This trial found that, among youth authorized to a Level II or Level III out-of-home placement, those who received FCT had better family functioning and mental/behavioral health outcomes, and lower probabilities of being subject of a child protective services report, entering (or re-entering) foster care, being arrested, being retained in grade, being chronically absent, dropping out of high school, or receiving an out-of-home placement, as compared to those who received such a placement. FCT was also associated with lower cost of care.