The numbers of youth in trouble in the school and the community are indicated by data on school dropouts, juvenile delinquency, and the use of drugs and alcohol. Much of the research and most of the interventions designed to help these youth rest on implicit assumptions that the problem lies within the child. However, our responses should also examine and respond to the ecological and structural factors that can intensify or reduce problem behavior. A few programs now exist that reflect a multifaceted understanding of troubled youth and that serve adolescent clients through multimodal and collaborative approaches. These include the Orion Center in Seattle, the Bridge in Boston, and the truancy project in St. Paul, Minn. In addition, several projects have been developed to change the structures of current delivery systems. These include the Child and Adolescent Service System Program designed by the National Institutes of Mental Health in 1983 and projects sponsored by the Robert Wood Johnson Foundation. 20 references.