The treatment foster care program model (TFC) recognizes that many youth who enter the foster care system require additional services and support. To this end, TFC aims to create a positive environment to keep youth in home-based settings in their community and out of more restrictive care settings such as hospitals, group homes, detention centers, and residential care. More specifically, TFC provides foster youth and families with enhanced services, skills, and support to manage challenging behaviors. This chapter examines the definition and scope of the model, the populations who are served, the existing evidence base for the model, and challenges to implementing TFC in communities. Finally, we comment on future directions for this widely used service model. What works in treatment foster care? A growing body of rigorous research studies indicates that coordinated care across settings, consistency, and ongoing training and support for the foster parents on the front lines result in improved outcomes for youth and families. Further, the studies attest to the model’s effectiveness both in the home and in the wider community–TFC represents a cost-effective alternative in both the short and long terms for youth and taxpayers alike.