Explore This Treatment Program

The Program in Substance Use & Addiction Services (PSAS), formerly known as the Substance Use Disorders Initiative, is designed to transform care for the chronic disease of substance use disorder in order to improve the quality, accessibility, clinical outcomes and value of treatment for our patients suffering with this illness.

Please watch these videos to answer questions about the ARMS progam.

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.

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.

During the initial assessment, we strive to provide recommendations and feedback on an appropriate treatment plan dependent on each patient’s particular circumstances and needs. However, this cannot always be done on the same day as the initial evaluation, since we may need to consult with other team members or outside providers to gather a comprehensive picture. If this is the case, we will schedule a follow-up appointment within a week.

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 our approach

Our Approach to Treatment

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 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, we help 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.

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

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. During the initial assessment, we strive to provide recommendations and feedback on an appropriate treatment plan dependent on each patient’s particular circumstances and needs. However, this cannot always be done on the same day as the initial evaluation, since we may need to consult with other team members or outside providers to gather a comprehensive picture. If this is the case, we will schedule a follow-up appointment within a week.

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. 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.

Treatment Options

We offer a variety of treatment options through 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
  • Recovery supports - clients have the opportunity to connect with our recovery coach to discuss different recovery paths, gain support attending mutual help or outside community appointments

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. Given census changes regularly, please discuss your interest in groups with our clinicians during your intake appointment.

Services 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

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
  • Individual parent coaching – 1:1 parent guidance and support with a clinician trained to support parents and address your unique needs, which can be billed to insurance. This treatment option is for those in a parenting role, not other family members
  • Parent long-term support group – free weekly after-care group for parents who have completed the parent education and support group
  • Parent peer support program – parent volunteers involved in ARMS act as peer support mentors for new parents seeking a familiar person who knows their experience to support them 

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

Our Research

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.

See completed studies

Bergman, B. G., Kelly, J. F., Nargiso, J. E., & McKowen, J. W. (2016). " The Age of Feeling in-Between": Addressing Challenges in the Treatment of Emerging Adults With Substance Use Disorders. Cognitive and behavioral practice23(3), 270-288.

Rengit AC, McKowen JW, O'Brien J, Howe YJ, McDougle CJ. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study. J Autism Dev Disord. 2016 Jul; 46(7):2514-9. 

Mckowen J, Carrellas N, Zulauf C, Ward EN, Fried R, Wilens T. Factors associated with attrition in substance using patients enrolled in an intensive outpatient program. Am J Addict. 2017 Dec; 26(8):780-787.

Yule, A. M., Lyons, R. M., & Wilens, T. E. (2018). Opioid use disorders in adolescents—updates in assessment and management. Current pediatrics reports6, 99-106.

McKowen J, Isenberg B, Carrellas N, Zulauf C, Ward N, Fried R, Wilens, T. Neuropsychological Changes in Patients with Substance Use Disorder after Completion of a One Month Intensive Outpatient Treatment Program. The American Journal on Addictions. 2018; 27(8):632-638.

Yule A, Carrellas N, DiSalvo M, Lyons R, McKowen J, Nargiso J, Bergman B, Kelly J. Wilens, T. (2019). Risk factors for overdose in young people who received substance use disorder treatment. The American Journal on Addictions. 2019; 28(5):382-389.

Isenberg, B. M., Yule, A. M., McKowen, J. W., Nowinski, L. A., Forchelli, G. A., & Wilens, T. (2019). Considerations for treating young people with comorbid autism spectrum disorder and substance use disorder. Journal of the American Academy of Child and Adolescent Psychiatry58(12), 1139-1141

Ameral A, Yule A, McKowen J, Bergman B, Nargiso J, Kelly J. A Naturalistic Evaluation of a Group Intervention for Parents of Youth with Substance Use Disorders. Alcoholism Treatment Quarterly. 2020; 38(3):379-394. 

Beckmann, David, Kelsey Leigh Lowman, Jessica Nargiso, James McKowen, Lisa Watt, and Amy M. Yule. "Substance-induced psychosis in youth." Child and Adolescent Psychiatric Clinics 29, no. 1 (2020): 131-143.

Bentley KH, Sakurai H, Lowman KL, Rines-Toth L, McKowen J, Pedrelli P, Evins AE, Yule AM. Validation of brief screening measures for depression and anxiety in young people with substance use disorders. J Affect Disord. 2021 03 01; 282:1021-1029

McKowen J, Woodward D, Yule AM, DiSalvo M, Rao V, Greenbaum J, Joshi G, Wilens TE. Characterizing autistic traits in treatment-seeking young adults with substance use disorders. Am J Addict. 2022 03; 31(2):108-114.

McKowen, J. W., Lowman, K. L., Watt, L., Yule, A. M., Burke, C., Kaminiski, T., ... & Kelly, J. (2022). The relationship between cannabis use and Self-Reported trait anger in Treatment-Seeking young people. Cannabis and cannabinoid research.

McKowen, J., Berger, A., Towbin, J., Yule, A. M., Woodward, D., Nowinski, L., ... & Wilens, T. E. (2023). A Manualized Behavioral Therapy Intervention for Youth with Autism Spectrum Disorder and Substance Use Disorder. Case Reports in Psychiatry2023. – IF YOU WOULD LIKE A FREE COPY OF THE MANUAL, PLEASE EMAIL: JMCKOWEN@MGH.HARVARD.EDU

Burke, C, Lanni, S, Berger A, et al (Submitted). Characteristics and Outcomes of Youth with Benzodiazepine Use Disorder in Outpatient Dual Diagnosis Treatment

Patient & Family Education

About ARMS

About ARMS

Watch these short videos to learn more about ARMS services.

Information for Young Adults

Information for Young Adults

Learn how substance use can impact you.

Information for Parents

Information for Parents

Learn more about how we support parents of young people with substance use disorder.

Tips for Families

Tips for Families

These tips can help families struggling with youth substance use.

Teens and Vaping

Teens and Vaping

Learn more about the dangers of vaping for teens.

Understanding Addiction

Understanding Addiction

It is important to understand addiction for the medical condition that it is.

Prescription Drugs

Prescription Drugs

Over-the-counter remedies and with prescription medications are being used recreationally.

Understanding Recovery

Understanding Recovery

Overcoming addiction takes effort, but it is the most likely outcome for most people.

The Developing Brain

The Developing Brain

Substance use can have a great effect on the developing brains of young people.



A drug education curriculum for middle and high school students.

  • Lisa Cohen, Staff Psychologist
  • Jessica Nargiso, Staff Psychologist
  • Allison White, Staff Psychologist
  • Oriana Federico, Clinical Social Worker
  • Joshua Towbin, Clinical Social Worker
  • Lisa Watt, Psychiatric Nurse Practitioner
  • Brittany Deruosi, Recovery Coach

Administrative Team

  • Mayra Zelaya, Practice Manager

  • Tiana Greaves, Administrative Coordinator 

ARMS Advisory Board

Community Partnerships

ARMS 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. We have 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.

Additional resources

The sites below provide helpful resources for addiction and recovery information and support.

Patient Resources

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 now