Clinical and research professionals working with youth who have sexually offended have increasingly advocated for community-based care. However, other scholars have noted the appropriateness of residential placements for many youth. Research is inconclusive concerning the degree to which youth with sexually harmful behaviors receive family services, particularly family therapy in either community-based care settings or residential settings, and has yet to thoroughly identify how placement influences family therapy involvement. This study reviews the files of youth who have been adjudicated of a sexual crime (N = 85) to quantitatively identify how living situations influence family therapy involvement. Using bivariate estimations, findings reveal that youth living out of the home and those who change placements were more involved in family therapy than those treated in their own communities or homes. Implications and future research directions are considered.