Family-centered care, in terms of parental involvement and family-centered staff attitude and behavior during placement in secure residential youth care, is increasingly being combined with systemic interventions. Little is known, however, about this combination of family-centered residential care and systemic interventions. This study assessed whether levels of parental involvement or family-centered staff attitude and behavior during placement predicted outcomes of systemic interventions. We first assessed the outcomes in the full sample of families receiving systemic interventions and thereafter in families receiving systemic interventions with a strong evidence base (Multidimensional Family Therapy, Multisystemic Therapy [specializing in treatment of individuals with an intellectual disability/with problem sexual behavior], Relational Family Therapy [MDFT, MST(-ID/-PSB), RGT]) and systemic interventions with a less strong evidence base (Attachment Based Family Therapy, Flexible Assertive Community Treatment [FACT], FamilyFACT, Forensic Ambulant Systemic Therapy, Systemic Therapy [ABFT, (Family)FACT, FAST, ST]). Results revealed that higher levels of parental involvement predicted less family empowerment and a longer duration of the systemic intervention. Higher levels of family-centered staff attitude and behavior predicted more parental distress, a shorter duration of the residential placement and a shorter duration of the systemic intervention. Combinations of secure residential youth care with different systemic interventions of different evidence bases resulted in different outcomes. Future research is needed to establish which components of family-centered care or systemic interventions contribute to adolescent outcomes.