The model is based on the authors' experiences as practitioners at New York City's Mount Sinai Adolescent Health Center (AHC), which provides mental health services to inner-city youth, as well as the findings of questionnaires completed by adolescents at admittance to the AHC. The model takes into account consumer preference, risk and worry, and youth development. Consumer preference pertains to how the client defines his/her needs; client risk and worries are what the practitioner identifies as having priority in addressing threats to the mental states of the client; and youth development consists of the strengths and coping capacities a youth brings to the treatment process. Regarding consumer preference, most youth coming to the AHC want to talk about employment, family, education, and substance abuse. Because employment and education rank so high among issues adolescents have wanted to discuss, consideration of youth development is essential in building on their positive coping capacities as pathways to achievements in employment and education. Also, risk/vulnerability factors must be addressed when clinically assessing and tracking youth. This means that therapists must sometimes lead the discussion into risks and vulnerabilities that are not uppermost in the client's mind, while still being prepared to pull back and listen to the client's perceptions and experiences of various impediments in reaching personal goals. Practitioners must also be competent in working with adolescents in developmentally appropriate ways, taking into account how well their families, social environment, programs and services, and communities provide opportunities for experiences that advance positive development. 7 tables and 28 references