Background <p>Pakistan is a lower-and-middle-income country where the mental health burden is increasing while the services are not enough to cater to the needs. Living in foster care settings is associated with an increased risk for different mental health conditions. It signifies the need to implement culturally sensitive preventive interventions to promote the well-being of these individuals.</p> Objective <p>This study aimed to adapt the content of the MY FRIENDS Youth Program and assess the preliminary efficacy of the program for adolescent girls living in orphanage of Pakistan.</p> Method <p>The efficacy of the Urdu version of My FRIENDS Youth program (<i>N</i> = 38) was assessed by comparing the girls living in an orphanage setting with the girls living in a community setting by using the Quasi-experimental, non-equivalent control group design. The culturally adapted outcome measures in the Urdu language were used in the current study.</p> Results <p>The results showed a significant reduction in behavioral problems on SDQ (F = 9.12, <i>p</i> &lt; .01) including overall externalizing (F = 4.96, <i>p</i> &lt; .05) and internalizing symptoms (F = 7.93, <i>p</i> &lt; .01), overall anxiety scores on SCARED (F = 12.18, <i>p</i> &lt; .01) and its sub-domains in the experimental group. Moreover, statistical improvement in pro-social behavior (F = 19.64, <i>p</i> &lt; .001), adaptive coping skills (F = 10.38, <i>p</i> &lt; .01), self-esteem (F = 10.15, <i>p</i> &lt; .01), and self-concept (F = 13.10, <i>p</i> &lt; .01) were reported in the experimental group. Intent-to-treat analysis using the Linear Mixed Model further strengthened our findings. The effects of the intervention were maintained at 3-month follow-up in the experimental group.</p> Conclusion <p>Being the first study with an Urdu-speaking population, the current study provides preliminary evidence for its efficacy with the at-risk population in Pakistan.</p>