Students with emotional behavioral disorders (EBD) are educated in restrictive placements at higher rates than students in other disability categories due to their challenging behavior and inability to function in the general educational environment (Bullock & Gable, 2006). The increasing utilization of alternative programming to educate students with EBD has prompted scholars to more closely examine and identify critical intervention components of these programs (Simpson et al., 2011). Although outcomes associated with restrictive placements have been investigated, there has not been any systematic investigation of whether the recommended elements of comprehensive programming are in place in these settings, whether they are being implemented with integrity and whether they, in turn, lead to improved outcomes. Therefore, a review of the literature aimed at examining studies of restrictive settings for the existence of the eight critical elements for effective EBD programs (Simpson et al., 2011) and the associated academic, behavioral, and social outcomes was conducted. The review revealed that none of the studies described the existence of supports in all eight areas. Examination of the outcomes across the studies indicated that students with EBD made some progress academically, behaviorally, and socially, but the extent and practical significance of that progress varied. A descriptive study was also conducted. Administrators and teachers from Board of Cooperative Educations Services (BOCES) specialized programs and approved day treatment programs in New York State were surveyed about the intensity and fidelity of implementation of evidence-based academic practices, effective behavior management and treatment plans, and social skills instruction. Means and standard deviations were used to summarize the levels of intensity and implementation fidelity across the sample. Two-way multivariate analyses of variance (MANOVAs) were conducted to determine the effect of type of program and the respondents' professional position on the three elements. Overall, the results suggest that the three critical elements are present in some capacity and implemented with at least medium fidelity across the two restrictive settings. Significant differences were found between programs and positions in regards to the perceived levels of intensity and fidelity of implementation of the practices. Implications for future research, practice, and limitations are discussed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]