In October 2020, the Department of Communities Tasmania, Children, Youth and Families undertook an Investigative Review in response to allegations questioning the safety and wellbeing of young people participating in the MC1D Therapeutic Residential Placement Program. This report provides advice and recommendations to the Minister for Children and Youth on the essential therapeutic elements required to improve the service system response for Tasmanian children and young people with highly complex needs accessing therapeutic residential care at the Many Colours One Direction program (MC1D) in the Northern Territory.