This study examined the impact of youth and family pre-placement risk factors on MTFC parent-youth interactions, youth treatment completion and outcome for male and female adolescents who have problems with chronic delinquency. In particular, this study examined 1) how levels of pre-placement youth and family risk factors for chronically delinquent boys and girls who were treated with MTFC impact parent-youth interactions during treatment, 2) how these interactions and pre-placement youth and family risk factors relate to treatment completion for boys and girls, and 3) how treatment completion for girls and boys impacts re-offending behavior during the 12 months post-placement. As hypothesized, results indicated higher levels of pre-placement youth and family risk for girls compared to boys, however, contrary to the author’s hypothesis, levels of pre-placement youth and family risk were not found to have a significant impact on MTFC parent-youth interactions. As expected, MTFC parent-youth interactions were significantly related to treatment completion, and treatment completion was significantly related to lower rates of re-offending behavior for both boys and girls. Treatment components specific to MTFC are reviewed and directions for future research are suggested.