This study examined outcomes with 170 children and youth admitted to residential treatment with complex mental health problems. Overall, outcomes at 2 years post-treatment was predicted by children and youth's behavioral pretreatment status reflected in lower internalizing and externalizing behavior at admission. These findings recognize a cluster of variables upon admission that are differentially predictive of specific outcomes. Higher school participation/achievement and an absence of witnessing interparental abuse predicted educational status. Family status was predicted at admission by higher family functioning, being younger in the family, and children and youth who had poor community behavior. The results are discussed as they relate to pretreatment screening and the need to evaluate service outcomes.