This article describes the current Acute Project within Child and Adolescent Psychiatry in Nordland County, Norway. One of the aims of the project is to gather information about referrals defined as acute. The numbers of acute referrals for the whole county from 1990 are presented, together with more detailed information from the Salten district. The following variables regarding acute referrals are given attention: gender, age, problem description, diagnosis, and cooperation and consultation with other professional agencies. During clinical work in 1990, the opinions of clients and co-workers were gathered concerning which aspects of working with children and their families in crisis they considered as important. These covered both direct client work and work with larger systems. A summary of these considerations is presented.