In 2000, the Washington State Legislature initiated a pilot rehabilitation program for juvenile offenders sentenced to a state juvenile justice institution. The program focuses on offenders with “co-occurring” substance abuse and mental health disorders. Offenders with both of these conditions are known to pose a high risk for committing new crimes upon re-entry to the community. The program—called the Family Integrated Transitions (FIT) program—was designed and implemented by Eric Trupin, Ph.D., and David Stewart, Ph.D., from the University of Washington. The program uses a combination of evidence-based approaches tailored to the particular needs of these high-risk youth. In this report, we present findings on the effectiveness of FIT in reducing recidivism, as well as an analysis of the program’s benefits and costs.