Objectives: The purpose of this study was to investigate the costs and benefits associated with multisystemic therapy (MST) for conduct disordered youth, 2 years following intake.

Methods: The study employed a secondary analysis of 156 youth enrolled in a randomized trial assessing the psychosocial and behavioral outcomes of MST.

Results: MST cost on average 105,400 SEK per youth. MST was associated with a direct benefit to participants of 1,000 SEK per youth and positively impacted the use of nonplacement downstream interventions for a benefit of 62,100 SEK per youth. These benefits did not offset the cost of MST.

Conclusions: MST was associated with a net loss to society after 2 years of 44,500 SEK per youth.