In this multilevel meta-analysis the outcomes of adolescents with complex problems at risk for school drop-out attending nonresidential alternative educational facilities were examined. Ten studies (87 effect sizes), examining outcomes on social-emotional functioning, academic achievement, academic attitude, externalizing and internalizing problems, were included. The findings indicated a small but significant overall effect (d ¼ 0.15, p ¼ .03), providing preliminary evidence that these facilities may be associated with positive outcomes for adolescents. Study quality, measurement type and reliability of the assessment instruments were significant moderators of the overall effect size. Results of this study urge for more high quality research on nonresidential alternative educational facilities, because they can contribute to positive youth outcomes, which in turn may prevent school drop-out and other negative life outcomes.

Summary In this cross-sectional study, we examined differences between 351 adolescents allocated to secure residential youth care and the non-residential alternative educational facility School2Care (12–18 years old, 63% boys). Data were collected by means of the official school registration system and standardized questionnaires. Findings Results showed that adolescents in both settings had severe problems. Emergency situations, problems in daily functioning in all life domains, and previous out-of-home placements were found to be associated with allocation to secure residential youth care instead of non-residential alternative education. These three factors may be considered risk factors for secure residential placement of adolescents with complex needs. Applications This study provides input for the prevention of secure residential youth care, because the two dynamic (changeable) risk factors for residential out-of-home placement (i.e., emergency situations and adolescent’s daily life functioning) should be considered as intervention targets in non-residential care, while static factors (i.e., history of out-of-home placement) can be used to improve risk assessment of residential out-of-home placement, with higher risk requiring more intensive treatment according to the risk-need-responsivity model for effective mandated treatment.