This chapter suggests that practitioners may need to carefully assess how experiences of racism affect the developing self-concept of adolescents in treatment. It attempts to summarize the patterns of risk that Adolescent Health Center mental health service applicants experience, what they worry about and how they cope. The chapter places these informational components in a tri-partite model of clinical engagement that takes into account: consumer preference; risk and worry; and youth development perspectives. Clinical implications are then discussed in the context of this expanded approach to the clinical engagement of adolescents. It demonstrates how this database was "mined" in order to create an overall picture of adolescent desire to talk, their environmental and behavioral risks, their worries, and their self-perceived coping. The chapter contends that when working with adolescent clients, effective practitioners must integrate a view through all three lenses simultaneously in order to get a complete clinical picture.