This study examined the treatment effects of manualized parent-child focused evidence-based programs (EBPs), characterized by an emphasis on parental involvement and engagement, on functioning and problem severity among a statewide sample of children and adolescents referred to outpatient psychiatric clinic for serious and persistent disruptive behavior. Propensity score matching was employed to account for baseline differences between children and adolescents (Mage = 8.4 years; 26% girls; 42% White, 10% Black, 42% Hispanic, 5% other) who received parent-child focused EBPs (treatment group; n = 220) and treatment-as-usual (comparison group; n = 2,543). Children and adolescents who received parent-child focused EBPs showed significantly greater reduction in problem severity compared to the comparison group, indicative of a drop below the clinical threshold for problem behavior. However, the pattern of improvement in problem severity was not paralleled by differential improvement in ratings of child functioning across treatment and comparison conditions. Finally, there were significant differences between the treatment and comparison groups pertaining to certain child and case characteristics that have potential implications for reaching high-risk populations of children and families. These findings support the potential of taking parent-child focused EBPs into scale to promote positive behavioral changes among children and adolescents. Parent-child focused EBPs may serve as an effective remedy that is less restrictive and more conducive to the healthy development of children and adolescents.