This paper describes the Home-Based Crisis Intervention (HBCI) program in New York and the outcomes of a study that investigated the effectiveness of the program. The HBCI program provides short-term intensive in-home services to families with children who are at-risk for out-of-home placements. Counselors work with families to prevent psychiatric hospitalization or out-of-home placement. The intervention focuses on family strengths and needs by using a multifaceted approach that includes skills building, counseling, and the provision of concrete services. The program effectiveness study included 221 children (ages 5-17) who were experiencing a psychiatric crisis requiring immediate intensive intervention, hospitalization, or placement in another restrictive setting. Results indicate that despite additional resources and expansion of services in the HBCI program, hospitalization rates did not change significantly at the two participating hospitals. Rather than preventing hospitalization, in-home services may represent another community-based option for children whose safety and clinical needs are not as acute as children judged to require hospitalization. Children enrolled in in-home services gained in self-esteem and these gains were maintaining over the follow-up period. Also, most were able to avoid hospitalization during the initial period of service. (Contains 10 references.) (CR)