In 1983 five youths with multiple offenses were referred to the program as an alternate to incarceration. In 1986, Oregon state hospital made referrals for adolescents leaving that setting. The author describes the "nuts and bolts" of the program, which constitutes the nuts and bolts of this book. The recruiting, training, and supervision of foster parents is the critical element. These parents have the responsibility of only one foster child. Program staff are in daily telephone communication with these parents during the entire time of the placement and visit frequently. At the same time, a staff member is working with the public school that the youth attends. An individual skills trainer or therapist is assigned to each participant, and a family therapist is preparing the family for the child’s return. The role of each staff member in the Multidimensional Treatment Foster Care program is explicitly delineated.