This article reports on a review of selected New York State school prevention program student case records. Methods: Data were extracted from Office of Alcoholism and Substance Abuse Services (OASAS) standardized Prevention Activity Summary forms. A total of 407 records from 12 high schools throughout New York State were reviewed. Results: The age range of students in this sample was 12 to 18 years old with a mean age of 15.5 years in an approximately normal distribution. Students in this sample were typically referred to services by school sources or were self-referred. The most frequently cited reasons for admission were personal problems, family problems, and alcohol or substance use or abuse. The majority of students are referred to individual sessions. Counselors rated services as producing positive change in all problem areas, with the largest change for adolescents whose parents used alcohol or other substances. Conclusions: Findings suggest positive outcomes for prevention counseling. Severity of alcohol and drug use decreased and severity of risk factors for alcohol and drug use likewise decreased. (Contains 2 tables.)