Background: This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. Method: Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received individualized mental health consultation focused on providing teachers with behaviorally-based, empirically-supported strategies for decreasing disruptive behaviors within the classroom. Caregivers were invited to participate in parent training (35% attendance). Effectiveness was assessed in contrast to an assessment/attention comparison group where typical treatment was available. Results: This treatment approach was more effective than the comparison condition in decreasing child disruptive behavior, increasing the use of appropriate teacher strategies, and increasing the use of appropriate parenting practices. Conclusion: Adapting empirically-supported treatments for use in mental health consultation may be a way to bridge the gap between research and clinical practice and increase effectiveness of mental health consultation in treating disruptive disorders in young children. (author abstract)