In this article, the author discusses the United South End Settlements' (USES) Arts Incentives Program (AIP), a clinically informed, arts-based, youth and community development program working with high-risk girls ages 11 to 19. These girls face a convergence of risk factors, such as trauma, abuse, neglect, poverty, substance abuse, and discrimination. In AIP, young people engage in community building within the program and become agents of positive community change. In revitalizing their communities, they rebuild a sense of self as essential, valued, and creative. AIP reconceptualizes art therapy as a community-linked treatment, integrating the knowledge of diagnostic categories and symptomotology with a therapeutic response grounded in theories of adolescent mental health treatment. How AIP evolves and adapts over time is described. (Contains 11 notes.)