This article examines techniques for holding youth in residential care accountable for their behavior. Based on the use of trauma treatment theory, the authors believe that holding one accountable can actually be conceptualized and put into practice as a nurturing operation. For traumatized individuals, more traditional approaches to accountability do not validate their perspective or feelings and, most likely, threatens them. Consequently, they feel discounted, their freedom restricted, and will feel unsafe and ultimately re-traumatized. Compassionate accountability improves relationships between staff and youth, and the achievement of mastery over trauma related symptoms is enhanced and facilitated versus diminished and blocked. Youth in residential care are empowered to take responsibility while simultaneously feeling validated and safe. Step-by-step guidelines and examples of how to implement this approach effectively are provided.