The trauma of child abuse is magnified for children placed in foster care. The disruption, disorganization, and discontinuity experienced in foster care further extend the trauma of abuse. Effective treatment of foster youth must prioritize the basic need for children to experience continuity, stability, and permanency in attachment to a healthy adult(s). Short-term, symptom-focused interventions are inappropriate for this population of ethnically diverse, socioeconomically disadvantaged, underserved, multiply traumatized youths with complex psychiatric comorbidity. We describe a long-term, psychoanalytically oriented, relational play therapy intervention for foster youth and present initial empirical results describing the impact of this approach.