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This article reviews the historical development in the United States of treatment family foster care as an alternative to the psychiatric hospitalization or long-term residential treatment of children and youth with serious emotional and behavioral disorders. Treatment family foster care has developed in three discrete systems of care: juvenile justice, child welfare, and mental health. The authors examine the relative contribution of each of these systems to its development, its current role in the provision of services to children with emotional and behavioral challenges, and the evidence-base for this form of care.

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