The complexity of child behavioral health and the importance of transitioning from the most restrictive to an intermediate level of care such as a partial hospitalization program (PHP) for high-risk youth is highlighted in this study. While inpatient hospitalization stabilizes youth in imminent danger, PHPs offer intensive treatment of those requiring more support than traditional outpatient care but less intensive than inpatient hospitalization. The transition between levels of care is determined by the severity of symptoms, high-risk behaviors, and clinical progress with planned step-downs from inpatient settings to a PHP and crisis-driven step-ups from a PHP to inpatient.