Background: Monitoring youth treatments requires outcome instruments sensitive to change. The Y-OQ and the Y-OQ-SR measure behavioral change during psychological treatment. Objective: The focus of this study was to compare treatment progress of youth in studies using the Youth Outcome Questionnaire (YOQ) or the Youth Outcome Questionnaire Self Report (YOQSR) in wilderness and non-wilderness treatment programs. Methods: Seventy-six manuscripts were examined. Inclusion criteria were (a) contained a version of the YOQ, (b) implemented mental health treatment, (c) contained sufficient data to obtain an effect size, and (d) had at least two data points (e.g., intake and termination). The final number of studies included for the Y-OQ was 15 and for the Y-OQ-SR was 11. Results: Random effects model results, for studies using the YOQ, indicated a large (Cohen in "Psychol Bull" 112(1):155, 1992) effect size (g = 0.98, 95 % CIs [0.71, 1.26]). The YOQ-SR results also indicated a large effect size (g = 0.80, 95 % CIs [0.63, 0.96]). Treatment setting demonstrated a difference between wilderness and non-wilderness programs. For the Y-OQ (parent/guardian observation) effect sizes were higher for wilderness programs Q[subscript between] = 91.82, df = 1, p < 0.001 and for the Y-OQ-SR (adolescent's self report) effect sizes were higher for non-wilderness programs Q[subscript between] = 8.62, df = 1, p = 0.003. Conclusions: Treatment programs for youth using the Y-OQ and Y-OQ-SR to measure behavioral change, are indicating strong and positive effects from pre to post testing. Clinicians should consider routinely monitoring progress of their clients to better understand changes between pre and post testing.