This Clinical Consultation Breakfast presents the changes over the last 25 years in the use of inpatient hospitalization for children and adolescents. Current indications for inpatient hospitalization are presented and the goals for inpatient hospitalization are discussed. This breakfast explores strategies to appropriately evaluate and manage patients, for working with severe family dysfunction, and for appropriate use of seclusion and restraint. It specifically addresses psychotic disorders, mood disorders, autism spectrum disorders, and disruptive behavior disorders.