Research investigating clinical versus actuarial prediction and judgment has consistently demonstrated the superiority of actuarial (statistical) methods. Little research to date has directly compared clinical and actuarial predictions in the context of patient-focused psychotherapy outcomes. The most relevant study on this issue was completed with an adult population and results indicated that the actuarial method was significantly more accurate at predicting client treatment failure compared to clinician’s predictions. This study examined clinical versus actuarial prediction of client deterioration in a sample of children and adolescents receiving treatment in a managed care and community mental health setting. Predictions of treatment failure made by the actuarial method were found to be significantly more accurate than predictions of treatment failure made by clinicians. More specifically, participating clinicians did not make a single prediction of treatment failure. These findings add further evidence to support the use of actuarial methods in enhancing clinical decision-making in community-based mental health services for children and adolescents.