The specific aims of this project are to establish a new program model, Family-Centered Intensive Case Management (FCICM) in three rural New York State (NYS) counties, and to compare the program's outcomes with those of Family-Based Treatment (FBT), NYS's model of therapeutic foster care. FCICM provides intensive services, including parent education, respite and 24-hour crisis intervention services to natural families to keep seriously emotionally disturbed children (SED) at home, while FBT uses professional parents to provide care for SED children. The research uses a positive controlled randomized study design with multiple observations, assigning children ages 6 - 12 referred for therapeutic foster care to one of two treatment conditions. The evaluation examines provider behavior (i.e., services provided), family outcomes (e.g., adaptability and cohesion, parenting skills and self-efficacy), child outcomes (e.g., school, home and community functioning), and system outcomes (e.g., costs and service network changes).