The rise in female delinquency has resulted in large numbers of girls being incarcerated in Youth Development Centers (YDC). However, there are few gender specific treatment programs for incarcerated female adolescent offenders, particularly for those with a history of substance dependency. In this article, we present a Multi-level Risk Model (MRM) for the assessment of adolescent female offenders and illustrate how components of effective gender-specific programming are germane for incarcerated teen girls with substance abuse and co-morbid mental health disorders. Application of this model to the HEART (Holistic Enrichment for At-Risk Teens) is presented. Implications for clinical, organizational, and research issues are discussed. (Contains 1 figure.)