Substance Use Prevention, Treatment, and Recovery Services

Individual Programs

Kalama Substance Use Disorder Treatment Program 

The Kalama Program is a 16-24 week intensive inpatient program American Society of Addiction Medicine (ASAM III.5) for males (ages 16 and under) and females (ages 12-25) who meet qualifications for chemical dependency at Echo Glen Children’s Center. Each resident undergoes a full assessment and is involved in the development of an individual treatment plan.   

A major focus of this program is to help individuals understand their drug use and to improve their quality of life through abstaining. Program goals are met through a blend of Cognitive Behavior Therapy (CBT), Twelve Step Facilitation (TSF), and drug and alcohol education. Group therapy, individual counseling, milieu coaching, and family support and involvement are also part of the Kalama program. Relapse prevention, continuing care plans, and recovery support are also provided. 

SMART Substance Use Disorder Treatment Program 

SMART is a comprehensive program that offers outpatient (ASAM I) and intensive outpatient (ASAM II.1) services for males (ages 17 to 25) living at Green Hill School. The length of stay in the intensive outpatient services averages eight to ten weeks followed by an average of six weeks of aftercare. 

SMART is a blend of cognitive behavior therapy and 12-step facilitation.  SMART is designed to assist individuals in acquiring skills to improve their quality of life through long-term recovery.  The heart of the program is The Matrix Model and CBT/DBT skill acquisition and generalization.  Individuals attend drug/alcohol lectures, groups, and individual counseling to help them understand the impact of substance abuse on their lives.  Community based sober support is offered when available.  The Aftercare Program is attended by individuals who have completed the Intensive Outpatient.  This program is designed to enhance recovery and prevent relapse. 

TIDES Substance Use Disorder Treatment Program 

TIDES is a ten-week intensive outpatient, regular outpatient, and recovery support program for male youth (ages 16 to 25) living at Naselle Youth Camp. TIDES is a closed-end matrix model-based program that provides three, one-hour group sessions per week. Individualized contact occurs for each resident once a week. Community-based sober support is offered when available. 

Opioid Use Disorder Prevention and Treatment Services

DCYF provides an intra-agency and community medical/behavioral health collaboration for youth with opioid use disorder needs youth needing medications for opioid use disorder (MOUD). These services are offered at Echo Glen and Naselle Youth Camp. Treatment is based on individualized programming, collaboration between the youth and staff, treatment targets, and interventions to accomplish youth’s goals. An individual’s continuing care plan covers a comprehensive transition plan for reentry back into the community. The ASAM placement criteria is used to determine youth transition between levels of care and after care planning.

Treatment Models

Adolescent Community Reinforcement Approach/Assertive Continuing Care

The Adolescent Community Reinforcement Approach (A-CRA) model is used for individuals with co-occurring substance use and mental health disorders. Individuals receiving these services must have received a substance abuse and mental health assessment. A-CRA is a developmentally-appropriate behavioral treatment for youth and young adults (ages 12 to 24) with substance use disorders. A-CRA seeks to increase family, social, and educational/vocational reinforcements to support recovery. This intervention has been implemented in outpatient, intensive outpatient, and residential treatment settings.

A-CRA includes guidelines for three types of sessions:

  • Individuals alone.
  • Parents/caregivers alone.
  • Individuals and parents/caregivers together. 

According to the individual’s needs and self-assessment of happiness in multiple life areas, clinicians choose from a variety of A-CRA procedures that address problem-solving skills to cope with day-to-day stressors, communication skills, and active participation in positive social and recreational activities. The clinician’s goal is to improve life satisfaction and eliminate alcohol and substance use problems. 

Practicing new skills during sessions is a critical component of the skills training used in A-CRA. Every session ends with a mutually-agreed upon homework assignment to practice skills learned during sessions. These homework assignments often include participation in pro-social activities. Each session begins with a review of the homework assignment from the previous session. 

A-CRA procedures are also used as part of Assertive Continuing Care (ACC), which includes home visits and case management following a primary treatment episode for substance abuse or dependence. ACC is primarily used as continuing care. As such, it stresses rapid initiation of services after discharge from residential, intensive outpatient, or regular outpatient treatment in order to prevent or reduce the likelihood of relapse. In clinical trials research, ACC was evaluated for a 90-day period, but it can be extended for additional weeks or months as needed. 

Eligibility Criteria
  • Diagnosis of substance use disorder.
  • Diagnosis of co-occurring substance use and mental health disorder.
  • Parole eligibility.
  • Four months of institution service before release and six months of parole. 

Matrix Model 

The Matrix Model provides a framework for engaging stimulant (e.g., methamphetamine and cocaine) abusers in treatment and helping them abstain. Patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become familiar with self-help programs. Patients are monitored for drug use through urine testing. 

The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship with the patient and using that relationship to reinforce positive behavior change. The interaction between the therapist and the patient is authentic and direct, but not confrontational or parental. Therapists are trained to conduct treatment sessions in a way that promotes the patient’s self-esteem, dignity, and self-worth. A positive relationship between patient and therapist is critical to patient retention. 

Treatment materials draw heavily on other tested treatment approaches and, thus, include elements of relapse prevention, family and group therapies, drug education, and self-help participation. Detailed treatment manuals contain worksheets for individual sessions; other components include family education groups, early recovery skills groups, relapse prevention groups, combined sessions, urine tests, 12-step programs, relapse analysis, and social support groups. 

A number of studies have demonstrated that participants treated using the Matrix Model show statistically significant reductions in drug and alcohol use, improvements in psychological indicators, and reduced risky sexual behaviors associated with HIV transmission. 


Wraparound with Intensive Services (WISe) is a voluntary service offered statewide to Medicaid-eligible youth up to age 21. WISe provides in-home and community support from a team consisting of the young person, their family and other supportive people in their life, a team coordinator, peer counselor, and therapist. Together, the team works to identify strengths and needs of the young person and their family to develop a culturally-relevant, individualized plan that emphasizes family voice and collaboration. The team supports the family in working toward their goals and connects the family with supportive resources in the community. For more information, please visit the Health Care Authority website.