The central purpose of this report is to examine the effects of treatment on individual change trajectories for symptoms, family functioning, and out-of-home placements from the time that youths in psychiatric crisis have been approved for emergency psychiatric hospitalization to 16-months later. The study presents findings from a 1-year follow up to a randomized clinical trial comparing multisystemic therapy (MST), regarding youths presenting psychiatric emergencies, with inpatient psychiatric hospitalization. The study consisted of 156 children and adolescents approved for emergency psychiatric hospitalization. This report focuses on key mental health, placement, and school attendance outcomes and the family relations assumed to drive such outcomes. Two sets of symptom-related findings are presented and discussed. First, across treatment conditions and measures, symptoms generally decreased from well above the clinical range to below the clinical range. The second set of findings pertains to differential trajectories of symptom change within the overall pattern of decreasing symptoms. Overall findings show that MST was initially more effective than emergency hospitalization and typical services at decreasing youths’ symptoms and out-of-home placements and increasing school attendance and family structure. In addition, youths with serious emotional disturbance might benefit from continuous access to a continuum of evidence-based practices titrated to clinical need. References