Managers and stakeholders across the Interior West are increasingly focused on managing for the uneven-age, mosaic patterns of individual trees, tree clumps, and openings (ICO) associated with frequent fire forests. These stand level patterns influence key processes and functions such as fire behavior, drought resistance, snow retention, wildlife habitat, and stand development. Until recently, methods to incorporate targets for spatial pattern into treatments were not well developed. To inform such methods, we reconstructed and stemmaped 55 x 4ha historical reference sites from frequent fire forests across interior Washington and Oregon. Reference sites show a definable envelope of patterns that can serve as targets for treatments. We developed a silvicultural tool that incorporates spatial pattern targets from reference stands into prescriptions. Results from treatment implementation indicate that explicit targets for spatial variability, in the form of clumping and opening targets, can be achieved in a practical, operational-scale manner. We also developed field based and LiDAR monitoring tools to compare spatial pattern from any treatment to reference conditions. Results from monitoring of 38 treatments, including prescribed fire, show that strict basal area and spacing based treatments do not restore reference spatial patterns, while approaches with explicit pattern objectives generally do.