The study compared attendance at a traditional office-based family systems approach, Functional Family Therapy (FFT), and attendance at a nontraditional, home-based, multisystemic family therapy approach, Ecologically Based Family Therapy (EBFT). FFT is based in a family systems concept. Similar to other systems models, FFT views problems with alcohol and drugs as behaviors that occur in the context of and have meaning for family relationships. EBFT is based in the perspective that substance use and other related problem behaviors usually derive from many sources of influence and occur in the context of multiple systems. It is based largely on family systems concepts of behavior and behavioral change. EBFT views behavioral problems as rooted in and maintained by problematic transactions within any given system or between some combination of pertinent systems. The current study hypothesized that treatment engagement and overall attendance would be significantly higher for families assigned to the home-based intervention. The youth were recruited from two runaway shelters in a large southwestern U.S. city. The sample consisted of 76 adolescents (31 males and 46 females). The number of male and female adolescents included in each type of treatment were the same. The average age of the adolescents was 15 years old. Treatment was provided by four therapists trained in the family therapy interventions. The assessment included interviews and self-report questionnaires. As expected, treatment engagement and attendance was significantly higher for those assigned to the home-based EBFT (n=37) compared to office-based FFT (n=40). Predictors of treatment attendance (income, family chaos, externalization problems, and level of youth substance use) were examined within each treatment modality. The findings indicate that home-based treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families compared to office-based treatment. Overall, the findings suggest that nontraditional forms of treatment that accommodate their structure and techniques to the needs of highly chaotic and disorganized family systems will be more effective than traditional treatment structures with logistics that impede attendance and engagement. 5 tables and 43 references