Background: Lack of engagement in child welfare services is a salient issue impeding client outcomes. Research findings indicate that providing incentives may be a promising strategy for enhancing client engagement. Objective: In response to low youth engagement and repeated re-entry into care, a Southeastern child welfare agency developed an incentive program aimed at increasing youths' participation and success in meeting treatment goals. This mixed methods study examined elements of effective implementation and the effectiveness of the incentive program piloted in a group home serving adolescent boys (n = 16). Method: A semi-structured focus group with service providers (n = 7) was used to inform the development of the pilot incentive program. We used a time-series design to measure youth perceptions of the therapeutic alliance with their therapists and weekly goal attainment. Baseline data was collected for 6 weeks (phase one) followed by 6 weeks of the incentive program (phase two). Results: Results of qualitative analyses revealed four themes related to therapeutic engagement, and two themes related to intervention implementation. Providers emphasized the importance of youth-driven care and building a strong therapeutic alliance. Findings also suggest that staff buy-in is critical to the success of intervention implementation. These results, along with suggested strategies for effective implementation, informed the development of the piloted incentive program. Results of simulation modeling analyses of time series data showed significant increases in therapeutic alliances and goal attainment following the incentive program. Conclusions: This study provides preliminary support for the use of incentive programs to facilitate youth engagement in residential programs.