatient programs, standard outpatient, etc.)
  • Diagnoses of substance use and/or mental health issues
  • Feedback on measures completed
  • Recommendations for other services including referral for psychopharmacology, neuropsychological assessment, vocational support, and/or school-based recommendations

At the conclusion of this appointment, the patient will be asked to visit the laboratory at the main hospital to complete a toxicology drug screen. This toxicology screen may include a urine sample, an oral fluid swap or a blood draw and is required of all new patients. The results of the toxicology screening will not in any way impede a patient from receiving services at ARMS; it is simply a tool we utilize for all patients, new and returning.

Read our Frequently Asked Questions to learn more about ARMS.

Treatment Options

We offer a variety of treatment options through the Addiction Recovery Management Service (ARMS) for both teens struggling with substance use disorders and their family members. Our team of clinicians evaluates each patient’s individual history and current symptoms to create a treatment plan that is the most likely to succeed. Contact us to learn more about the treatment options below or read our Frequently Asked Questions.

Treatment Options for Young People

We have several different outpatient treatment options at ARMS:

  • Individual psychotherapy (Please be aware that there may be a wait time depending on our availability)
  • Group therapy - we have several different age-specific group therapy offerings appropriate to each patient’s readiness for sobriety, which is determined at the evaluation and on an ongoing basis
  • One-time consultations - trained addiction psychiatrists who can be seen for consultations or on an ongoing basis to provide medication support both for mental health issues and substance use
  • Medication support - trained addiction psychiatrists who can provide medication support both for mental health issues and substance use, including naltrexone/vivitrol and suboxone programs

If a patient signs up for ongoing services at ARMS, we do require random drug testing throughout treatment. You will not be terminated from treatment based on your toxicology screen results.

Group Therapy Options

We have several different outpatient groups at ARMS. Patients may be recommended to attend multiple groups per week, or a specific combination tailored to their needs. This will be determined at your evaluation.

  • Dialectical behavior therapy (DBT) skills group – 13-week group program, meets once weekly incorporating DBT techniques for patients 18-26 years old to help teach emotion regulation skills for depression, anxiety and anger
  • Skills and support – 8-week group program, meets once weekly for patients 18-26 years who are not sure if they are ready to change their substance use behavior
  • Dual Diagnosis – 8-week group program, meets once weekly for patients 18-26 years struggling with mental health and substance use issues
  • Long-term after-care group – a weekly group for patients who have completed a group program and are looking for ongoing support to meet their substance use and life goals

 ARMS also has two drop-in groups each week to help patients with urgent needs or those who need additional support:

  • Drop-in therapy group – a flexible weekly group for established patients who may not be ready to commit to regular therapy or for those who need additional support
  • Drop-in psychiatry group – a flexible weekly group for established patients who need to see a psychiatrist for support, discuss medications, or be seen before a formal psychiatry appointment if there is a wait for that appointment
At present we do not offer any groups for 14-18-year-olds, but we are actively working to build a group therapy program for these patients.

 

Parent Services

We offer a variety of different services for parents of young people with substance abuse problems:

  • Parent orientation group – 30 minute free group to orient parents to resources for parents at ARMS
  • Parent education and support group – weekly free group for parents, 8 week clinician led curriculum providing education and skills to parents of youth with substance use problems
  • Parent coaching group – insurance billed, 6-8 week small parent treatment group providing tailored support for specific issues
  • Parent long-term support group – free weekly after-care group for parents who have completed the parent education and support group

We understand that children are not always motivated to continue treatment, so we welcome you continue using our parent services even if your child is refusing care.

Our Research

The Addiction Recovery Management Service (ARMS) is committed to improving our understanding of effective treatments for youth with substance use disorders, decreasing risky behaviors associated with substance use and identifying factors that support recovery.

See the list below to learn more about the research being conducted at ARMS. Contact us at 617-643-4699 if you have any questions about research at ARMS.

Active Studies


Substance Use Disorder and Bipolar Disorder Treatment Study

Principal Investigator: Amy Yule, MD
Funding Source: The American Academy of Child and Adolescent Psychiatry and the National Institute of Drug Abuse  
Project Number: 5K12DA000357-17
The goal of this study is to examine the effect of quetiapine on substance use and mood in youth with substance use disorders and bipolar disorder.

Learn more about this study.


Mind and Body Recovery Study

Principal Investigator: David Eddie, PhD
Funding Source: The National Institute on Alcohol Abuse and Alcoholism
Project Number: F32AA025251-01
The goal of this study is to better understand psychological and physiological factors that may put individuals receiving treatment for alcohol use problems at risk for alcohol use relapse. 

Learn more about this study.


Completed Studies


Neuropsychological Predictors of Treatment Drop Out in Patients within an Intensive Outpatient Program

Principal Investigator: James McKowen, PhD
Funding Source: Mass General Department of Psychiatry
Project Number: n/a
The goal of this study is to examine which executive functioning deficits predict drop out in clients with substance use disorders enrolled in standard intensive outpatient programs.


Overdose in Treatment-Seeking Youth with Substance Use Disorders

Principal Investigator: Amy Yule, MD
Funding Source: Mass General Gerstner Scholar Award
Project Number: n/a
The goal of this study is to examine in treatment-seeking youth with substance use disorders the prevalence of overdose and substance use and psychiatric characteristics associated with overdose.


Development and Testing of Adolescent Twelve-Step Facilitation

Principal Investigator: John Kelly, PhD, 2011 - 2016
Funding Source: National Institute of Alcohol Abuse and Alcoholism
Project Number: R01AA019664-01A1
This study is the first to develop and test the efficacy of an integrated 12-step facilitation intervention tailored for young people in a randomized experimental design.

 

 

Patient Education

  • Information for Young Adults – You may not think that your substance use is a big deal, especially if your friends drink or use drugs. However, if you do use substances, you should be aware of how they are impacting you and what the possible consequences may be.
  • Information for Parents – When young people develop substance-related problems, their whole family is impacted. At ARMS, we strive to support parents. Learn more about how we can support you as the parent of a young person with possible substance use disorder.
  • About the ARMS Program – Video series featuring clinical director James McKowen, PhD discussing the program, staff and treatment options.
  • Teen & Young Adult Substance Use: Tips for Families - Adolescents are more vulnerable to developing substance use disorders because of how the brain develops, so it’s important for parents pay attention and to intervene as soon as a possible substance use problem is identified. These tips can help families struggling with youth substance use.
  • Understanding Addiction – In order to understand addiction, it is necessary to move past the many emotional responses that both those in recovery and their loved ones have to the word itself, and it is important to understand addiction for the medical condition that it is.
  • Prescription Drugs: The New Epidemic – Over-the-counter remedies, including cough syrup and cold medicine, along with prescription drugs are being used recreationally by an increasing number of young people, who may think of these drugs as a harmless way for them to relieve anxiety or get high.
  • Understanding Recovery – Addiction is a chronic illness influenced by genetics, environment, life events, and behavior. Overcoming addiction takes a lot of effort, and while stable recovery can take time to achieve, it is the most likely outcome for people suffering from addiction. Many find the journey of recovery to be a powerful and transformative one, where they not only give up substances but also experience new personal growth and an increased sense of meaning and purpose.
  • The Developing Brain - Substance use can have a great effect on the developing brains of young people.

Resources

Helpful Resources for Addiction and Recovery Information and Support

 

Community Partnerships

The Addiction Recovery Management Service (ARMS) at Massachusetts General Hospital strives to build bridges with community business and organizations that are supportive to youth in recovery. We know that youth get well in their community and that sports, work and other activities are critical to a meaningful and rewarding recovery.

ARMS has fostered connections with the following programs and organizations, which are invested in building healthy, rewarding, and meaningful lives for those affected by addiction.

ARMS is a non-profit organization and does not hold any conflicts of interest or financial partnerships with these organizations.

FAQ

Frequently Asked Questions

Patient Questions

  • What levels of care does ARMS provide?
  • How long does the initial evaluation process last?
  • How long can I get treatment at ARMS?
  • Other programs have kicked me out if I’ve relapsed. Will ARMS terminate me if I struggle again?
  • Will I be drug tested every visit?
  • Does ARMS address comorbid mental health issues?

Parent Questions

  • If my child stops treatment, can I, as a parent, still receive services?
  • Can I receive information on how my child is doing in treatment?
  • Whom do I communicate with about my child’s progress in treatment?
  • My child is unwilling to get an evaluation. What should I do?
  • Can my child keep their current providers and still receive treatment at ARMS?
  • Do you provide family therapy?
  • Do you provide services for siblings or other family members?

Support Our Work

The ARMS clinic relies on philanthropic contributions to fund its groundbreaking work in dual diagnosis substance use disorder treatment, research, education, and training. When you give to ARMS, you will create a very real impact on our ability to expand knowledge about substance use disorder, treatment, and prevention.

There are many different ways to support the work of ARMS. Use our online form to make a donation—under “I’d like to designate this gift to a specific program or area at MGH” enter “ARMS”.

Give online today

Memorial and Celebration Gifts

Making a gift to ARMS can be a meaningful way to remember a friend or loved one, celebrate an occasion such as a wedding or birthday, or commemorate an event. Use our online form to make a tribute gift. Be sure to check the box marked “I am making this gift in honor or memory of somebody”.

Planned Gifts

Through planned giving, you can achieve your charitable intentions while also establishing an income stream for yourself or beneficiaries. Call us to learn more about life income arrangements, gifts of life insurance, endowed and named gifts and bequests.

Event and Program Sponsorship

Help us share vital information about the treatment of substance use disorder at our public forums and educational events.

For more information on these and other opportunities for supporting ARMS please contact:

Molly McCarthy
Associate Director of Major Gifts
Massachusetts General Hospital
617-643-8827 or toll free at 877-644-7733
E-mail: mmccarthy50@mgh.harvard.edu

Give online today

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