For troubled youth and children who are emotionally disturbed, delinquent, neglected, or chemically dependent and who are being cared for or treated in residential centers, institutions, group homes, temporary shelter care, correctional facilities, psychiatric hospitals, or home and community-based programs, the bottom line involves relationships with adults and not with programs or the environment. As caregiver's, adults can support growth, recognize change, and discuss feelings with youth. Unfortunately, however, many caregivers never fulfill their role potential because the caregiving system is not able to provide them with financial incentives, supervision, and training needed to sustain a high level of commitment. There are some psychiatrists, psychologists, social workers, and teachers who have tried to support and enhance the caregiver role, but these efforts represent the exception. The recommended team approach encompasses the establishment of caring relationships, developmental dynamics, re-education of youth, youth involvement in daily living and high interest activities, family involvement, and discipline alternatives to punishment. A generic approach is presented as one step further than the team approach in which professional protectionism and competition are minimized and those closest to youth make major decisions about how youth are treated. The importance of caregiver professionalization and public awareness of problems in youth care is stressed. 2 figures, 27 references.