The therapeutic relationship is increasingly recognized as important to understanding how process variables contribute to treatment outcomes. In this paper, we examine the therapeutic relationship between children with serious emotional and behavioral disorders and their treatment providers in the context of an observational study of Therapeutic Foster Care (TFC). Our findings suggest that the quality of the relationship between the treatment parent and youth in a TFC setting is significantly associated with better emotional and behavioral functioning for the youth. It appears from these findings that the quality of the relationship between the youth and treatment parent in a TFC setting is at least one of the mechanism or process factors that contribute to improved functioning for the youth. © 2008 Springer Science+Business Media, LLC.