There is as need for creative, cost effective, evidence-based protocols for treating children and adolescents with disruptive behaviors, such as maladaptive aggression. This Workshop demonstrates a manualized, intensive outpatient psychiatry (IOP) program developed to help disruptive youth who are stepping down from higher levels of care or failed to respond to routine outpatient care. Discussion includes the development of two manualized curricula: Parenting Approaches to Challenging Kids (PACK) and Mastery of Psychosocial Skills (MaPS) for children. The programs are sustainable in a managed care environment, applicable across a broad patient population, and effective in several key outcome domains. Participants learn specific, proven strategies that optimize access to care, cost effectiveness, and retention in treatment. Through the practice of specific group therapy techniques presented in several PACK modules, such as parental empathy and parent-child communication, problem solving, and behavior modification, participants gain hands-on experience in proven parent-training techniques.