In this study, a continuum of care offered within a single treatment approach is addressed from the perspectives of youths participating in treatment at a 3 year step-down therapeutic community program with four levels of care. These distinct levels are residential treatment, intensive day treatment, day treatment with work/school release, and ambulatory meetings. Attendees of the program must complete all four levels of care before they are eligible for program graduation. Data were taken from 53 qualitative semi-structured and open-ended interviews conducted with 45 adolescents and young adults. While youths reported experiencing fear, worry, and distress at and during points when they transitioned from one level of care to another, they also indicated that overall emotional and psychological transition point stress was minimized because these transitions were experienced within a single program structure that built upon a supportive network of parents and peers in treatment and a uniquely open relationship with program staff. Each transition encountered by adolescents and young adults as they stepped down from residential to day treatment, day treatment to reentry, and reentry to ambulatory followed a similar pattern: stress surrounding the transitional period, followed by social and emotional support from peers, staff, and family members. Potential negative trigger points such as learning how to build peer relationships and trust other youths, renegotiating family relationships, locating a job, forming new friendships outside of the program, and learning how to distance themselves from the program support structure were discussed and practiced within the treatment context. Risk factors associated with transition from one level of care to another were minimized by program-driven protective factors. The consistency in staff, peers, program philosophy, and behavioral expectations was a key element during stressful transitions between different levels of care. Future research should determine the extent to which a transition between treatment approaches and introduction to new staff and new program peers would impact transitional period stress and facilitate or impede retention within the continuum of care. 1 figure, 5 notes, 12 references