Positive Behavioral Interventions and Supports model, first introduced into public schools, has been extended to alternative settings. This article highlights applying PBIS to day treatment and residential treatment education programs increasingly challenged to serve seriously emotionally disturbed youth whose risk factors have become more complex. The results demonstrate a more positive environment enhancing children's treatment and education along with decreasing numbers of safety holds and need for out-of-classroom supports. (Contains 4 figures and 7 tables.)