According to the New Freedom Commission report (2003), the mental health system for children is very fragmented. Gaps of knowledge exist of effective, culturally competent, community-based services for children and adolescents with a serious emotional disturbance. Multisystemic therapy (MST) stands out as a culturally competent home-based service with strong empirical evidence for treating youth in the juvenile justice system and may have promise for treating youth with a serious emotional disturbance in the community mental health system. This article will present the theoretical basis of MST, program design, and service provision. A review and critique of the empirical literature on MST will be presented. Finally, implications for social work practice and research with children and adolescents in the community mental health system are discussed. Tables and references (Published Abstract)