Group and residential care programs are each a type of live-in, out-of-home care placement in which staff are trained to work with children and youth whose specific needs are best addressed in a highly structured environment. These placements are time limited and offer a higher level of structure and supervision than what can be provided in the home. Examples include community-based group homes for adolescents who are pregnant and parenting or residential campus facilities for children and youth with mental health or behavioral problems. Residential programs may be operated by public or private agencies and often provide an array of services, including therapeutic services for children and families and educational and medical services for children or youth. Placement in a group or residential care facility should only be considered once community-based services have proven ineffective. Programs should be evidence based, trauma focused, and should provide ongoing comprehensive assessments for clients in order to determine whether children and youth are making progress toward their goals, as well as to determine if this higher level of placement continues to be necessary.